1. ‘Building your Story’ – effective decision making National Mental Health, Dementia and Neurology Intelligence Networks (MHDNIN) Heather Heard

2. Mental Health, Dementia & Neurology Intelligence Networks The Mental Health & Wellbeing Intelligence Network (MHIN), Dementia Intelligence Network (DIN) & Neurology Intelligence Network (NIN) launched on 18 th June The Network aims to provide reliable intelligence to support transformation PHE has the system-wide responsibility to lead and develop Health Intelligence Networks for: o Cancer (http://www.ncin.org.uk/home)http://www.ncin.org.uk/home o Child and Maternal Health Observatory (http://www.chimat.org.uk/)http://www.chimat.org.uk/ o End of Life Care www.endoflifecare-intelligence.org.uk & www.elcqua.org.ukwww.endoflifecare-intelligence.org.ukwww.elcqua.org.uk o Cardiovascular Disease Intelligence Network (http://www.yhpho.org.uk/default.aspx?RID=182342)http://www.yhpho.org.uk/default.aspx?RID=182342

3. Aim of MHDNIN DataIntelligence Knowledge Access Flow Quality Utilisation Care Pathway Profiles Data Briefing reports Data visualisation Economic modelling What Good Looks Like Case Studies State of the Nation reports

4. The Intelligence Hub A tour of the MHIN site, how to navigate the resources & tools (where applicable) by thematic area http://www.yhpho.org.uk/mhdnin Profiling tools: http://fingertips.phe.org.uk/profile- group/mental-health/http://fingertips.phe.org.uk/profile- group/mental-health/ o Severe mental illness o Common mental health disorders o Children & Young People’s Mental Health o Community Mental Health Profiles

6. Data is presented by geographical view Domains into which data is gathered Own data can be compared with geographical and statistical neighbours Data views, info on data and access to data for own processing

7. Significance testing to inform conclusions Data quality assessed to aid interpretation

8. MHIN Crisis and whole system measures Profiling Tools to establish your baseline & benchmark progress

9. Scope Aims to provide the intelligence needed by local systems to improve services and deliver better outcomes for service users Scope - the health, public health and social care system; mental health and well-being system Intelligence resources www.yhpho.org.uk/mhdnin and profiling tools http://fingertips.phe.org.uk/profile- group/mental-health/www.yhpho.org.uk/mhdninhttp://fingertips.phe.org.uk/profile- group/mental-health/ DH-led Mental Health System Board commissioned MHIN to produce a Crisis Concordat focused profiling tool

10. Methodology Aim to support a system-wide Crisis Concordat by producing a Profiling Tool; working with partners to develop shared metrics across health, social care and criminal justice system partners The Crisis Concordat Profiling Tool will reflect the Crisis Concordat pathway/key principles: A.Access to support before crisis point B.Urgent and emergency access to crisis care C.Quality of treatment and care when in crisis D.Recovery and staying well / preventing future Working jointly with NHSE and NHSIQ to ensure consistency of approach, shared governance and access to resources with overall accountability to the System Board

11. An effective pathway to improve crisis care responses Access to support before crisis point Tele triage and tele health Early Intervention Services Suicide prevention Personalised care budget Helplines Peer Support Help at Home Supported Housing Adult placement Urgent and emergency access to crisis care ‘ Parity’ between responses to physical or Mental Health emergencies Single point of access to specialist mental health services 24/7 Crisis Home Treatment team Crisis and respite house Hospital Admission See Effective Bed Management Pathway Quality of treatment and care when in crisis Physical assessment and treatment Mental state assessment Safe, competent treatment at home wherever possible Timely ambulance transport to appropriate NHS Facility Access to Liaison & Diversion from police custody or Court Care and treatment (inc MHA, MCA,CPA) Recovery and staying well / preventing future crises Crisis Plan (NICE) Self management and family involved crisis plan All utilities working, food in house, debts and benefits sorted Transition to GP led care (with ‘fast track’ access back) Support before crisis point Urgent and emergency access to crisis care Quality of treatment and care when in crisis Recovery and staying well / preventing future crises Getting a life back

12. MHIN Crisis and whole system measures Liverpool Case Study

13. Liverpool’s position within the most deprived decile

14. Social Care service measures relating to the prevention of crisis intervention Relatively low levels of intervention given high prevalence and high health service contacts Relatively low numbers receiving home care and higher residential and day care rates than other areas

15. Primary Care quality and outcome measures that relate to preventing the requirement for crisis intervention Some relatively low measures of primary care management of those with SMI Relatively poor management of physical health of those with SMI may lead to crisis

16. Suicide as an indicator of whole pathway Now starting to climb again, need to understand if change is significant, and if yes, why? Clear downward trend in suicide for 8 years until significantly below England

17. Suicide as an indicator of whole pathway Clear downwards trend over many years. Significantly below England until last reading. Generally lower rates of suicide than other deprived areas. Trend data compared to those in the same (most deprived) deprivation decile

18. Excess Mortality in adults with serious mental illness as an indicator of work still required Trend data compared to those in the same (most deprived) deprivation decile Liverpool clearly consistently above England. And has generally higher rates of excess mortality than other deprived areas.

19. Liverpool: Summary High levels of need as identified by numbers in contact with services and psychiatric A&E attendances Social care service data suggests different casemix and /or service model to national picture Do primary care and social care support specialist MH health care enough? Whole system measures suggest a good system overall that still has more to do

20. Forward Look

21. Developing the MDNHIN New Profiling Tools (Fingertips) –Dual Diagnosis & Suicide –Crisis Pathway –Dementia roll & Headache Care Pathway and Mental Wellbeing Indicators (Fingertips & CfV) –Psychosis, Common Mental Health Disorders –CYP, Neurology (Epilepsy) & Dementia Data Briefing & What Good Looks Like (WGLL) Factsheets –Summaries of international best practice by care pathway Summary Reports (Analysis of Data for publication, led by NCD) –Analysis of Care Pathway intelligence against WGLL summaries Local SCN, PHE sponsored engagement and ‘consultation’ events

22. Deliverables & milestones Crisis Concordat aspirational metrics supporting the Crisis Concordat Key Principles and Action Plan commitments across the system partners (Engagement events) Data mapping project resource to be identified to map availability and flows of data and reporting across the system partners Profiling Tool based on these metrics reflecting currently available/reported indicators Action Plan to develop and flow new indicators over time to be agreed across system partners Timelines are contingent on securing partner organisations commitment and access to resources

23. For more details visit our ‘Intelligence Hub’ http://www.yhpho.org.uk/mhdnin and profiling tools http://fingertips.phe.org.uk/profile-group/mental-health/ or email us at MHDNIN@phe.gov.uk MHDNIN@phe.gov.uk Heather Heard Head of Intelligence (Mental Health) MHDNIN Heather.Heard@phe.gov.uk