1. Overarching Transformation narrative – progress so far and next steps
Nov 2017

2. What is the Transformation Programme?
The West London Mental Health Local Service Transformation Programme brings together clinical and management leaders from the NHS, people with lived experience, including families, friends and carers, voluntary and community service representatives and local authority representatives from across West London to share best practice and work together to deliver improved local mental health services, through coproduction.

3. What are the objectives of this programme?
To share best practice and work together with our partners to improve local mental health services
To deliver modern and responsive services that are as close to patient’s homes and communities as possible
To oversee the delivery of six mental health service transformational work strands ensuring a focus on benefits to patients and working to reduce any risks
To ensure alignment of the Trust’s work with NHS England’s Five Year Forward view, local commissioners, and the North West London Mental Health Strategy

4. Which work strands form the core of the programme?
Adult Services - Access and Urgent Care
Adult Services - Primary and Planned Care
Adult Services - Rehabilitation Service
Children and Young People services - Child and Adolescent Mental Health Services (CAMHS)
Adult Services - Cognitive impairment and Dementia
Perinatal Mental Health

5. Adult Services - Access and Urgent Care transformation
Achievements so far
Adult Services - Access and Urgent Care transformation
In 2016, a single point of access (SPA) helpline was launched.
Patients and carers can call this helpline 24/7 for help or advice in a crisis from trained mental health advisors and clinicians.
GPs and colleagues from the police can also make referrals and seek advice.

6. Adult Services - Access and Urgent Care transformation
Achievements so far
Adult Services - Access and Urgent Care transformation
In 2016, Crisis Assessment and Treatment Team (CATT) was also established in Ealing, Hammersmith & Fulham and Hounslow.
Crisis assessment and treatment teams now provide fast, responsive assessment and care to people referred via the trust’s Single Point of Access in each of our three boroughs.
Patients are seen quickly in their homes or local clinics.
The CATT have strict standards in place for responding to emergency referrals within 4 hours and urgent cases within 24 hours.

7. Adult Services - Access and Urgent Care transformation
Achievements so far
Adult Services - Access and Urgent Care transformation
Towards the end of 2016 and early 2017; we worked with NWL Like Minded team to complete an evaluation of SPA and CATT services.
This evaluation is positive and we are working on some of the recommendations to improve these services even further.

8. Adult Services - Access and Urgent Care transformation
Achievements so far
Adult Services - Access and Urgent Care transformation
We are working hard to ensure that inpatients only stay as long as they need to.
We are working with partners right across the system to reduce delayed discharges and discharge patients when it is medically right to do so.
We have developed a co-produced vision and standards for inpatient care working alongside our service users, carers, staff members and the West London Collaborative.

9. Adult Services – Planned and Primary Care transformation
Achievements so far
Adult Services – Planned and Primary Care transformation
Community pathways have been reviewed to make our services more responsive to individual patient needs by organising staff and structures around each patient’s diagnosis.
We are working to ensure that more patients have a timely discharge from acute (inpatient) care into community/primary based care (improving flow).

10. Adult Services – Perinatal Service transformation
Achievements so far
Adult Services – Perinatal Service transformation
A perinatal mental health service has been established to provide specialist assessment, treatment and support for women with current or previous moderate to severe mental illness who are pregnant or have given birth within the past year.
Evaluation of this service in its first year has been extremely positive.

11. Children and Young People Services – CAMHS transformation
Achievements so far
Children and Young People Services – CAMHS transformation
As part of the New Models of Care (NMOC) Programme, a new integrated 24/7 crisis service is due to launch in December It aims to provide children and young people with inpatient care closer to home. The new crisis pathway improves the quality of care by supporting early discharge, better care planning and preventing unnecessary admission.
The CAMHS Out of Hours service is now an integrated part of the crisis pathway. The phase 2 co-produced (future) crisis pathway design aims to shape our long term vision to develop a North West London a outreach and intensive community treatment team.

12. Achievements so far
Adult Services – Cognitive impairment and Dementia Service transformation
Dementia link workers are now in place in two boroughs (Ealing and Hounslow) and help patients access the full range of support available, such as social care and health services. They link with GP practices, and can make home visits or talk by telephone and update other parts of the system on how someone is doing at home.
We are also planning on launching the service in Hammersmith and Fulham and are currently recruiting link workers.
NB – In place in 2 out of 3 of the boroughs. Recruitment for the service in H&F is underway.

13. Transforming how we involve and support carers
In order to ensure that carers are included informed and better supported when caring for someone who is unwell, we are introducing the Carers Trust’s Triangle of Care.
By implementing the Triangle of Care, we will:
Train staff so they are more ‘carer aware’.
Identify a carer and their essential role as soon as possible.
Introduce carers to staff and ensure they receive information across the care pathway.
Offer a range of services to support carers.
Review our policies and practices about sharing information with carers.
Create specific posts responsible for supporting carers.

14. What are we focussing on next?
To sustain improvements made to date in improving our urgent care and inpatient services
To continue work to improve how different parts of our service work together to improve the patient’s experience
To further develop the benefit that our community teams provide for patients and carers
To continue to embed co-production in every stage of the transformation
To continue to improve our crisis pathway and waiting time standards for children and young people