IMPs – Intermediate Mental & Physical Health Care Team Kashif Munir (Physiotherapy Lead) 12th November 2014

Background to Service Started in 2008 Influenced by: Local audit – adults & older adults with mental health problems were staying longer in acute hospitals & difficulty in accessing rehab pathways. NSF for Older Adults: Standards 3 & 7

The Role of the Team Short term (Target 8 weeks +/- ) rehabilitation to clients. Support people at home. Clients whose physical health rehab is impeded by mental health problems or their physical health is impeding their mental health recovery. Prevent unnecessary admission to an acute setting and reduce avoidable use of long-term care. We provide a multi-faceted service encompassing; holistic assessment, community rehab, discharge support and prevention of admission where possible.

Acceptance Criteria Westminster residents only. Medically stable with rehabilitation potential. Age: Adult 18 + Current mental health condition is affecting their physical rehabilitation. Physical condition is affecting their mental health resulting in challenges in their rehabilitation. Clients to engage with Mental Health and Physical Care Practitioners to enable holistic, goal specific, time limited interventions to effectively optimise recovery. Clients cognitive impairment has deteriorated significantly or is resulting in prevention of realistic rehabilitation due to complex needs/condition.

Referrals Accepted from: All health and social care professionals GP, Hospital discharge team, Reablement team, Community rehabilitation team, District nursing, Community matron, Social services, Rehabilitation unit, CMHT, WMS, Psych Liaison Service, ABT team, Inpatient mental health ward, Care navigators and Nursing/residential homes. Referral: Accessible via the IMPS webpage SAP form Basic risk assessment For clients currently known to CNWL Trust a referral letter is acceptable

Diagnosis F01- F09: Mental disorders due to known physiological conditions F10 – F19: Mental and behavioural disorders due to psychoactive substance use F20 – F29: Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders F30 – F39: Mood [affective] disorders F40 – F49: Anxiety, dissociative, stress-related, somatoform and other non psychotic mental disorders F50 – F59: Behavioural syndromes associated with physiological disturbances and physical factors No Mental Health Disorder

Average age of clients: 75 years Patient discharged to: GP, CMHT and Social inclusion. Average cases within the six years of IMPS: Year 1 – 13 per month Year 2 – 15 per month Year 3 – 19 per month Year 4 – 21 per month Year 5 – 32 per month Year 6 – 35 per month.

Senior Physiotherapist IMPS Structure Service Manager Mental Health Clinical Nurse Specialist RMN Associate Practitioner Physiotherapy Physiotherapy Lead Senior Physiotherapist Physiotherapist Senior Occupational Therapist Rehab. Assistant Psychology Clinical Psychologist Administrator Psychiatric Cover Occupational

Treatment/Interventions Providing Comprehensive Assessment. Providing structured individual care plan that involves active therapy, treatment or opportunity for recovery. A planned outcome of maximising independence and typically enabling people to resume or continue living at home. Cross professional working, intense and frequent input with flexible durations to suit and meet the needs of each individual. Physiotherapy Assessment and Treatment. Psychological Therapies Psychosocial Interventions Environmental Assessment & Support Review & Rehab of ADL’s Medication Review Functional Assessment Financial Guidance and Referral Family and Carer Support Diagnosis Facilitate access to community services Social Inclusion

Client feedback

Future work “Patient discharged due to dementia” (CSP Frontline, 2014) NHS must treat mental and physical health - stop treating patients with mental health as second class (DOH, 2013). More AHP leadership opportunities and support especially in Mental Health Services.

Locality and Hours Vauxhall Bridge Road Older People’s and Healthy Ageing Service Line Located with CMHT, HTT, JHTT, ABT, Recovery Team. Closely working with CMHT, Memory Service, Mental Health Inpatient Ward, Liaison Psychiatry Service. Mon – Fri (0830 – 1630) Assessment 3 working days assess if urgent or 10 working days for non-urgent

How To Contact Telephone: 02078544151 Fax: 020 79318087 Email: imps@nhs.net Webpage: http://www.cnwl.nhs.uk/imps.html Address: 3rd Floor 190 Vauxhall Bridge Rd London SW1V 1DX