1. Adult Mental Health Service Transformation Secondary Care redesign
consultation

2. Overview
Context for the countywide Adult Mental Health transformation programme
New Enhanced Primary Care Service (“Worcestershire Healthy Minds”)
Secondary Care co-production and emerging themes and consultation
Next steps and timelines
Sue

3. Context To meet all of the above we have to do
Reducing budgets (2016/17 = 7.5%)
Rising demand and expectations
Need for earlier intervention/prevention
Scale up self care and recovery
More options /choice across the pathway
To meet all of the above we have to do
things differently, working collaboratively
with partners

4. A new offer for the County: Wellbeing Hub
Services that have been redesigned to provide easier and quicker access to assessment & treatment (including self referral and direct access to Talking Therapies the first for MH in Worcestershire)
New ways of working with General Practice and the Voluntary and Community Sector to increase choice and access
Provides countywide coverage and increasing options in local communities building on what people tell us they want
A new offer for the County:
Wellbeing Hub
More choices (app, internet, talking therapies)
More support in General Practice

5. Wellbeing Hub
Managed by Community First and co-located with our clinical Single Point of Access (Professional Referral point)
Self referral for Talking Therapies, signposting and community courses (Moodmaster) provided by; Onside, Inspire CiC, Simply Limitless, Stonham and Springfield Mind
Peer support developments underway
Seamless transition to secondary care where needed
550 self referrals to date – most contacts to date from Redditch and Worcester City.

6. Most viewed webpage on the public site
WHM Website
10,546
April – August 2016
2nd
Most viewed webpage on the public site

7. The Trust’s first self help app
In house development of new Healthy Minds app
Live on Android Google Play store on IOS app store
Opportunities to develop further and align to long term conditions and our Patient Self Management Programme.
245
downloads to date
The Trust’s first self help app

8. Secondary Care redesign: summary of the background…
The services that need to be redesigned are:
Community Mental Health Services
Acute In Patient Wards
Home Treatment Service.
We have to offer inpatient and community services that are:
Clinically effective
Safe
CQC compliant – environmental and quality of care standards
Meeting commissioner and patient expectations
Implemented within clear time lines
Save money and work within the resources we have available

9. One year one - building the new model together
4 Co-Production ½ day Workshops – 120+ participants
4 Staff Engagement ½ day Workshops – 150+ participants
Patient Forum Sense Check including Health Watch – 10 participants
HOSC presentations – Autumn, December & January with monthly reports
4 x CMHT & Acute Care Pathway redesign ½ day workshops with managers & medics
Monthly CCG clinical leads meeting with Commissioners
Sue

10. Three Workshops – 5 recurring themes
Reduce In Patient Acute Wards – facilities to be Centralised or provided North / South
In Patient Wards with a clear function to provide:
Intensive Triage / Assessment
b) Treatment for the Acutely mentally ill
Alternative provision in the form of locally available Crisis Beds or Safe Houses and Recovery / Rehab focussed Step Down.
Increased & improved Home Treatment Team provision to care for more people in their own home
Specialist Community Mental Health Teams with a clear function and remit to provide services to patients with serious mental illness
Zelda

11. Key Principles
Patients and carers have told us that what matters most to them are services that offer the following:
Consistent staff who have time to listen and care
Information – about services, treatment options, medication, diagnosis / prognosis, discharge
Staff who involve patients and their families and carers and who work holistically
Talking Therapies – not just medication
Inpatient wards that offer activities and calm spaces and that are only used by those who really need them
Zelda

12. Community Mental Health Teams
We are proposing a Specialist Community Assessment & Recovery Service (CARS) that has been developed through:
National Guidance - NICE, Royal College Psychiatrists, AIMS
An in depth analysis of current staffing, role & function, caseloads and location.
A further analyses of caseloads in order to identify any patients who could be offered new range of Primary Care Talking Therapies interventions (Worcestershire Healthy Minds).
A review of the Gate Way Worker role to enhance Community Mental Health Team “step down and rapid access up” functions and liaison with GPs.

13. In Patient Wards
Proposing an Intensive Assessment Ward (7 day admission) aligned with a separate Treatment Ward:
Co production asked for separate wards as currently very unwell patients are mixed with those recovering and about to go home
Clinically advised to separate the Intensive Assessment from the Treatment Ward
A separate Assessment Ward needs a 1:2 ratio of Treatment beds
Current estate can only support this if we use Holt 12 beds, Hillcrest 25 beds
Develop alternatives to admission (i.e. safe houses, community personality disorder pathway, 24 hour supported living etc)

14. Next Steps…
Taking the themes from Co Production into remodelling of the Acute Care Pathway & Community Mental Health & Recovery Teams
Formal Consultation & further re modelling: July / September 2016 including:
Wide distribution of consultation document, with Peer Support to enable completion
Presentations at key meetings across the County
Locality events
Linking into partner networks
Implement proposed new model – October / December 2016