1.5 Evaluate potential for a dedicated home treatment / rapid response intermediate care team for older people with dementia. July 2016 Somerset Partnership NHS FT & Somerset CCG Maintain independence, treatment and care/support in home environment where possible, avoiding of institutional care and potential dependence. Map existing situation and develop proposals for emergency/urgent support e.g. emergency respite or rapid response. Facilitate options for Independent Living Teams to access. To be started. to meet with Somerset Partnership NHS FT to discuss and to include Service Development and Clinical Engagement Manager (CCG), who is supporting work around dementia. 2. Access to support before crisis point No. Action Timescale Led By Outcomes Improve access to support via primary care 2.1 Develop schematic resource describing mental health pathways, referral and signposting options for people in mental health crisis, for inclusion on GP Navigator App in Somerset. October 2016 Somerset Partnership NHS FT and Somerset CCG Improved primary care practice in referral and signposting, reduced level of inappropriate referrals and of secondary care referrals Easy access for GPs to existing information resources e.g. Somerset Choices. To be started. CCG lead GP for Mental Health & Somerset Partnership NHS FT to be engaged in this work. 3. Urgent and emergency access to crisis care No. Action Timescale Led By Outcomes Improve NHS emergency response to mental health crisis
3.3 Develop business case and proposal for crisis/recovery provision in Somerset, providing step up and step down residential facilities to avert admission to hospital and to provide a supported return to home following a period of in-patient treatment. Works alongside crisis resolution and home treatment service. July 2016 Somerset Partnership NHS FT, working with third sector partners and Somerset CCG Reduced need for admissions to hospital. Reduced length of stay for people who do need admission. Improved recovery outcomes and reduced re-admissions. In progress. Mind Taunton and West Somerset also getting views on this from service users. 3.4 Review and develop business case for specialist CAMHS outreach response for young people experiencing a mental health crisis, including out October 2016 Somerset Partnership NHS FT and Somerset CCG Reduced admissions to local CAMHS unit and to out of area provision. More young people supported at home and in the community. Reduced pressure on the on-call psychiatrist cover at night In progress. Business case completed and funding agreed. Initial meeting to develop service specification took place on 27/10/15 and to be completed by 31/12/15.
of hours crisis response protocols. 3.5 Clarify pathways for urgent assessment of children and young people, including management arrangements for out of hours/on call arrangements. October 2016 Somerset Partnership NHS FT Clarity across partners agencies and avoided delays for Children and Young People in mental health crisis. Establish / map operational working links with Children’s Social Care. Tie in with current work in Somerset on developing a 0-25 youth service In progress. Head of Adult Inpatient Services (Somerset Partnership NHS FT) to liaise with Head of Division – Children (Somerset Partnership NHS FT) to arrange for this work to be taken forward. Social services’ contribution to mental health crisis services 3.6 Improve collaborative arrangements in deciding whether an individual requires a Mental Health Act Assessment. July 2016 Somerset County Council Somerset Partnership NHS FT Avon and Somerset Constabulary. Reduce inappropriate use of police cells and arrest powers In progress. Decisions waited re. Triage pilot update, being led by Avon & Somerset Constabulary. 3.7 Disseminate agreement between police and ambulance services to ensure ambulance service March 2015 SWASFT Improved emergency response and arrangements for conveyance. Completed
3.9 Review and refresh the Somerset joint policy guidance for all staff involved in operational mental health crisis response. To include refresh of the joint section 135/136 operating protocol January 2016 Somerset Partnership NHS FT & Avon and Avon and Somerset Constabulary. Ensure that the protocol reflects latest good practice and facilitates improved user experience and outcomes. Clarify agencies’ role when service users are inebriated and/or violent or pose a risk to staff. In progress. Multi-agency review group in place. Meetings taking place from September to end of December 2015 to agree protocol. 3.10 Develop a proposal and business case for a section 136 triage pilot programme 2016 Somerset Partnership NHS FT and Avon and Somerset Constabulary More responsive triage and initial assessment of individuals involved in incidents. Reduced number of detentions under section 136 and therefore reduced demand for places of safety. Identification of multiple detainees enabling follow up work with these individuals. This project will look at potential collaborations between police and ambulance control rooms and coverage across multiple counties; and potential collaborations with other service areas such as substance misuse. In progress. Police exploring a force wide control solution. Local Model also being explored. 3.11 Review current liaison psychiatry arrangements in September 2016 Somerset Partnership NHS FT, Extending psychiatric liaison to a whole hospital, multi-disciplinary approach enabling a holistic response In progress.
Musgrove Park and Yeovil District Hospitals with a view to adopting RAID approach, incorporating facilities within A&E departments for mental health assessments to be managed appropriately by all agencies (whether under MHA provisions or informally) Taunton and Somerset NHS FT, Yeovil District Hospital NHS FT, Somerset CCG to people experiencing mental health crises and averting crises for those at risk Where physical space restrictions limit the availability of rooms, alternative solutions on site will be evaluated Includes identification and escalation of repeat A&E attenders with mental health problems. Awaiting outcome of business case of non-recurring funding. Review of current provision and required model commencing in November 2015. Improved training and guidance for emergency services staff 3.12 Incorporate mental health into workforce development and training plan for police officers April 2016 Avon and Somerset Constabulary See 3.6 In progress. Group wanting to adopt a multi-agency approach. 3.13 Source/develop a training module for roll out to police officers and other professionals, including A&E staff April 2016 Somerset Partnership NHS FT and Somerset County Council See 3.6 In progress. Public Health to commence attendance at Group to take forward action.
who might encounter people in mental health crisis, covering introduction to mental health conditions, Mental Health First Aid and knowledge of relevant provisions of the Mental Health Act Public Health October 2015 College of Policing have revised training for Officers. Network training approach to be taken forward by Subgroup. 3.14 Establish mental health group within SWASFT. Role to include reviewing incidents and complaints, service developments and care pathways. Incorporate mental health training and education internally and within university provision March 2015 SWASFT Increased skills and knowledge of mental health among ambulance personnel, improving patient experience. Opportunities for learning by experience in place and ongoing. 3.15 Review of A&E facilities as designated places of safety July 2016 Somerset Partnership NHS FT, Taunton and Improved understanding and response from A&E department to people in mental health crisis In progress.
Somerset NHS FT, Yeovil District Hospital NHS FT Increased capacity for places of safety in Somerset – as adults stop being detained in cells from 2017. Evaluation of options for detention of children and young people Subgroup to meet and explore options. 3.16 Review transport and transfer protocols for conveyance of mental health patients, or s136 detainees, including transfers between NHS facilities and transport of people from the community to NHS care, including places of safety. Also transfers of children and young people. July 2016 Somerset Partnership NHS FT, SWASFT, Avon and Somerset Constabulary Provides clarity to staff of all agencies, sets agreed response times and reduces delays Includes a review of operational information sharing between crisis service and ambulance NB: Includes an evaluation of alternatives to current expenditure on private ambulances and other possible improvements to conveyance In progress. Transport contract under review, SWASFT lead to keep group updated. AMHP hub to support review/establishing level of need with data provision. Review of Transport for Mental Health patients taking place on 17th December 2015. Improved services for with co-existing mental health and substance misuse issues 3.17 Refresh and roll out joint dual diagnosis strategy and protocol for people with co-existing October 2016 Somerset Drug and Alcohol Partnership via SCC Public Improved outcomes for service users from better collaboration in case management and access to the right service at the right time and in the right place In progress.
substance misuse and mental health conditions, to include young people and adults Health, Somerset CCG, Somerset Drug and Alcohol Service (SDAS), Somerset Partnership NHS FT Somerset Partnership NHS FT has agreed to support as part of a working group. 3.18 Review joint working protocols relating to conveyance of people under the influence of any substance (drugs / alcohol) July 2016 Somerset Partnership NHS FT, SWASFT, Avon and Somerset Constabulary, Somerset Drug & Alcohol Partnership via SCC Public Health Clarity between agencies regarding responsibility for conveyance. Avoided inappropriate conveyances to custody, A&E or places of safety. In progress. To review as part of S.136 protocols and conveyance policies. 4. Quality of treatment and care when in crisis No. Action Timescale Led By Outcomes Review police use of places of safety under the Mental Health Act 1983 and results of local monitoring
4.1 Review alternative section 136 places of safety for children and young people Oct 2016 Somerset Partnership NHS FT Provision of more suitable separate place of safety arrangements for under 18 year olds, leading to improved user experience In progress. Head of Adults Inpatient Services (Somerset Partnership NHS FT) to liaise with Head of Division – Children (Somerset Partnership NHS FT) to arrange for review. Place of Safety subgroup to also explore options. 4.2 Update and improve place of safety environment at Rowan Ward, Yeovil April 2015 Somerset Partnership NHSFT Improved environment for ensuring better separation from ward Complete. Joint Head of Mental Health Services visited POS after last meeting. Service User/Patient safety and safeguarding 4.3 Sharing and dissemination of each agencies protocols and sharing of best practice for the use of restraint in relation to mental health patients. October 2016 Somerset Partnership NHSFT, SWASFT, Avon and Somerset Constabulary 2015 Shared understanding of guidance and limitations on each agency. Dissemination and lesson sharing between agencies and common understanding of DOH guidance on restrictive practice. Avoidance of potential dangers to patients and reduction in complaints. Sharing of approaches on restraint and restrictive practice. In progress. National College of Policing reviewing protocols. Somerset Partnership NHS FT have a protocol and a Positive and Proactive Care Group in place. Joint Forum to be explored.