1. Current SEL HBPoS Sites
South East London: Mental Health Crisis Care
Contact: Kim Solly Mental Health Project Lead, Our Healthier South East London
1. Background
South East London (SEL) committed to reviewing and improving mental health crisis services in line with national and regional guidance, including the Mental Health Five Year Forward View (MHFYFV), Crisis Care Concordat and Care Quality Commission (CQC) thematic review of mental health crisis care.
Providers across SEL are working collaboratively to deliver 24/7 mental health urgent and emergency care, and ensure parity of esteem – i.e. giving mental health emergencies the same impetus as physical health emergencies.
Mental Health is a key priority within the SEL Sustainability and Transformation Plan (STP) published in October 2016.
Work continues with providers to develop the mental health programme established in Our Healthier South East London (OHSEL).
3. STP Priorities
Priority 1: Improved s136 pathway and Health Based Place of Safety (HBPoS) provision
Ensuring all SEL providers meet the pan-London s136 pathway and London HBPoS specification by 2020.
New South London and Maudsley NHS Foundation Trust (SLAM) HBPoS opening 2016/17 will consolidate 4 services into 1.
SLaM will be one of the first providers to pilot the HBPoS specification.
HBPoS capacity tool in development for all HBPoS sites in South London to help support the implementation of the pathway and specification.
Lambeth
Bromley
Bexley
Greenwich
Lewisham
Southwark 5 2 1 4 3 6
Lambeth Hospital
Maudsley Hospital
Oxleas House
Greenparks
House
Croydon 136
Suite
Ladywell Unit
Current SEL HBPoS Sites
2. Mental Health in SEL
All SEL boroughs have higher than average levels of mental health need as indicated by the Person-based Resource Allocation for Mental Health (PRAMH) Formula.
In 2011 all mental health disorders in SEL were associated with substantially lower life expectancy compared to national statistics.1
Analysis of the drivers of mental health needs, such as deprivation, population mobility, and ethnicity indicates that SEL has some of the highest levels of risk factors in the country.
Priority 2: Crisis resolution home treatment teams (CRHTTs)
CRHTT service provision in all areas by 2020/21 delivering a 24/7 community-based crisis response and intensive home treatment as an alternative to acute in-patient admissions.
CRHTT to align with best practice standards as described in the CORE fidelity criteria by 2020/21
Review of current position to take place in 2016/17.
Priority 3: Core 24
By 2020/21, all acute hospitals will have all-age mental health liaison teams in place - at least 50% of these will meet the ‘Core 24’ service standard as a minimum.
Gap analysis to determine SEL position against the ‘Core 24’ standard
The SEL ‘health tree’ looks at five broad population groups: people known to be nearing the end of life (1%), people with three or more long term conditions (9%), people in the early stages of a long term condition (25%), people experiencing inequalities and are at risk of developing long term conditions (50%) and people who are healthy and well.
Importantly, it shows that just 16% of people are in the healthy and well group.
It tells us that only about one in six people are healthy and well without being at risk of poor health.
Half of all people are at risk of having a long term mental illness.
Priority 4: Out of area placements (OAPS)
Department of Health, NHS England, NHS Improvement and NHS Digital recently agreed on a national definition of OAPs.
This priority aims to eliminate inappropriate OAPs in all areas by 2020/21.
To meet a demonstrable reduction in inappropriate OAPs by March 2017, SEL will carry out the following actions between :
Assessed the baseline capacity and developed a SEL plan - March 2017
Put routine data collection processes in place to maintain monitoring (bed type, placement provider, placement reason, duration and cost) - March 2017
Developed a standardised care pathway for all OATs which is in place across 50% of SEL boroughs - March 2018
Further work needed to:
Look at interdependencies with wider crisis care pathways - March 2018
Review links with community housing/placements and alternative provision - March 2018
Standardise the care pathway across SEL 2018/19
References
1 Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London, Chang et al, 2011, (