1 Prof Steve Pilling, Dr Steven Reid and Douglas McKelvie Camden Crisis Care Pathway – Options for Development July 2015

2 Crisis Care Review Development, dissemination, implementation and monitoring of an integrated multi-agency crisis pathway. Development of pathway as a dynamic system which responds effectively to people in crisis and is based on the best available evidence on service configuration and the principles of pathway re-design. Developed by representative group of providers and service users. Resources - project manager and data analyst for a limited time period.

3 Crisis Care Review Review and enhancement of staffing and service specification of the Crisis Resolution Teams comprising: Establishment of 24 hour crisis helpline (Live from July 2015). Extension of Crisis Resolution / Home Treatment teams (CRHTT) to provide a full 24 hour response. o Extending cover to 24hrs. o Increase capacity to deliver more home treatment. o Adjusting the skills mix including increased medical time.

4 Crisis Care Review Review and enhancement of Psychiatric Liaison Services in the Emergency departments. Move to the recommended CORE 24 model across both EDs in Camden. Provide 24 hour service with additional medical staffing. 30 additional staff.

5 Crisis Care Review Develop and establish a community-based drop-in service (CDIS). Crisis Drop-In to provide alternative to ED or CRHTT operating out of hours (18.00 to 23.00) 7 days per week as primary provider of short-term support and working closely with other services.

6 Crisis Care Review Review capacity of community services to support people at risk of crisis. Enhancement of Community Support – increased staffing required for community services to contribute to a reduction of people presenting in crisis is difficult to estimate. Needs fuller review of current capacity of community services and consideration of current cost pressures on community services. Simulation modelling of increased community staff suggests discernible impact.

7 Crisis Care Review Restructure community services and provide practice-based community teams aligned to primary care. Practice-based teams providing: o single point of entry o advice, consultation and management of mental health crisis in primary care, linked to IAPT o assessment and interventions for complex mental health problems integrated with non-statutory, social and housing services o effective links with physical health services and specialist mental health services (e.g. CRHTT, early intervention in psychosis (EIP), in-patient services). Developed from a re-structuring of existing services: o Agree whether to integrate drug and alcohol services or not, with a view to offering multidisciplinary, NICE-compliant treatments in line with Access and Waiting Time Programme.

8 For more information please contact: UCLPartners 3rd Floor 170 Tottenham Court Road London W1T 7HA