that respond to gaps identified. 4 New Action Review service pathways to ensure parity of esteem for people with mental health, physical health and substance misuse. Actively address inclusion for homeless people and foreign nationals. March 2017 NWL, CNWL, WLMHT, CCG Commissioners Service users/carers W L Collaborative /MAD Alliance Local Authority Leads New action Cross reference Section 4 Ref 1 5 Service specifications for Urgent Care is included in 2016/17 contracts. March 2017 NWL Contract leads CCG Commissioners Existing service specification to be discussed with providers for agreement to include in 16/17 contract. WLMHT Urgent Care service specification included in 16/17 contract Action S&T PM’s to liaise with NWL Contract Leads 6 Service specification and service outcomes to be monitored in accordance with operating performance and quality contract process March 2017 NWL Contract leads CNWL, WLMHT CCG Commissioners NWL contract and performance team Action S&T PM’s to follow up with NWL Contract Lead 7 Development of system level’ care pathway for access to secondary mental services, including urgent and emergency access Development of success criteria, in terms of process and system change, outcomes (or proxy outcomes), with supporting framework for March 2017 CNWL, WLMHT CCGs, Service users/carers W L Collaborative/MAD Alliance Voluntary Sector Business cases completed and signed off via governance processes CNWL area (June 2015) & WLMHT area (September 2015). Pathway review/development in process Action Evaluation of impact and QA of Rapid Response Services to be reviewed via joint working with CNWL ,
New Action across 8 CCGs to review progress and disseminate learning and good practice Service users and carers W L Collaborative/MAD Alliance CCG Commissioners NWL S&T PM’s S&T PM’s to review original baseline data for source and update baseline via working group. Objective 2 - Prevention, Early Intervention and Support to de-escalate or resolve crisis without referral Ref Actions and milestones By when By whom RAG Action 1 Single of access per Trust/CCG/Borough, 24/7/365, providing expert advice and support for all external agencies, users and carers, and with direct access to known patient records and ability to book an initial emergency, urgent or routine or assessment. 2016 CNWL, WLMHT SPA implemented for CNWL area 3/11/15 CNWL rapid response services 90% in place by 3/11/15. CNWL teams continue to relocate to new bases until 29/2/16 WLMHT Implementation Q4 2015 Action remains open but expect to close end of quarter 1 and RAG Green 2 Review of support and information for carers when family/friends are in crisis. Recognise carers as partners. What needs to happen to maintain carer wellbeing when the person they care 2017 CNWL, WLMHT CCG Commissioners Local Authority Leads Carer Groups Service users and carers Action Urgent care service specification to be reviewed for carer well being. Focus groups and one – one focused interviews with carers to be arranged Consider models of good practice e.g.’Triangle of care’
Action close this action and set new action and milestone for training 7 on Police liaison and diversion pilots; explore commissioning opportunities to expand police liaison and diversion capacity. March 2017 CCGs, CNWL, WLMHT W L Collaborative/MAD Alliance MH Trusts and CCG Commissioners are waiting to hear of the outcome of future funding from NHS BY 31/3/16. WLMHT considering options for ‘street triage ‘models. NWL represented on NHSE Liaison & Diversion Strategic Advisory Board. Research of other models to be undertaken for comparative analysis ( WL Collaborative and members of MAD to undertake the research) Link with item 9 re Street Triage) Action on-going 8 Review alternatives to beds when a person is in MH crisis. Research best practice models of Crisis House care March 2017 CCGs. CNWL, WLMHT, Service users/carers Action explore options alternatives to in-patient services. Research proven models of care for alternative provision 9 Review models of Street Triage and consider options 2017 CCG Commissioners CNWL, Service users/carers Link with item 7 -Research other models Objective 3 - Access to emergency urgent and routine assessment and care
Ref Actions and milestones By when By whom RAG Action 1 New Action Review access to urgent care standards for quality and service user/carer feedback. Link this action to ‘I’ statement Making sure people with mental health problems can get help 24 hours a day and that when they ask for help, they are taken seriously March 2017 CCGs Trust, Service users/carers W L Collaborative/MAD Alliance Review as part of the formal contractual quality and performance schedules. Consider formal evaluation Agree methods and mechanisms to share service user and carer feedback. West London Collaborative and MAD members to discuss options/methods for gathering feedback and reporting on outcome to service providers and commissioners. New action Red as not commenced 2 24/7/365 community emergency assessment to take place in a ‘where clinically appropriate’: a safe place, defined by user/carer/referrer, typically away from secondary mental health or acute hospital settings: Assessment to be focused on recovery and information to support and sustain recovery should be clearly communicated and documented. March 2017 CNWL, WLMHT Service users/carers W L Collaborative/MAD Alliance Action review as part of evaluation of Rapid Response implementation and evaluation process Action feedback from service users and carers on effectiveness to be captured and reported to appropriate forums. 3 Joint plan with Children’s and Young People’s Service commissioners and providers to secure appropriate crisis MH March 2017 CAMHS Commissioners & CNWL, WLMHT CAMHS Out of Hours pilot launch: CNWL area Jan 2016; WLMHT area Feb 2016 The agreement to secure community and in-patient crisis treatment and crisis MH services for young people is covered in the
services for young people, in particular those in transition (16-18) or considered vulnerable (e.g. looked after children, offenders) ( joint NWL Transformation Plan (priority 7) which is currently in planning phase. CNWL working to develop SPA for CAMHS Action S&T PM’s to update and review in line with NWL Transformation Plan 4 Availability of prompt formal Mental Health Act Assessments by s12 doctors and Approved Mental Health Professional (AMHPs), in line with the RC Psychiatry Standard < 3 hours unless there are clinical grounds to delay it. March 2017 CNWL, WLMHT & LAs No known issues with delays in MH assessments. WLMHT have duty rota in place which covers 24/7 availability. CNWL contact available doctors from list held by AMPHS. Action to continue remain as amber 5 Development of s136 protocols, from first identification of a potential detainee, through referral and possible detention, that secures active engagement from crisis mental health and social care services, and an appropriate onward pathway to a place of safety or ward, thereby minimising or eliminating such use of custody suites (>50% reduction by 2014/15). March 2017 NHSE & Pan London Op Group Action MH PM’s to obtain update from Pan London Op Group. The sharing of s136 data needs to be available and reported to appropriate governance forums. Information and update received 23/3/16 6 Appropriate health transportation: should services users (and their carers) need to be March 2017 NHSE; Pan London Op Group; LAS Lead Commissioner Stakeholder briefing produced 2015 NHSE are/ or have been working with LAS and commissioners to review current
transported in an emergency, or routinely, either to access their treatment or whilst in treatment, patients and carers will feel that is safe, appropriate and timely NWL, CNWL, WLMHT transport arrangements and explore new ways of service delivery. LAS are currently piloting a new pathway for detained patients in Camden & Islington using their Non-Emergency Transport Service (NETS) with view to rolling out NETS as the new provider across London. (NHSE update 23/3/16) On-going action 7 Emergency Departments and Wards across NWL will have access to high quality, timely and effective Liaison Psychiatry Services aimed primarily at those with primary physical and secondary mental health presenting issue. Those services will arrange seamless referral into mental health services for those with emergency/urgent needs where this is indicated. March 2017 CNWL, WLMHT CCG Commissioners Service specifications in place for LPS services across NWL On-going review for quality and effectiveness Stocktake of issues that arise from acute reconfiguration Action S&T PM’s to follow up on progress Objective 4 – Availability & Quality of Treatment and Care when in crisis Ref Actions and milestones By when By whom RAG Action
1 'Parity of esteem’ in the commissioning and delivery (quality, impact, cost effectiveness and availability) of specialist mental health services for those in a mental health crisis, their carer’s and their GP, including, but not limited to, (ageless) home treatment services; PICU; acute (functional) NHS places of safety; crisis/recovery houses). 2017 CCGs, CNWL, WLMHT On-going action to deliver ‘Parity of esteem’ Action rolled over date revised – cross reference with Section 1 Ref 4 2 Clear agreements with Children’s & Young People’s Commissioners and Providers to secure appropriate services for children’s and young people’s community and in-patient crisis treatment. March 2017 CCGs, CNWL, WLMHT NWL Transformation Plan (priority 7) which is currently in planning phase will address crisis treatment for children and young people. Review MH Transformation Plan and update this plan as appropriate Action S&T PM’s to update and review in line with NWL Transformation Plan 3 In-patient facilities and transport services minimise use of, and operate, control and restraint in line with the Code of Conduct March 2017 CNWL, WLMHT Action to remain Completion date revised S&T MH PM’s to update Objective 5 – Staying Well: user and carer support, ‘treatment start to GP transfer’ – for recovery and ‘harm minimisation’
Ref Actions and milestones By when By whom RAG Action 1 Discharge plans routinely created to include ‘staying well’ component; all parties to enacting the plan are involved (as far as possible) and are aware of their roles. March 2017 CNWL, WLMHT Service users/Carers W L Collaborative/MAD Alliance NWL Contract and performance team Action All section 5 objectives to be reviewed with service users/carers for actions and milestones NWL Contract leads to progress inclusion in quality schedule S&T PM’s to liaise with NWL Contract West London Collaborative and MAD members to look at existing mechanisms for ‘ staying well’ 2 All services users who have had a crisis episode are offered a ‘Crisis Plan’, in line with the NICE Quality Standard 14 - Crisis Planning. March 2017 CNWL, WLMHT As above 3 Named Worker, 24/7/365, for safe & rapid crisis advice and support for the user, carer and GP, in place for a clearly defined (and accepted) period following discharge from secondary to primary. March 2017 CNWL, WLMHT Service users /Carers W L Collaborative/MAD Alliance NWL Contract and performance team As above W L Collaborative to link with WLMHT Pathway review lead to see if named worker is included. S&T PM’s to review original business case submissions to see if workers was included as service development, 4 Availability of Tier 0 and 1 (self-help/guided support) to promote recovery, avert crises and increase the protective factor of social integration. March 2017 CNWL, WLMHT SU’s/Carers NWL Contract and performance team As Above