Mental Health
What did we say in Healthy Ambitions?*
1
The Mental Health Pathway identified considerable variation in services provided in localities and the speed in which services have been modernised.
It also found some pathways complex and difficult to navigate, for professionals, users and carers.
They therefore recommended that:
- Help when it is needed – no queues
- The adoption of a vision for mental health "to live free from discrimination, disability and poverty"
- A single access point to ensure you get the right support quickly
- Investment in community mental health services to ensure capacity meets demand
- Mental health teams attachedto GP practices
- Modernised dementia services.
Who is taking this work forward?
2
PCTs across Y&H have worked with the SHA to agree which of the recommendations of the mental health pathway group should be taken forward locally and which might need action at regional level. This is summarised in fig.2.
*Full details can be found at www.healthyambitions.co.uk/mental_health.html.
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When is it happening?
3
The actions to be taken forward in the first year of implementation for the Mental Health pathway are shownin fig.3.
Where is it happening already?
4
PCTs have prioaritised the recommendations in Healthy Ambitions in light of the needs of their local community and the current position of their services.
Working with local partners and providers they have all set out the action that they will take to start to turn the recommendations in Healthy Ambitions into reality in the five year strategic plans.
An example of the action being taken by North Lincolnshire is shown in fig.4.
How could you help?
5
Everyone with an interest in improving mental health services can play a part in taking forward the recommendations in the mental Health chapter of Healthy Ambitions.
In fig.5 we have set out some of the suggestions from staff about how people could help implement the recommendations.
As an NHS publication – this section has just focussed on the roles that NHS Staff could play – but we very much recognise that our partners have a big contribution to make if we are to deliver the recommendations of the of the mental health chapter in Healthy Ambitions. We know that local authorities have a big part to play – e.g. in working with the NHS to provide integrated services, in identifying and supporting people in need of mental health services and in referring them from a variety of settings including social services and education. We are committed to working with our partners to help make this happen.
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Who will make sure that this work happens?
6
There are a number of key leadership roles in the delivery of this pathway:
Locally
Each PCT is responsible for working with local providers and partners to ensure the delivery of recommendations in line with their local priorities and their own strategic plans.
Collaboratively and Regionally
Delivery will be overseen by a Pathway Delivery Board – as described in chapter on governance arrangements
For Mental Health the chair will be Ailsa Claire Chief Executive at NHS Barnsley. The delivery board will assure:
(i) The production of a document setting out what should be expected in the next contract round, for commissioners to use. This will incorporate a working definition of what might be meant by ‘no waits’.
(ii) The establishment of peer review to both share learning and audit arrangements.
The clinical lead is Nick Morris, Director of Strategy and Nursing at Bradford District Care Trust, who will oversee progress against the mental health pathway recommendations, act as a champion for the recommendations, advise on delivery processes and encourage regional colleagues to continue to focus and give priority to the mental health recommendations.
Sue Proctor, the SHA’s Director of Patient Care and Partnerships, will oversee progress on implementation of the mental health pathway with the clinical lead.
How will we measure success?
7
We have developed a “Healthy Ambitions Dashboard” based on a small number of key indicators which taken together can be used to start to measure the success of the Healthy Ambitions programme as a whole. This is underpinned by trajectories which each PCT will set and which will show the measurable improvements they are making in each pathway area. This will supplement the “vital signs” indicators and trajectories which support delivery of the targets set out in the NHS Operating Framework and the selection of outcome measures which PCTs have included in their strategic plans. All of these measures will feature in PCTs annual operating plans to be agreed with the SHA and be the basis for the SHA’s performance management regime.
Recognising that the pathway recommendations are many and various we intend start by tracking progress against the key pathway pledge, which for mental health is to ensure we have no waits for mental health services.
We know that this doesn’t tackle all the priorities in this chapter. Access to psychological therapies, CAMHS effectiveness, service users in settled employment and accommodation will all be tracked through existing routes. Access to psychological therapies and effective CAMHS are already Vital Signs, whilst a series of standards relating to access to MH assessment and services for people with learning disabilities are contained in the CQUIN measures.
Work is underway to develop key indicators we will track in the “Healthy Ambitions Dashboard”. It is likely that we will use the CQUIN measures identified below, although this is subject to final agreement.
- The number and percentage of service users of all ages, requiring non-urgent assessment, who receive face to face contact with a qualified practitioner within 14 days of referral being made
- The number and percentage of service users of all ages, requiring assessment for home treatment or admission, who receive an assessment by a qualified practitioner within 4 hours of referral being made.
Work will then be undertaken to establish baselines for the indicators and by the end of March ’09 trajectories for improvement will have been agreed between the SHA and PCTs and will be reflected in annual operational plans.* We intend to publish progress against individual trajectories.
*More details can be found in the performance metrics chapter.