1. Management of Psychosis Pathways/commissioning Prevalence (National / Local) Mental Health services in Northampton – where we are Mental Health Services in Northampton – future plans Conclusions

2. O.N.S In Britain, every year per 1000 people Around 300 people will experience mental heath problems 230 of these will visit a GP 102 of these will be diagnosed as having a mental health problem 24 of these will be referred to a specialist psychiatric service 6 will admitted to a psychiatric hospital Northampton 2000 (population 680,000, 18-64 - 437,000) 204,000 will experience mental health problems 155.000 of these will visit a GP 68,217 of these will be diagnosed as having a mental health problem 7,000 of these will be referred to a specialist psychiatric service 200 will admitted to a psychiatric hospital Northampton CCG 2013 (population 694,000, 18-64 - 448,000) 208,200 will experience mental health problems 159,619 of these will visit a GP 70,787 of these will be diagnosed as having a mental health problem 77 GP surgeries 84 Adult beds + 7 PICU + 60 Old Age beds + Rehab and Forensic

3. Psychiatric Morbidity Survey 2000 Prevalence rates/1000 Depression26 Neurotic disorder164 Personality disorder44 Psychotic disorder5 (Male 5 Female 6) Psychotic disorders were defined as one of a number of disorders under the categories of schizophrenia, schizotypal and delusional disorders and affective disorders such as manic episodes and bi-polar affective disorder. They are disorders that produce disturbances in thinking and perception that are severe enough to distort the persons perception of the world and the relationship of events within it. Psychoses are normally divided into two groups; organic psychoses, such as dementia and Alzheimer’s disease and functional psychoses, which mainly cover schizophrenia and manic depression. To obtain an estimate of the prevalence of psychotic disorder as assessment of probable psychotic disorder was applied.

4. Management of Psychosis in Northampton Current modelChallenges Consultant Clinics CMHTs (Working Age + Old Age) EIS/AOT Misc: SPoA, CRHTT, Inpatient Care homes/Nursing homes Clozapine and Depot clinics GPs Not known to services DNAs and cancellations in clinics Waiting list for CMHT allocation Physical Health monitoring Stable patients being held by secondary services for many years e.g. patients on depot, Clozapine etc Poor engagement with sources/services other than GP or secondary services Access/Waiting times Psychosis Prevalence in Northampton Based on population as per ONS 2000 Based on population as per CG 2013 NHFT actual data Cluster 10-17 Working Age218522401735 Old Age12151230219 Total340034701954

5. Future plans Mental Health redesign (Working age and Old age Mental Health) Developing a Primary Mental Health Team with GP commissioners JCP Model Move resource to primary care along with a fraction of patient population, e.g. stable psychosis, some cluster 3 + 11, patients on depot injection Improve communication with GPs (e.g. medication management) Dynamic and smaller CMHTs Monitoring Re-referral rate to secondary service Hospitalisation SIs and suicide rate

6. Conclusions Improve efficiency Clinical safety Efficient use of resources Financial savings Working in partnership Primary care with Secondary care