partners, together we will promote prevention, early intervention and resilience. principles, Equality, diversity & inclusivity, devolution Action: Promote growth in areas which improve early intervention, prevention and health promotion. Action: Increase access to psychological therapies for children, young people, adults and older adults, building on current provision and seeking opportunities for growth and expansion. 3 Working with partners there will be “no health without mental health” and services will be “joined up”. Principles: SMR principles Enabler: Increased external focus and involvement of psychological expertise in partnership working. Action: Increase partnership working across systems to ensure psychological perspectives are well understood and influential. Action: Ensure equitable access to psychological interventions for the population in all settings via integration of psychological services into multidisciplinary teams. 4 The Trust’s Mental Health and Disability Services will be sustainable and deliver real value to the people who use them. Enabler: Measurement of meaningful outcomes Objective: All psychological practice is safe, caring & compassionate, effective, cost-effective, responsive & well led. Workforce objective: Deliver sustainable, accessible & equitable psychological services, making best use of resource & minimising waste Objective: All psychological practice is safe, caring & compassionate, effective, cost-effective, responsive & well led. 5 The Trust will be a centre of excellence for mental health and disability. Principles: SMR principles, co-production Enablers: Co-production, Embedded professional leadership and active participation at all levels of the Trust Objective: We will identify and pursue strategic growth, research and innovation opportunities for Psychological Services 6 The Trust will be regarded as a “great place to work”. Principle: Equality, diversity & Inclusivity Workforce strategy objectives: -Support and value our staff & develop our leadership, resilience and flexibility -Develop career pathways across clinical
As an ambitious organisation that is always striving for excellence, we need to ensure we are updating our knowledge and skills across our systems. Joint development opportunities with service users and partners can be particularly productive. Arts Psychotherapies Review An additional piece of work has been carried out to review Trust-wide provision and governance of Arts Psychotherapies. This is a small specialism of only 13 staff members in 11 wte posts, across a range of Art, Music, Drama and Dance Movement Therapists, working mainly in inpatient services for adults and children with severe and complex mental health problems and/or learning disabilities. This review has produced two recommendations: Develop a clearer organisational & governance structure and career pathway for Arts Psychotherapists within NTW. Develop more equitable access and resources for Arts Psychotherapies to meet needs across service lines. Summary/Recommendations The Psychological Services Strategy has been developed collaboratively and is grounded in Trust values and principles, and aligned with the Trust’s six strategic ambitions. It includes a draft five year action plan to achieve the identified objectives: (i) All service user and carer contact & input across the whole Trust is psychologically informed. (ii) All psychological practice is safe, caring & compassionate, effective, cost-effective, responsive & well led. (iii) We will identify and pursue strategic growth, research and innovation opportunities for Psychological Services. Specific recommendations include: That the Trust supports the development and implementation of shared psychological language and practice. That the Trust supports the implementation of guidance on the governance of psychological practice. That NTW signs up to the BPS-New Savoy Staff Wellbeing Charter That a Trust-wide framework to guide job planning in psychological services is rolled out and embedded. That under-utilised research skills in Psychological Services staff are identified as a resource to the Trust and harnessed to help with service evaluation, development of practice based evidence, improving outcomes and innovation That inequities in access to psychological services are addressed as far as possible within financial and contractual constraints That opportunities to redesign skill mix are taken up in order to address workforce gaps and improve service users’ experience and outcomes That Psychological Services staff are supported to develop further their clinical, leadership and management skills and to develop career pathways within the Trust That the Trust supports the implementation of a Psychological Services Growth and Innovation Forum.
Appendix 2 – Psychological Services Five Year Plan 2017-2022 Objective Year 1 Year 2 Year 3 Year 4 Year 5 1. All service user and carer contact and input across the whole Trust is psychologically informed 1.1 Psychological ways of thinking to be embedded across the Trust by further coproducing, developing and implementing a common psychological language and approaches which are accessible to all. Develop common language building on work with Service Users and Carers, 5Ps plus plan formulation, reflective practice, complexity and stepped care models. Review and check against e.g. SMR & PIE. Continue initiatives to support the spreading and embedding of these concepts, e.g. for reflective practice continue to lead, support and develop Schwartz Rounds. Embed in and through complex case reviews. Common language and practice is embedded and used routinely 1.2 Increase partnership working across systems to ensure psychological perspectives are well understood and influential 1.2a Scope psychological services presence across all NTW decision making fora (operational and clinical) and address any gaps. Build confidence and capacity by training (including shadowing) for involvement in Trust processes (complex case reviews, SUI panels and complaints) Increase involvement in Trust processes for complex case reviews, SUI panels and complaints investigations. Review levels of involvement and impact, address gaps
1.2b Further develop strategic links with commissioners to influence the understanding of, relevance and usefulness of psychological approaches and evidence based practice. Identify opportunities for engaging with Commissioners (e.g. join relevant groups, and attend events) and links with key local stakeholders including Service Users and Carers. Initiate discussions with NTW Execs, Contracts and Commissioning team re formal involvement in discussions with commissioners, contract reviews etc. Psychological Services representation at formal/informal discussions with commissioners. 1.2c Further develop influence through external involvement in e.g. NICE,
National Standards and Policy, National Accreditation Scheme, BPS and BACP. 2. All psychological practice is safe, caring & compassionate, effective, cost-effective, responsive & well led 2.1 Ensure good governance of trust wide psychological practice 2.1a Produce & consult on governance guidance document Disseminate and support trust wide implementation Audit adherence 2.1b Adapt psychological professional management structures & processes to fit with each Clinical Business Unit’s needs Implement consistent psychological professional management structures & processes Review effectiveness & address any issues 2.1c Seek APPTS accreditation for all appropriate NTW Psychological Services Discuss and agree a programmatic approach to accreditation & identification of funding 2.1d Develop a clearer Implement organisational &
organisational & governance structure for Arts Psychotherapists within NTW governance structure for Arts Psychotherapists 2.2 Ensure best practice 2.2a Support Trust’s workforce development strategy, identifying psychological knowledge & skills required Identify/provide bespoke training and embed. Identify and implement recruitment. Continue to review predominant psychological model(s) appropriate to each pathway Identify/provide bespoke training and embed. Identify and implement recruitment. Continue to review predominant psychological model(s) appropriate to each pathway 2.2b Scope gaps in psychological services staff’s knowledge & skills including re. medicines awareness and concordance. Identify/develop & provide appropriate training & supervision. Develop supervision pyramids so that skills are developed and sustained more broadly across the Trust Psychological Services workforce has full range of skills in place to deliver comprehensive evidence based practice in all the pathways of the Trust in which we are involved. 2.2c Ensure continuous learning from evolving best practice,
incidents and AARs, outcome measurement, audits. 2.3 Implement consistent and meaningful outcome measurement Support clinicians in meaningfully utilising psychological outcome measurement clinically and identify appropriate psychological metrics in partnership with SUCs. Include qualitative as well as quantitative outcomes Pilot implementation & analysis in early adopter pathways and promote use of outcome measurements. Roll out to all pathways Make systematic use of appropriate, reliable outcome measures pertinent to Service User groups in clinical areas (CROMS, PROMS & PREMS) 2.4 Elicit and act on robust Service User & Carer feedback Review current feedback mechanisms and response rates. Investigate other examples of best practice. Discuss and agree best practice for implementation. Implement in selected areas & review. Roll out to all psychological services. Audit & review. 2.5 Identify & implement guiding Link with SUs, Develop action Sustainable
principles re co-production within psychological services. PSW and R&D colleagues to agree principles, e.g. PANEL principles make it easy for people to take part. plan to maintain existing good practice and develop in areas where there are gaps. process of coproduction embedded in all our services 2.6 Further develop leadership knowledge and skills across psychological services Align with, contribute to and participate in Trustwide leadership development programmes Provide opportunities for clinical and professional leadership development. Review Psychological leadership competency frameworks & adopt/adapt/ develop a framework for use in NTW. 2.7 Use our leadership skills to support multidisciplinary colleagues through systemic reflections and interventions, sharing and implementing psychological knowledge and practice, providing guardianship for e.g. clinical Participation in Trust Operational Management, Quality & Performance and Service Development meetings.
supervision Supporting Schwartz Rounds. 2.8 Contribute to training and clinical supervision for all pathways to ensure practice is co-produced, client centred and responsive to Service User issues. 2.8a Ongoing contribution to clinical skills training stars 2.8b Provide clinical supervision and help develop clinical supervision skills of colleagues Offer specific training & supervision Evaluate quality of training and impact on clinical practice Review best practice and update ensure training is aligned 2.9 Ensure equitable access to psychological interventions including Arts Psychotherapies for the population in all settings via integration of psychological services into multidisciplinary teams. Ensure that psychological interventions match need at the right intensity and skill level. 2.9a Involve SUC in exploring accessibility issues. Review access by population groups. 2.9b Address resource gaps in partnership with Collective Leadership Teams Engage with groups, aiming to find ways to improve access Engage with commissioners and partners to discuss improvement options 2.10 Ensure effective, timely and personalised communication with service users and families Systems to communicate directly re appointments Systems to support person centred and accessible Help develop Trust wide person centred communication