1. Central London Mental Health Transformation stakeholder engagement event
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

2. Welcome Mike Waddington – Communications Director, CNWL
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

3. Agenda for the day
12:00 – 12:30 – presentation covering: current services; areas for development; clinical model development; co-production; next steps 12:30 – 12:50 – small group activity 12:50 – 13:10 – small group activity (switch tables) 13:10 – 13:30 – group feedback 13:30 – 14:00 - open discussion and panel Q&A
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

4. Acronyms and Jargon We might use the following acronyms today:
CNWL – Central and North West London NHS Foundation Trust
CLCCG – Central London Clinical Commissioning Group
CMHT- Community Mental Health Team
MH – Mental Health
CRHTT- Crisis resolution and Home Treatment Team
PCP- Primary care plus
SPA – single point of access
Please let us know if we are using Acronyms without explaining them in full, or any jargon!
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

5. Developing the clinical model Dr Jo Emmanuel – Divisional Medical Director, CNWL Dr Neville Purssell – Chair, CLCCG Alison Evans – Social Care Lead Mental Health Westminster, City of Westminster
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

6. Primary Care Networks in Westminster – Central London CCG
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

7. What are our current services?

8. What do people tell us about our current services?
We want less assessments and more treatment
Good, accessible, communication about my care is important to me
I want to understand where and how to access mental health support
I want to be seen as a whole person e.g. professionals understand the impact of my housing
We need a shared system (between primary and secondary care) that people can believe in
We want people with lived experience of mental health problems involved in our care

9. Why should services change?
Feedback from National Collaborating Centre for Mental Health and NHS England work on introducing the framework for community mental health support, care and treatment.
Community mental health services are often not responsive and referrals take a long time to get to the right place
Outcomes and services for people are variable and demonstrate inequalities
We need wider support for people with MH problems, as support provided by community mental health services form only a small part of a person’s life and care

10. Why should services change?
Feedback from CNWL staff community services event
“CMHT is all things to all people“ so is unclear on its role
Lot of resource focused on care coordination and multiple assessments rather than treatment
Provision of care is segmented leading to multiple inter-team referrals and potential for rejections
Untapped community resource - new innovative roles, 3rd sector provision under-utilised
Lack of communication between primary and secondary care
‘Step down’ from secondary to primary care is not smooth resulting in many patients remaining in CMHTs for longer than needed, impairing recovery focus
Focus on process measures rather than patient outcomes
Using NHS resources as effectively as possible
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

11. Making A Difference Alliance Strategic Priorities
Options for better individual outcomes:
Recovery focused services
Remove barrier between primary & secondary care
Not focus on moving from one care setting to another
Community safe havens, community spaces
Social prescribing
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

12. National Direction of Travel
This community offer includes access to psychological therapies, improved physical health care, employment support, personalised and trauma-informed care, medicines management and support for self-harm and coexisting substance use.
Local areas will be supported to redesign and reorganise core community mental health teams to move towards this new way of working.
NHS Long Term Plan, January 2019
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

13. What do we want to change?
We want people with mental health problems to be at the heart of every decision that is made, with effective communication to both patient and GP so that they have timely access to good quality, evidence-based mental health care in the least restrictive settings.
We have set up a collaborative clinically led transformation programme to develop a more streamlined system which allows us to make best use of available resources, reduce silo working and deliver quality clinical care on a needs basis.
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

14. Clinical model development to date
We have set up a partnership clinical group to develop our model
We want to remove the boundary between primary and secondary care, develop a community mental health offer which is centred around the four local primary care networks, and ultimately around the needs and aspirations of the patient.
Through engagement with wider stakeholders, a more detailed model will be developed.
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

15. What are we proposing?
New population-based model of care which is aligned to the existing four Primary Care Networks in Central London CCG.
Enhance patient experience and maximising the support available
More intervention than assessment
Redefining discharge: no cliff edges where support drops off
Enhanced the community offer incorporating the 3rd sector, social care and lived experience
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

16. SPECIALIST COMMUNITY SERVICES
Primary Care Network
Integrated Community Mental Health HUB GP GP
SPECIALIST COMMUNITY SERVICES
Patient GP GP GP GP GP
Primary Care Network
Integrated Community Mental Health HUB
URGENT ASSESSMENT HUB
Patient GP GP GP GP
CLINICAL COORDINATING CENTRE
SPA for urgent referrals and distinct advice line GP GP GP
Borough Wide Services
Primary Care Network
Integrated Community Mental Health HUB GP GP
Patient GP
ACUTE TREATMENT GP
CRHTT GP
SPECIALIST INPATIENT SERVICES
Primary Care Network
Integrated Community Mental Health HUB GP
Patient GP GP GP GP

17. To be able to work in this way we need:
Services working together, no working in silos
Focus on interventions rather than repeated assessment
No cliff edges between services where support drops off, seamless care instead
Flexibility around discharge and top-up support
Improved patient experience
Support and Education for GPs
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

18. Impact on patients
Supports recovery focussed working across the system
Flexible support available around needs
Allows more focus on individual outcomes and less on movement between services
Less focus on referral and discharge
Improved information sharing processes so everybody involved in your care knows your plan
Potential to develop mental health hub services around local population need
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

19. Opportunities for co-production
Service users and Carers
Primary Care
NHS Commissioners
NHS providers
City of Westminster
Voluntary sector
We want to develop this model together
We need your help to work out how to do this
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

20. Proposed plan for change
Development of the model
Systems preparation
Staff training
Mobilisation
Implementation and Review
Ongoing engagement and coproduction with stakeholders
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

21. Small group session
There are 6 tables around the room, each table will have one of the following 3 questions on it:
How would you like to be involved in developing the new model?
What does good communication look like, with you and between services?
Feedback on the new model
Please select one table that you would like to join, after 20 minutes we will ask you to move to a table with a different topic, the facilitators will stay on their tables
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

22. Group feedback Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

23. Panel Q & A Dr Jo Emmanuel – Divisional Medical Director, CNWL
Dr Neville Purssell – Chair, CLCCG
Alison Evans – Social Care Lead Mental Health Westminster, City of Westminster
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group

24. Next steps
We will gather all of your feedback and share with the clinical group, please complete a form before you leave
If you would like to stay up to date with the programme and future workshops please provide your details on the feedback form provided
Potential for further discussion with existing groups or follow up events
You can stay up to date with the programme through CNWL website or by ing
Central and North West London NHS Foundation Trust
Central London Clinical Commissioning Group