1. REDESIGN OF ADULT SECURE SERVICES TRANSITIONS
CO-PRODUCTION WORKSHOP th June Claire Holmes - Programme Lead Dr Katina Anagnostakis - Clinical Lead
REDESIGN OF ADULT SECURE SERVICES TRANSITIONS

2. Aims for today…
Ensure all stakeholder views included in ongoing progress
New Care Models & IMPACT programme update and context
Focus on Transitions:
Highlight new developments & good practice
Review Task and finish group work
Work on how this progresses
Organisational buy in

3. Overall Aim:- Provide better support in the community, less reliance on secure beds to achieve improved outcomes for service users and their families
How we will achieve this:- Shorter lengths of stay, reduced admissions, improved community infrastructure

4. New Care Models: East Midlands
We are using this as an opportunity to completely redesign adult secure mental health services in the East Midlands hence we are holding these events to ensure as many people as possible can be involved and provide their views.
The organisations involved are:

5. PEOPLE FIRST & WORKING TOGETHER EMPOWERMENT & OPPORTUNITY
IMPACT Values
Safety: shared responsibility; public protection
Least restrictive: closest to home; positive risk taking
Autonomy: control of our own lives; choice; no decision about me without me
Empowerment: passion; pride; best practice; innovation
Opportunity: encouraging resilience; recovery opportunities
Inclusivity: respecting diversity including families, carers, staff
Honest
Transparent
Clear Mutual Expectations: clear pathways and expectations; not setting people up to fail; not ‘sugar coating’ things
Trust
Accountability
Person Centered: people first; not them & us; one team; respect
Working Together: collaboration; co-production
Genuinely Responsive: real; genuine; listening
PEOPLE FIRST & WORKING TOGETHER
OPENNESS & HONESTY
SAFE & LEAST
RESTRICTIVE
EMPOWERMENT & OPPORTUNITY
HOPE

6. What do we want to achieve through the programme?
Better quality of life and experience for service users and families
More people being effectively supported within community settings with access to educational and employment opportunities
Avoidance of people entering into forensic mental health services without a negative associated impact on other services such as adult mental health
Faster admission into a secure unit if required without any unnecessary delays through streamlined assessment processes on a regional basis.
Less time spent in an inpatient unit ie only when needed
Less people having to go out of area due to lack of availability of secure beds in the EMs
Reinvestment into new and different community services which can be achieved through less use of beds.

7. April Co-production event: Community Infrastructure

8. You Said…. We Did…April 2019
Discussions with third sector organisations
Built into the bid for new Assertive
Transitions service
Now built into the bid for new Assertive
Senior leadership panel convened today
More Peer support &
community navigation
within new service
developments
Work with
Carer’s and families
You Said:
There are too many assessments to get into secure services
Individual choice as to where people are placed is often not taken into account.
We did:
We are introducing a single “approved assessment” process that negates the current practice of multiple assessments
We have developed a “decision tree” ie a set of principles that are applied by all clinicians when people are placed in a secure bed or move between levels of security. Service user and family choice will be central .
This will be introduced when the new referral form starts being used from 1 June. Decisions around bed allocation will be audited to ensure choice is consistently applied.
There should be more support available to help people well before discharge from secure services and after discharge
Peer support and support workers are needed in forensic services to provide practical advice and assistance including emotional support.
We are developing a new service that will provide support to people up to a year before discharge and help transition in the community; a large part of the staff will be peer support and support workers.
People are often “stuck” in secure services; they don’t know when their discharge date is or what is happening.
We have set up a new task & finish group to look specifically at transitions and a system whereby there will be much more oversight of people when in secure care including a “single point of exit”.
This group is also looking at how we can end repeated assessments when people move between levels of security.
The Women’s blended pilot at St Andrew’s should reduce the times people transition; if successful this can be rolled out across other services.
Organisational buy in
for service changes

9. Thank You Thank you for listening We hope you enjoy the workshop!

10. Summary & next steps…
Themes and actions from all four events summarised into business case