Mental Health and Dementia Strategic Clinical Network Event 23 September 2013

Cheshire and Merseyside Strategic Clinical Networks and Senate Update on progress for meeting on 23 rd September 2013

Report Key progress – first 6 months Achievements – next 3 months Challenges and risks Success/ opportunities 3

Report Progress – clinical leads appointed/ service mapping completed/ development workshops held/ priorities identified and shared with systems/ initial work programmes developed/ setting up network architecture Next 3 months – enlarged engagement/ SCN structures operating/ progress with work programmes on target Risks – internal resource/ old ways of thinking/ engagement challenges Opportunities – working with non - NHS partners/ financial challenges/ expand clinical leadership involvement 4

5 Mental Health & Dementia Strategic Clinical Networks (London Region) Strategic Clinical Network 23 September 2013

Key Progress (First 6 months)Achievements (Next 3 months) London Clinical Director appointed SCLG established Mental health priority areas identified Engagement Event held (July 2013) Working in partnership with AHSN (UCLP) Working relationships with charities & third sector - developing PPI plan Liaised with Health in the Justice System Work streams started Host SCLG meetings to decide specific objectives under priority areas Commence work streams in each priority area Support the Mental Health CCG Network Support Mental Health in Criminal Justice System Work with primary care commissioning, transformation & informatics teams within NHE England Mental Health SCN

SuccessesOpportunities Clinical Director presentation on MH to Senior Management Team NHS England (London) Engaging with key partners e.g Social Care, AHSNs, PHE, Voluntary Sector Building on previous work e.g Perinatal Network, NW Urgent Assessment Pathway, CCG Leadership programme Integration/pressure on A&E Working across other clinical networks (e.g. CVD) Mental Health Informatics Prevention/Resilience Leadership in clinical commissioning (Mental Health CCG Network) Mental Health SCN ChallengesRisks Mental and Physical health “parity of esteem” Mental health in Primary Care Mental health in a context of wider challenges in NHS Fragmented NHS systems Variable capacity within CCGs Resource pressures

London Mental Health SCN Priorities 2013/14 Strategic work plans & desired outcomes 8 Primary care commissioning. Working with AHSN (UCLP) to support London CCG MH Network Mental health in Primary Care (depression, anxiety) Psychosis & urgent care pathways Integration of mental health into physical health care pathways. Support those with long term conditions who also have mental health conditions Prevention of mental illness in the early years. Building resilience in young people Support Health in the Criminal Justice System Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelines Benchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards

Key Progress (First 6 months)Achievements (Next 3 months) London Clinical Director appointed SCLG established Six priority areas identified Working in partnership with all AHSNs and NHS IQ Working relationships with charities & third sector Mapping CCG strategies Launch of Dementia Action Alliance for London GP leaders meeting SCLG meetings to decide specific objectives under priority areas Training event with network of 100+ staff – 23 October Dementia Action Alliance commitments under way Providing advice to medicines management leads following anti- psychotic audit GPwSI – communicating to commissioners Dementia SCN

SuccessesOpportunities Dementia Commissioners Network Launch of London DAA – London region signed up to three stretching commitments Integration/pressure on A&E Working across other clinical networks (e.g. end of life care) Working will all three AHSNs & NHS IQ Close working with social care Health Education England – taking forward training Dementia SCN ChallengesRisks Leadership in clinical commissioning Developing the post diagnosis ‘offer’ Fragmented NHS systems Variable capacity within CCGs Resource pressures

London Dementia SCN Priorities 2013/14 Strategic work plans & desired outcomes 11 Living well with dementia, including in care homes Improved end of life care Improved quality of care within the NHS Strategic commitment to improve care and integrating innovation Good quality early diagnosis & intervention Optimising medicines use Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelines Benchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards

South East Coast

First 6 months – key progress 1.SCN core team recruited inc. Clinical Director 2. Work programme developed 3.Stakeholder/Launch event & wider engagement 4.PPI/PPE strategy developed 5.Work plans developed (MH, CAMHS, Neuro & Dementia) 6.SCN structure developed (Steering Group and Clinical Advisory Group) 7.Commissioning Forum proposed 8.Baseline reviews completed and shared /2014 Commissioning Guidance sent out 13

Achievements in next 3 months Clinical Leads appointed Clinical Advisory groups initial meetings Task and finish/project groups convened Five year strategy developed (CtA) AT clinical strategy Specialised Commissioning derogation action plans Continue engagement work/stakeholder buy in/development of wider network 14

Challenges and risks 15 Structure untested Inability to secure buy in for strategic plans Limits on recruitment (Clinical Leads!) Shared Themes Emphasis on diseases not outcome domains Complexity of new NHS landscape Commissioners and clinicians overwhelmed with information Meaningful patient and public engagement on a large geographical scale Capacity/capability of team

Successes and opportunities Positive initial feedback from stakeholders Good relationship with AT(s) colleagues Strong links with Senate Baseline reviews have proved useful to wider system Joint work with AHSN/HEE Programme budget

Domain 1: Preventing people from dying prematurely. Lead - SCN Manager Theme: Early diagnosis/Health Checks. Lead - QIL Theme: Diagnostic pathways, capacity & decision making. Lead - QIL Domain 2: Enhancing quality of life for people with long-term conditions. Lead - SCN Manager Theme: Supporting people to self- manage their long term conditions. Lead - QIL Theme: Integration of care around the needs of the patient. Lead - QIL Domain 3: Helping people to recover from ill-health or following injury. Lead - SCN Manager Theme: Rehabilitation, recovery, ESD, Survivorship. Lead - QIL Theme: Safe and sustainable maternity, paediatric and new born services. Lead - QIL Clinical Director CVD SCN Clinical Director CANCER SCN Clinical Director MCYP SCN Clinical Directors MH,D & N SCN Crosscutting themes: Oversight and Planning Group, SCN AD, SCN Managers and Senior QILs SCN and Senate Work plan lead: AD Lucy Sutton Quality Improvement Leads and admin team Overarching strategy: SCN Manager Project support to SCN steering groups and subgroups Administrative support to SCN steering groups and subgroups Wessex Strategic Clinical Network Clinical Leads: Dr Christopher Kipps and Dr Denise Cope Contact: England.

First 6 months – Key Progress Reviewed commissioning plans, JSNAs & JHWS across Wessex Identified gaps and links between and across plans MHDN Stakeholder Event on 11 th June, more than 100 delegates – informed priorities Initial work plans agreed by local Commissioning Assembly Initial work plan for SCN approved by Oversight and Planning Group in July 8 Project briefs drafted, based on challenges identified so far, for consideration by SCN Decision to appoint 2 people as CDs to manage the breadth of work 18

Next 3 months Initial meeting of MHDN SCN Steering Group 1 st Oct. Prioritise actions and projects / teams Local champions identified to lead specific projects Oversight and Planning Group authorise ‘refined’ plans late Oct Involve patients and public, influence local PPI Strategy, due Nov Better use of limited resources to effect change Refine our understanding of network tools and drivers Go out and meet people 19

Challenges, Successes, Risks and Opportunities Challenge – to ensure support network is appropriately adapted to the needs of the developing network Success in: –engagement across Wessex to date –dual leadership –Integrating with support team Risk losing confidence of key stakeholders if we don’t establish ourselves quickly and demonstrate effectiveness Opportunities to deliver significant improvements and improve parity of esteem for mental and physical health 20

WEST MIDLANDS SCN Mental Health, Dementia and Neurological Conditions Ben Parfitt - Network Manager Dr Karim Saad and Dr Sharon Binyon - Clinical Directors

Work to Date New Network in West Midlands Stakeholder engagement Linking with existing West Midlands Groups and previous work done, e.g. Provider forum for PbR and their Quality and outcomes subgroup West Midlands SHA Dementia work stream West Midlands IAPT pilotsLaunch event July Launch event July

Mental Health Priorities Developing and supporting outcomes-based commissioning Improving physical healthcare for people with a mental health problem Improving primary care mental health services (including IAPT) Developing psychological therapy services for children closer to home Developing care pathways for people with neuro- developmental disorders

Dementia Priorities Supporting increased prevention and timely diagnosis for people with dementia and ensuring appropriate support before and after diagnosis Promoting 'Dementia Friendly Communities' Improving the experience of care for people diagnosed with dementia Improving the experience of end of life care for people with dementia and their carers

Yorkshire & the Humber Strategic Clinical Networks Mental Health, Dementia, Acute & Chronic Neurological Conditions Mental Health & Dementia National Meeting 23 rd September 2013

APRIL TO SEPTEMBER 2013 Yorkshire & The Humber 3 rd Largest Senate Area, 24 CCGs, 14 Acute Hospitals, 7 MH/Community Hospitals, 14 Local Authorities, 3 Area Teams covering 5.6m population over a huge and varied urban and rural demography Intelligence Gathering, Scoping and Making our ‘offer’ to stakeholders : ( CCGs, Prescribed Commissioners, LAs, Voluntary, Charities, Area Teams, AHSN etc.) PPE Stocktake and Strategy Development Appointment and induction of Clinical Leadership Draft Work Programme Development/Consultation– Sept 2013 to April 2015 Identify Cross Cutting themes with 7 sister networks S136 and Neuro-rehabilitation projects – early wins Formal SCN Launch 17 th September

NEXT 3 MONTHS Firm up Work Programmes and agree Comms Strategy for the SCN Establish formal governance to underpin structures/ways of working Commence project work using MSP/PRINCE type methodology Quarterly reports to CCGs/Area Team/Stakeholders and presentations to collaborative commissioning groups/NHS England commissioners Confirm PHE relationships to support this SCN Firm up PPE arrangements Agree cross cutting project management arrangements (e.g. IAPT, CYP Transition in MH, Parity of Esteem, CAMHS etc.) 27

CHALLENGES/RISKS CCG Engagement with SCNs generally and with specific areas such as acute neurology where this may not be seen as a priority Access to data to provide Dashboard information that adds value to commissioners Accessing groups that have existed for many years (change management behaviour) Local Authority engagement – “clinical networks” are perceived as being health only – some aversion to nomenclature Small resource in the SCN team in a financially challenged host Area Team Duplication of work with AHSNs, ATs, HWBs, NHSIQ – CCG confusion of roles/responsibilities 28

SUCCESSES/OPPORTUNITIES Formal Launch of the SCN ! Excellent clinical leadership and engagement in Y+H Do once and share and up the pace of the work Influence commissioning plans for 2014/15 Joining up MH and physical health National and Regional sharing of best practice For 12 national SCNs to really make a difference and place MHDN on the same platform that cancer, cardiac and stroke have enjoyed over the last years Well respected and very credible NCDs ! 29

Yorkshire & the Humber Mental Health, Dementia, Acute & Chronic Neurological Conditions 30 Dementia Acute & Chronic Neurological Conditions Clinical Leads Dr Wendy Burn & Dr Oliver Corrado - Dementia Dr Helen Ford & Mr David Broomhead - Neurological Conditions Dr Wendy Burn (Interim) – Mental health

YORKSHIRE & HUMBER CONTACTS Ian Golton, Associate Director – Alison Bagnall, SCN Manager - Sheriden McKiniry, QIM (A&CNCs) - Penny Kirk, QIM (QIM- dementia) - James Barnes (QIM (MH) – details to be confirmed Dr Wendy Burn – (Dementia and MH Dr Oliver Corrado – Dr Helen Ford – Mr David Broomhead- 31