Transcript Slide 1
North Tyneside - Improving outcomes for people experiencing mental health crisis Jacqui Old Director of Adult Social Services November 2014 Life expectancy & disability-free life expectancy & premature mortality rates Context • • • • • • • • • Children / Adult cover 65% of council budget N. East - By 17/18 40% reduction resources North East highest level of decrease in spending power Worrying signs that gap could widen - impact of recession Flaw in public spending is shown - NHS as an island Local government & Benefits seen as easy for cuts Consequences for NHS. Trusts finances/ operational sustainability over next 5 yrs Need for more granular information on the impact of austerity Challenges in North Tyneside • Availability and access to Place of safety beds • Joint training front line police and mental health practitioners • Supported Housing Offer • Parallel Tracks • Separateness of each imitative • Excess use of police cells for people with mental health problems • Cliff-edge of lost support as children and young people with mental health needs reach the age of 18 • Out of hour access to crisis beds for young people (17+) • Transportation of people with mental health problems in Crisis Emergent Thinking Access to support before crisis Quality of Treatment & Care Service data to track and assure Beds readily available Single commissioning budget Recovery and staying well - Early Intervention/Prevention - Information and Advice - Care and Connect Universal single point of access - Thresholds, Gateways Universal Services Information and advice Primary care Urgent and Emergency Access to Crisis Care 136 Pathway /Crisis team/ MEAM - Improved services for those with coexisting mental health and substance misuse issues Chronically excluded from services AMPHS Access to support before crisis point Access to support before crisis point • Help this person to recover, become more independent and reduce care needs • Maximise ways to promote prime interventions to support recovery • Develop a clear political model of care which has promoting independence for citizens and find some of the care solutions from communities families and individuals Access to support before crisis point • Phone for help- divert you to menu of options • Improve access to support via primary care • Awareness of local mental health and substance misuse services and how to engage them • Focus on outcomes from our interventions • New compact with community • Work with ph to make every contact count 2. Recovery and staying well • Divert people away from formal care through good info and advice services • Develop the right level of preventative interventions in order to help people at the right time • Service model of the future will be radically different • Changing the model of care from one of paternalism and protective interventions to one which promotes independence and manage risk with customers • Instead of asking what is the matter with you - what matters to you. • Carers 2.Recovery and Staying Well • We will not assess person in crisis until we have given them the opportunity to recover/rehab • Never make long term decision in middle of crisis • Develop the right set of interventions that prevent long term placement • What is the practice and interventions that work • Is Reablement /recovery delivering cost effective outcomes ? 3.Urgent & emergency access in crisis 136 Pathway • Process mapping workshops held with key partners across all areas • Issues raised in the mapping workshops brought together in partnership meetings to agree actions required. MEAM • Improved services for co-existing mental health substance misuse issues • Getting costs down before - not building costs up 4. Quality of Treatment and Care • Commissioning team with eye on the ball and team who are much more forensic • Commissioning that allows for beds to be readily and locally available in response to urgent need • Commissioning provision for under 18 year olds that ensures local provision for young people in urgent need • Single budget- commissioning for adults. • Proper sense of partnership. 4. Quality of Treatment and Care • Effective joint performance framework – Create system that gives clarity and purpose • Sufficient amounts of service data info that we can track and provide assurance that services are working • Build intelligence so we have an informed approach to strategic and operational decision making • Response Timescales/Esculation/Bed avaiability/ AMHPs • Focused on managing demand and cost- Know weekly if they are meeting need So where we have got to ? • A shared perspective - joint statement about how public services will work together • Agreed set of principles and good practice • Switched into different gear. Not the solution but good focus and start. • Recognition that we can`t do this in isolation – interdependency • Systems leadership Thank-you