12 Increase Home Treatment Team Capacity From Dec 2014 to March 2015 Oxleas NHS FT Recruit 2 band 6 CPN / social workers to increase crisis care capacity to avoid admissions and also to increase in reach to the wards to facilitate early discharge. Extend capacity out of working hours to improve access to crisis need to include evenings and weekends Ensure Primary care has immediate access to making referrals to these resources Recruitment completed – improvements were evidenced during the winter pressures period as an outcome of the additional resources. Monitor the outcome of the MH re-design during 2016/17 to evidence and map improvements in community provision. Social services’ contribution to mental health crisis services 13 Increase support to adults with enduring mental health living in the community to prevent relapse and avoid crisis and admission From Dec 2014 to March 2015 LBB MCCH Additional resource from NHS Bexley CCG transferred to brokerage service to provide additional support to adults in the community Reduction of crisis referrals Reduction of admission to bed based services and / or crisis beds Work completed during the winter pressures period. Some evidence to show positive outcomes and reduced use of crisis beds MHG Placements and Advisory Panel will continue to engage health and social care through integrated commissioning to maximise the resources available to those in crisis and avoid admissions. Improved quality of response when people are detained under Section 135 and 136 of the Mental Health Act 1983 No. Action Timescale Led By Outcomes Actions to Date Follow up RAG 14 Consider the opportunities for a detention suite to be established within Bexley at the Woodlands Site From Feb 2015 Oxleas NHS FT Ensure parity of the provision of an appropriate provision Reduction of Out of Borough admissions and associated costs to the CCG and LBB economy Improved timely access to local services and reduced transfers of care across geographical boundaries MH re-design underway during 2015/16 Need to review requirements during 2016/17. Currently, capacity is meeting demand for services without a service in Borough however continued monitoring will help inform need. 15 Ensure all Approved Mental Health Professionals maintain From April 2015 Oxleas NHS FT LBB All Approved Mental Health Professionals meet the legal competency requirements Development is undertaken in line with personal Ongoing monitoring will be devolved to local managers within health and social care.
competence through an agreed Development programme Mental Health Act assessments are undertaken in a timely fashion in accordance with the legislation / Code of Practice development plans. Assessments are completed in a timely manner Review of Section 12 Doctors provision to be undertaken in Quarter 4 2015/16. Improved information and advice available to front line staff to enable better response to individuals 16 Independent Mental Health Advocacy service information material to be available to patients and front line staff From April 2015 LBB Oxleas NHS FT MIND in Bexley Improved awareness and understanding of the IMHA role. Increase in referrals for clients to the IMHA service ensuring service user involvement in decisions affecting their lives. Ensure that information is available to all patients and staff across all services Continued promotion of IMHA has been successful with all services ensuring offer of advocacy. Re-tender of services to commence in 2016/17 and continued monitoring of update to be monitored through contract monitoring review meetings. 17 Raise awareness of services and approaches available to people in mental health crisis From April 2015 NHS England CCG Primary care services know how to support their patients at time of mental health crisis GP Education and training in MH to be supported by NHSE New GP Mental Health Lead to be appointed to the Bexley MHSPG New MH GP lead yet to be appointed following unexpected move out of Borough by the current lead. Recruitment process underway for MH GP lead. Update required from NHSE on primary care support. Ongoing support and local interaction with primary care to continue Improved training and guidance for police officers 18 Ensure all officers undertake mental health training within the context of a rolling programme to be agreed From 2015 Oxleas NHS FT LBB- Community Safety Group Increased awareness of mental health issues for police officers leading to more personalised and sensitive responses Improved referral and return rates to avoid detentions Reduction to zero of police cells used to detain MH patients Oxleas have been undertaking MH and therefore outcomes will be reviewed at year end 2015/16 Audit of use of police cells for Bexley patients to be completed at year end 2015/16. Improved services for those with co-existing mental health and substance misuse issues
Referrals to community services promptly will reduce risk of Understanding patient’s patterns will help development of pathway plans for better management to prevent attendance monitoring will continue. commissioning Core 24 MH liaison services. End of year review in Quarter 4 15/16 of frequent attenders at A&E to identify support mechanisms required to reduce impact and sustain community stability 22 Thorough routine review of incidents, accidents and complaints through CQRG to identify and reduce patterns / of prevalence From Jan 2015 CCG Oxleas NHS FT All Providers Reduction in the number of incidents, SUI’s and reportable events across all providers Improvement in service quality will lead to reduced vulnerability of patients and more effective interventions Better use of advocacy services by patients and carers will help inform service improvement Review of all incidents undertaken through contract monitoring and quality review of service providers through the CCG quality and governance team. Continued monitoring within proven frameworks will continue – the CCG has adopted a three Borough approach to review of (jointly commissioned) providers to ensure holistic review of service provision Staff safety 23 Thorough routine review of incidents, accidents and complaints through CQRG to identify and reduce patterns / areas of prevalence From Jan 2015 CCG Oxleas NHS FT All Providers Reduction in the number of incidents, SUI’s and reportable events across all providers Improvement in service quality will lead to reduced vulnerability of staff and more effective interventions As As above Primary care response 24 Increased use of IAPT services for both new and existing patients relevant to presenting need From Jan 2015 NHSE CCG MIND in Bexley Improved access to IAPT will reduce risk of relapse Addressing the presenting need in the context of long term MH needs will enable a focussed intervention relating to the patients’ needs at that time and make best use of resources IAPT activity has been on an increasing trajectory and additional resourcing has supported further improvements. All ‘shadow’ access and Continued contract monitoring and quality review and impact of additional resources deployed to be monitored to ensure performance outcomes across all aspects are being achieved.
waiting time targets are being achieved and exceeded however work still to be done on slight shortfall of recovery rates 25 Engagement of an additional GP Mental Health Lead within Bexley From March 2015 CCG Improved GP awareness, evidence and response to patients with mental health needs at risk of crises/relapses Recruitment for a short period achieved however GP moved out of the Borough Recruitment drive to secure another GP MH lead is underway Recovery and staying well / preventing future crisis No. Action Timescale Led By Outcomes Actions to Date Follow up RAG Joint planning for prevention of crises 26 Information regarding the Mental Health Advocacy service and the Carers Groups to be widely distributed across all patient facing and teams From April 2015 CCG LBB Oxleas NHS FT Engage with service users to raise their awareness of or alternative services, increasing their choices and improving their knowledge of their rights Cope with a crisis at home without involving emergency services and escalating Carers respond in a calm way with support to help reduce the stress for the service user Following MH service re-design and consultation with carers, continued positive promotion continues Engagement with Carers (independent Carers Support Worker) will continue to be monitored and ensure that Carers access information readily 27 Monitoring of the crisis rehabilitation service at Chapel Hill to evaluate demand and planning for 2015/16 to ensure capacity From Dec 2014 CCG MCCH Appropriate number of short term crisis beds available to meet demand Rapid turnaround of patients to return to the community Reduction of patients presenting at A&E Reduction in admissions and maximise use of community resources Service has been accessed appropriately during 2015/16 (YTD) further Update and demand to be reviewed at year end 2015/16 and outcomes incorporated into commissioning plans for 16/17 as needed to meet the demand for crisis beds and respite. 28 Promote and extend the use of Advance Care Plans, Crisis Plans From April 2015 CCG LBB All Providers All known service users will have a future crisis plan that lessens the likelihood of a repeat crisis and ensures Review to be undertaken at year end 2015/16. To be confirmed following year end review.