discreet services for LD and whether these can link to adult LD provision 30/09/15- CAMHS transformation plan approved- reference to transition protocols Review timelines- NEP transition protocol as part of the SDIP. Essex wide protocol will have to review timeframe after November due to new provider. 1.3 To ensure that the recommendations made in ‘A safer place to be’ are used as a baseline for section 136 practice in North Essex. From April 2015 NEP/ Essex Police/ CCGs/ Essex County Council/ East of England Ambulance service/ British Transport Police To ensure broad range of stakeholders have been involved in development of agreement Provide opportunity for wider engagement across communities Undertake a review of the Essex joint policy for section 136 Development of a standard report to all boards on section 136 changes 18/08/15 Draft copy of the NEP policy has been shared with the group. This has been reviewed and finalised by NEP. Final copy to be shared from NEP 05/10/15 copy circulated- complete
There is an Essex wide group that oversees all 3 Essex concordat plans 1.7 North East Essex CCG Care closer to home commissioning- ensuring all service users with a long term condition are screened for mental health problems and referred to appropriate mental health support (i.e. IAPT services) March 2016 North East Essex CCG To improve the working between mental and physical health services To help prevent people with LTCs reaching MH crisis Specification clearly defines MH screening requirements, services to go live March 2016 1.8 North Essex Crisis Care concordat action plan to be published on the national concordat website End March 2015 End October 2015 Essex concordat action plan group chair National sharing of plan available to general public via national website Submitted at end of March 2015. 30/10/15- Plan resubmitted to national website 1.9 Completion of the Essex wide CAMHS procurement joint exercise between Essex County Council and CCGs New service to commence October 2015 CCG CAMHS commissioners/ Essex County Council/Thurrock and Southend Councils To improve value, access and responsiveness Contract awarded, procurement complete 1.10 Needs analysis to inform potential business case for peer-led crisis house to aid recovery and From May 2016 CCGs/Essex County Council Understanding current best practice Using JSNA refresh to inform business case 1.11 Ensuring that core access standards to services are in place for mental health providers To be included in all 2015/16 North Essex CCGs Ensuring providers are held to account for delivery of core standards Included in North Essex NHS MH contracts- complete and will continue to be included in 2016/17
contracts with providers contracts. Shadow EIP reporting arrangements are in place. 1.12 Publication and implementation of the North Essex Personality Disorder Strategy From April 2015 North Essex CCGs Improving patient experience of people with Personality Disorder Developing a community based model Improving access across north Essex 18/08/2015 Approved at NEE CCG board in May 2015. Approved at West Essex CCG June 2015. 05/10/2015 Approved at Mid CCG in September 2015. Intentions reflected in commissioning intentions 2016/17 documents sent to provider at the end of September 2015. Contract negotiations for 2016/17 will commence in November 2015. 1.13 Establishment of a Community Resilience model From April 2015 All concordat stakeholders Individual organisations to update on community resilience projects. A separate to be appended to plan with individual organisational actions. All stakeholders to feedback on projects by the end of June 2015 28.09.15 Mid Essex Social Prescribing update 1.14 To ensure detailed consultation with the Public and Service users on Ongoing All concordat stakeholders Ensuring public and service can hold us to account for delivery 18/08/2015 Previously discussed as wide. Group to look at
health crisis including those who are assessed and detained under the Mental Health Act. Ensure inclusiveness of the voluntary sector and ‘seldom heard’ groups 30/09/15- Group agreed to hold workshop on development of crisis line provision through 111. MH liaison bid being developed looking at alternative models of crisis response. 1.17 Review and set out future requirements for workforce training. Development of a business case for joint workforce training From December 2015 All concordat stakeholders To improve the skills of the local workforce To develop opportunities for service user and peer led training 30/09/15- Agreed focussed agenda item on workforce at NEP Clinical quality review group in December 2015 Exploring opportunity to develop new roles as part of national MH liaison bid 1.18 Sharing of best practice at the national concordat event April 2015 All concordat stakeholders To review local plan against other geographical areas To review and implement national best practice North Essex stakeholders attended National Conference- sharing of best practice examples 1.19 Ambulance national specification – Ensuring that local specifications define waiting times targets for MH service users. From April 2015 East of England Ambulance Service Ensuring ambulance service meets contract requirements Completed in ambulance contract 1.20 2015/16 NHS contract SDIPs with acute providers setting out how providers will ensure that April 2015 North Essex CCGs, CHUFT, PAH, MEH Ensuring (by 2020) the acute trusts have 24/7 18/08/2015 Funding in place until end of March 2016
1.23 Local railway related data to be shared with British Transport Police From April 2015 British Transport Police The divisional or FHQ SPMH team should be able to provide simple and clear information which sets out the level of mental health and suicidal activity within a given area. 16/06/15 In Weekly report on people identified at risks at train stations and nearby train lines to link into missing person’s data base. 4.13 4.14 1.24 Improve the understanding across the whole sector in relation to the issue of MH/Substance Misuse issues From June 2015 Essex County Council Improved identification of Dual Diagnosis issues Improved treatment and care Improved outcomes for service users Reduction in opportunities to “bounce” clients between service provision 16/06/15 Working with ECC to work out old CDAT – embedded into MH outreach provision to ensure assessment and recovery more appropriate. wide task and finish group set up. 05/10/2015 Partnership Agreement between ECC and NEP+SEPT, clearly defines responsibility regarding Dual Diagnosis. All Substance Misuse Services Specified accordingly. 1.25 Health and Social care commissioners to establish the crisis/emergency care pathway for CYP with LDD, including children with LDD and neuro developmental disorders who present with challenging behaviour. existing By 1st November 2015 - aligned with ECC North and South Essex CCGs/Thurrock and Southend LA’s Improve the understanding across health, education, social care, and police on the crisis/emergency pathway for CYP with LDD, and CYP with LLD and neuro developmental Contract awarded, procurement complete
Government commitment to investment in CAMHS nationally CCG additional funds secured on submission of robust Transformation Plan focusing on making more professional help available 2.6 Develop a range of education programmes including- Delivery of education CQUIN in NEP 2015/16 contract around MH education Delivery of MH education to key stakeholders including emergency services staff Delivery of suicide prevention education to primary care, secondary care and emergency services. This includes: multi-agency training, including schools and universities (to include resilience training) cross-agency promotion of Teenage Suicide prevention guidance developed through the Essex From April 2015 All concordat stakeholders Raise awareness of mental health issues Improve understanding and outcomes of mental health conditions Improve patient experience Improve diagnosis, timely access and early intervention Reduce stigma Change of culture Sustainable programme of education (through train the trainer courses) Improve working across concordat stakeholders Improve tolerance and understanding of mental health issues NEP education 15/16 programme agreed for year. Life skills programme rolled out to 25 secondary schools, this is the risk avert scheme. Healthy relationship module funded through Domestic Violence prevention. Emotional Health and wellbeing module being delivered through risk avert. Essex university and a PHD around efficacy and evaluating risk avert courses. NEP and Samaritans to continue their partnership working NEP to discuss 2.12
Safeguarding Children Board community awareness Safe Talk Apps Establishment of Stop Suicide website Adopt principles and approach of perfect depression pathway and zero suicide pledge with support from Dr Coffey and the Strategic Clinical Network Identify sources of funding for training Mental health first aid training Education in primary care to support early identification of mental health issues and services available for referral Development of education programmes aimed at: The public – identification of any quick wins Coders – to support capture of MH presentations in acute trusts with CCG commissioners future developments. STOP suicide campaign to increase training for the ambulance trust. Further discussion re – 2016/17 programme as part contract negotiations. Sustainable system-wide training solutions to be considered as part of MH Liaison bid.
content for delivery within Fire Break Programmes with key stakeholders Improving self-esteem and confidence 2.12 Continued delivery of ECC school based wellbeing programme “Risk Avert”/ explore opportunities for joint working on programme content with CAMHS and ensure referral links to emotional wellbeing provision are developed and implemented From April 2015 Essex County Council/ CAMHS Reduction in risky lifestyle choices Improving self-esteem and confidence Programme being delivered to 25 secondary schools 2.6 2.13 British Transport Police potential to refer at risk individuals to relevant agencies From April 2015 British Transport Police to develop local protocols where high risk individuals can be referred into local multi agency safeguarding and risk management arrangements such as MASH (Multi Agency Safeguarding Hubs), and Community MARAC (Multi Agency Risk Assessment Conference) 1.23 4.13 4.14 2.14 Development of a targeted scheme for hoarders From April 2015 Essex Fire Service To reduce risky behaviours To reduce the risk of MH crisis To reduce the risk of fire in the home 18/08/2015 Fire Service Hoarding Protocol developed in line with the Safeguarding Adult Board and due for ratification in September. Urgent and Emergency access to crisis care
3.1 Development of an improved approach between CCG and NHS England commissioners in relation to the availability and access to CAMHS beds and the step up and step downs in services required From April 2015 NHS England, North Essex CCGs Improved multiagency communication Improved service user experience of CAMHS services 18/08/2015 NHS England ensuring there are more beds nationally in line with the money available – especially Tier4 – to ensure collaborative working. CCGs invited to NHSE in September to discuss and take forward. 3.2 Continue commissioning of Accident and emergency mental health liaison services in MEH, CHUFT and PAH hospitals and ensure links to existing A&E Liaison provision in relation to Alcohol are developed From 2015 North Essex CCGs, Essex County Council, MEH, CHUFT, PAH, NEP Improved multiagency communication Improved service user experience Reduction in admissions for MH service users Eradicating 4 hour A and E breaches for MH Improving sign posting and referrals to appropriate services 18/08/2015 Funding agreed until March 2016 with further expectations by NHS England that this may be taken forward by secondary care moving forward. A range of alcohol liaison provision is commissioned by ECC. ECC commissioners engaged in development Psychiatric Liaison bid (for submission 9th November 2015) 3.3 Development of a business case to deliver a full RAID service within MEH, CHUFT and PAH hospitals and ensure links to existing Alcohol From April 2015 North Essex CCGs, Essex County Council, MEH, CHUFT, PAH, NEP Improved multiagency communication Improved service user experience Enhanced liaison rather than full RAID to be commissioned for 15/16
Liaison Nurse Services are developed appropriately Reduction in admissions for MH service users Eradicating 4 hour A and E breaches for MH users Improving sign posting and referrals to appropriate services See 3.2 above RE liaison development 3.4 Development of business cases to continue the commissioning of the street triage pilot delivered in North Essex between Essex Police and North Essex CCGs March 2016 North Essex CCGs, NEP Reduction in section 136 detentions Reduction in usage of section 12 doctors assessments Improved working between MH and Police services Improved service user experience Currently funded agreed until end March 2016. Currently reviewing evidence from alternative national models. 3.5 3.5 Review the street triage model delivery and develop further for 2016/17 to involve a wider range of stakeholders Engage and work with partner commissioners to review the opportunities to join up with the planned Offenders with Complex and Additional Needs provision, Street Triage and MH/LD Liaison and Diversion provision to address issues of multiple disadvantages in the Offender cohort. From July 2015 North Essex CCGs/ Essex County Council Reduction in section 136 detentions Reduction in usage of section 12 doctors assessments Improved working between MH and Police services Improved service user experience Street triage going to market as part of the offenders with complex needs procurement. The procurement will address provision for LD & drug and alcohol offenders. A County wide commitment will be required for this scheme. Group to consider how to work with the ambulance 3.4
Crisis line provision requires improvement Group to develop actions where development needs have been identified. 05/10/15 to ALT, Identifying recommendations for a robust AMHP service. Link to crisis line review workshop December 2015. 4.6 Implementation of relevant recommendations made within the CQC thematic report on north Essex crisis services From June 2015 North Essex CCGs/Essex County Council/ NEP To ensure that recommendations from the CQC thematic review are reviewed and implemented where appropriate As above 4.5 4.7 Reviewing restraint processes to ensure in line with national guidance on restraint ‘Positive and Proactive care’ July 2015 NEP/ Essex Police/ Essex County Council/ North Essex CCGs To ensure that best practice is being applied in the use of restraint In place 4.8 Implement the guidance on commissioning crisis services for BME, seldom heard and vulnerable groups From December 2015 All concordat stakeholders To ensure equal access to all members of the public to services Link to revised MH JSNA completion 4.9 Ensure relevant contract clauses are in place with community providers, including school nursing to ensure that mental health April 2016 North Essex CCGs/ Community Health services providers To ensure all children’s services treat mental health awareness as core business On-going discussion with CCG Commissioners about potential opportunities via CQUIN, SDIP 2016/17.
awareness is core business to children’s community services providers 4.10 Work with Health watch to ensure service user and wider views are captured (e.g. community providers, welfare to work, CAMHS, Health watch ambassadors, Health Access Champions) on the provision of crisis care From October 2015 All concordat stakeholders To improve crisis services resulting from feedback received 4.11 Audit to be undertaken to determine: the reason for the relatively low uptake of use of personal budgets in north Essex what people are choosing to use their personal budgets for From October 2015 Essex County Council/ North Essex CCGs Improve understanding of service user requirements 4.12 Ensure learning from joint CRHT/Samaritans programme is shared April 2015 NEP Sharing of good practice Embedding of learning Learning from work shared with group. NEP continue to develop partnership working opportunities with Samaritans 4.13 To ensure that the street triage staff have access to police missing persons forms as risk of crisis would be heightened for missing individuals during this time April 2015 Essex Police/ NEP Improved multiagency working and information sharing 16/06/2015 All staff have access to forms. Street triage linking into MISPER team 3.14 2.13
plan in line with NICE quality standard 14- Crisis planning 5.3 Piloting of personal health budget usage for mental health service users From October 2015 Essex County Council/ North Essex CCGs Enhanced focus on recovery and prevention NE CCG leading for North Essex. DONS meeting regarding roll out Late June 2015 5.4 Recovery social inclusion model development From October 2015 County Council/ North Essex CCGs Enhanced focus on recovery and prevention 05/10/15 See 2.7 for update. 5.5 Development/promotion of tools and apps to service users and the public, including: Buddy App Depression Apps 5 Ways to Wellbeing 10 steps to happiness Also: gain input from Recovery College and CAMHS service users explore potential to work with Anglia Ruskin University/ University of Essex on application development By March 2016 All concordat stakeholders Improving public knowledge and awareness of MH issues NEP have completed a thematic analysis and have a national tool developed which is on their intranet be available for public use from the end of July 5.6 Exploration of national funding to support initiation of tele health schemes From March 2016 All concordat stakeholders Improving public knowledge and awareness of MH issues Possible link to 16/17 contract CQUINs 5.7 Working with return to employment organisations to assist in prevention of MH crisis From October 2015 Essex County Council Improving multiagency working to aid prevention and recovery of mental