MACRO PRINCIPLE 1: A locality’s mental health policy is interagency. There are no specific measures relating to this principle. No policy on how a locality will deliver improved outcomes for CYP mental health. Child mental health is not included in the Sustainability and Transformation Plans (STPs) or Local Transformation Plans (LTPs). is no implementation plan in place. There is a policy on how a locality will deliver improved outcomes for CYP mental health. However this is not jointly created with all agencies. There is no clear implementation plan in place sitting alongside this policy. Child mental health is included in either the LTP or STP, but this is not comprehensive. There is a policy on how a locality will deliver improved outcomes for CYP mental health. Creation has involved some of the relevant agencies, but not all. Child mental health is included in both the LTP and STP. There is an implementation plan in place that sits alongside this, however this does not span all agencies in the locality. is a policy statement/ document that clearly articulates the locality’s approach to delivering improved outcomes for children and young people’s mental health. This is jointly created between health, care and education, with clear third sector input. mental health is included in both the LTP and STP. There is a clear plan for implementation
all elements of the localities provision. are no jointly owned outcome frameworks, but there is effort to align these and the board is working towards integration. There is a governance structure that includes each of these and all agencies are regular attenders of joint commissioning board meetings. This governing body has developed joint outcome frameworks to manage their own performance and to support contracting. There are joint budgets in operation. (Example: an effectively functioning devolved
Macro System Considerations (Populations of young people, commissioning and interagency working) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving Practice Level 2 Level 3 Level 4 Practice is very THRIVE-like MACRO PRINCIPLE 3: Contracting of services, and the performance management of these, is informed by quality improvement information There is no regular consideration of the contracts within a locality. There is little consideration of performance or quality data during the commissioning cycle. Providers do not have good systems in place to collate and report the quality data required to enable effective management of the contract. Commissioners have a schedule in place for reviewing contracts. There is some consideration of data and outcomes in the commissioning cycle, but there are problems in accessing the full range of data and quality improvement (QI) information that is needed. This is in part due to a lack of systems within the providers to enable collection and collation of this data. Although there is performance management of contracts using data, the relationship between the commissioners and Commissioners have a schedule in for reviewing contracts. Data and quality information is used well in developing the commissioning and contracts, however there is still some development to do in terms of the collection and reporting of data to support this. There are good relationships between the commissioners and providers, but there are not always established forums that enable the discussion of this data meaning that while it is used to support decisions and contracts, it is Commissioners develop annual commissioning plans taking into account service performance and quality data. There are clear agreements about the use of data within contracts and on-going performance management of these. There are systems in place in providers to collate this data and it is routinely and comprehensively
System Considerations (Populations of young people, commissioning and interagency working) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving THRIVE-like Practice 2 Level 3 Level 4 Practice is very MACRO PRINCIPLE 4: Use of population preference data is used to support commissioning decisions. Preference data is data that is collected on the preferred treatment option that has been agreed on as a result of a shared decision making process. Preference data is not collected, reported on or used by commissioners to make decisions the effectiveness and value of services that are commissioned. Preference data is collected in some services. This is either not reported on, or is not used within the service to support improvement or commissioning decisions. Preference data is collected in most services. This is collated and reported on however it is not yet used within the commissioning cycle to support decision making. Preference data is collected routinely and utilised to support decision making. This includes resource allocation, contract management and the of services. Providers have systems in to collect and report this.
Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 MACRO PRINCIPLE 5: Services working closely together such that service users experience integration of care positively 1 2 3 4 Meso System Considerations (the five based groups of children and young people set out in the THRIVE framework and the services that support them) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving THRIVE-like Practice 2 3 Level 4 Practice is very MESO PRINCIPLE 1: A comprehensive network of community is little effective signposting that is undertaken between the services. Some effective signposting is undertaken, this is not systematised. The network does not include a full There is an established approach to signposting to a network of non-NHS providers locally. The The full range of community providers is known about and actively signposted to. This includes commissioned
providers is in Signposting may happen effectively in isolated but there are no effective systems in place to enable this to happen routinely as part of assessment or ongoing care planning. There is no way for CYP or their families to access information about services locally. range of providers (e.g. it only considers commissioned services) and less than half of local third sector providers are included. There are no established relationships between community providers and those signposting. There is no detailed consideration of referral processes to community providers. network includes the majority of providers and includes both commissioned and services. There is an attempt to build relationships with community providers, in particular those that are commissioned, but there is still work to be done in relation to third sector/other independent organisations. There is a and services provided by independent, third sector, local authority, primary care, education etc. There are good relationships with community providers and criteria for entry and referral processes to those services are known by professionals that are signposting. Professionals undertaking assessments
‘don’t meet their criteria’. There is some evidence of CYP re-presenting for CAMHS assessment due to ineffective signposting, or frustration from community providers due to a high number of inappropriate referrals to them. While the signposting is not perfect, there is some evidence that it is working effectively – referrers do not have their referrals returned without advice on what services are helpful, and community providers are not overwhelmed with inappropriate referrals due to lack of understanding of their service criteria. information to be able to support them to access these services themselves. Community providers don’t feel that there are a large number of inappropriate referrals into their services as a result of ineffective signposting, and there are not a high number of to CAMHS as a result of failed signposting.
Rating Circle the rating that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes MESO PRINCIPLE 1: Comprehensive network of community providers is in place 1 2 3 4 Meso System Considerations (the five needs based groups of children and young people set out in the THRIVE framework and the services that support them) THRIVE Principle Measure used relevant) Level 1 Some way to go to achieving Practice Level 2 Level 3 Level 4 Practice is very THRIVE-like MESO PRINCIPLE 2: Quality Improvement (QI) data used to inform decisions, and this involves multiagency consideration of the data MINDFUL approach (CORC mindfulness measure): The following elements of the measure are relevant to the Meso system and would ideally be present in a THRIVE-like system: 1. Outcome and process measures are collected routinely and used to help shape service provision. 2. There is an outcomes framework that addresses all the THRIVE-groups. 3. Data is collated and feedback to staff to support QI work. No elements of the Mindful approach are reliably in to enable QI data to be used to inform service data. Two areas of the Mindful approach are reliably in place to enable QI data to be used to inform service data. Three areas of the Mindful approach are reliably in place to enable QI data to be used to inform service data. Four or five areas of the Mindful approach are reliably in place to enable QI data to be used to inform service data.
Some way to go to achieving THRIVE-like Practice Practice is very THRIVE-like MESO PRINCIPLE 3: Help is delivered the conceptual framework of five needs based groups A: A THRIVE would be classed as having been implemented if CYP managed in the locality are identified as being in one THRIVE group, and services are organised to deliver care according to the needs of CYP in the respective None or only one of the THRIVE groups are fully implemented. There are plans to transform services according to THRIVE principles but implementation is not yet underway. There are plans for the approach to be multi-agency but implementation has not reached all agencies as yet. At least two THRIVE groups are fully implemented. The implementation has not fully involved all agencies at this stage, although plans are in place to enable this. Informatics are not established within the services yet and so reporting according to THRIVE remains problematic. The THRIVE groups are implemented for the most part and there are clear services that enable the delivery of care according to the needs identified in these groups. Implementation includes all agencies but it may not be fully mature in all of them. Assessment of need is established and CYP are able to access care according to the THRIVE groups as a result of that assessment. All of the THRIVE groups are fully implemented. Implementation includes all agencies. Services are organised to deliver care according to the five groups. There is an effective assessment process that enables CYP to be signposted into the right THRIVE group for them. There is a way of recording this in electronic patient records.
The information systems are not fully in place which means that performance management according to THRIVE groups is currently being established. It is possible to report on the activity and outcomes for each of the THRIVE groups. B: Staff survey The staff survey demonstrates that 20% staff across the locality agree that care is being delivered according to the THRIVE needs groups. The staff survey demonstrates that 40% staff across the locality agree that care is being delivered according to the THRIVE needs groups. The survey demonstrates that 60% staff across the locality agree that care is being delivered according to the THRIVE needs groups. The staff survey demonstrates that 80% staff across the locality agree that care is being delivered according to the THRIVE needs groups. Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes MESO PRINCIPLE 3A: Help is delivered using the conceptual framework of five needs based groups 1 2 3 4
Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes MESO PRINCIPLE 4: on strengths and family resources wherever possible 1 2 3 4 Meso System Considerations (the five needs based groups of children and young people set out in the THRIVE framework and the services that support them) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving Practice Level 2 3 Level 4 Practice is very MESO PRINCIPLE 5: Evidence based practice is available and aligned to need using the 19 sub categories of needs Evidence of alignment of therapy with guidance, where clearly relevant (e.g. CBT for anxiety) Evidence of alignment of therapy with guidance, where clearly relevant (e.g., CBT for anxiety) Evidence of alignment of therapy with guidance, where clearly relevant (e.g., CBT for anxiety) Evidence of alignment of therapy with guidance, where clearly relevant (e.g., CBT for anxiety)
as set out in the payment systems work is achieved for at least 20% of relevant cases. is achieved for at least 40% of relevant cases. is achieved for at least 60% of relevant cases. is achieved for at least 80% of relevant cases. Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 MESO PRINCIPLE 5: Evidence practice is available and aligned to need using the 19 sub categories of needs as set out in the payment systems work 1 2 3 4 Micro System Considerations (relationships between professionals and CYP and inter-professional relationships) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving THRIVE-like Practice 2 3 Level 4 Practice is very THRIVE-like PRINCIPLE 1: Shared Decision Making A: Measure of extent of implementation CollaboRATE has not been implemented. SDM is not articulated in the strategy. CollaboRATE has not been fully implemented. SDM is a part of what the locality aspires to deliver, but this has not been fully CollaboRATE has been implemented systematically in at least one setting. SDM is articulated in the strategy of the local area. CollaboRATE has been implemented in local authority, third sector and healthcare settings.
(where relevant) Some way to go to achieving THRIVE-like Practice Practice is very MICRO PRINCIPLE 3: People (staff, CYP and families) are clear about for help and reasons for ending A: survey – 50% staff must have completed the survey. survey (min. 50% completion rate): 20% staff agree that there are clear parameters for the length of treatment, and that clear reasons for ending are set out at the beginning of therapy. Staff survey (min. 50% completion rate): 40% staff agree that there are clear parameters for the length of treatment, and that clear reasons for ending are set out at the beginning of therapy. Staff survey (min. 50% completion rate): 60% agree that there are clear parameters for the length of treatment, and that clear reasons for ending are set out at the beginning of therapy. Staff survey (min. 50% completion rate): 80% staff agree that there are clear parameters for the length of treatment, and that clear reasons for ending are set out at the beginning of therapy. B: Reasons for ending proforma and information for patients. Reasons for ending proforma: 0-40% of case notes have the reasons for ending proforma Reasons for ending proforma: 40% - 59% of case notes have the reasons for ending proforma Reasons for ending proforma: 60-79% of case notes have the reasons for ending proforma Reasons for ending proforma: 80-100% of case notes have the reasons for ending proforma
MICRO PRINCIPLE 4: Outcome data is used to inform individual practice with the purpose of improving quality Routine outcome data refers to the clinical data identified as part of CYP IAPT Routine outcome data is not collected, and it is not used as part of QI processes within providers. There are no systems in place to enable the collection of routine outcome data – it is not an explicit part of the organisational strategy and QI is not really a part of the organisation’s culture. Many have not had QI training. Routine outcome data is not collected regularly in most parts of the service. Services have plans to collect data routinely and use this to inform individual practice. This does happen in isolated areas but it is not yet a part of the organisation’s culture. Many staff have not had QI training. Routine outcome data is collected and utilised to support QI processes within providers in most services. The systems in place to enable data collection exist in many services, but this is not or across all provider types. Data is used to inform individual practice but this is not standardised across services. Most staff are familiar with QI approaches and have some experience in the use of a standardised QI methodology. Routine outcome data is collected and utilised to support QI processes within providers. There are systems in place to enable this – it is part of the organisational strategy and there are specific times and places (e.g. a team meeting, or during supervision) where outcomes and any variations in outcomes between teams or individuals are discussed. QI is a part of the approach of all provider in the locality. Staff are familiar with QI approaches and feel confident in the use of a standardised QI methodology. Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes MICRO PRINCIPLE 4: Outcome data is used to inform individual practice and improve quality 1 2 3 4 Micro System Considerations (relationships between professionals and CYP and inter-professional relationships) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving 2 3 Level 4 Practice is very
THRIVE-like Practice MICRO PRINCIPLE 5: Any intervention would involve explicit agreement from the beginning about the outcome being worked towards and the likely timeframe. There would be a plan for what happens if it is not achieved. A: Audit Case audit: CYP and their families are managed within the recommended number of therapy sessions. Case audit: 40-59% CYP and their families are managed within the recommended number of therapy sessions. Case audit: 60-79% CYP and their families are managed within the recommended number of therapy sessions. Case audit: 80-100% CYP and their families are managed within the recommended number of therapy sessions. B: Audit Case in 0-39% of notes, the goals and expected outcomes for treatment are discussed with CYP and their families and recorded in notes. There is a plan in place for what happens if this is not achieved. Case audit: in 40-59% of notes, the goals and expected outcomes for treatment are discussed with CYP and their families and recorded in notes. is a plan in place for what happens if this is not achieved. Case audit: in 60-79% of notes, the goals and expected outcomes for treatment are discussed with CYP and their families and recorded in notes. There is a plan in place for what happens if this is not achieved. Case audit: in 80-100% of notes, the goals and expected outcomes for treatment are discussed with CYP and their families and recorded in notes. There is a plan in place for what happens if this is not achieved. Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes
Rating Circle the rating level that best describes your service. Capture key points in the deliberation and note particular areas of strength or opportunities for improvement. THRIVE Principle 1 2 3 4 Notes MICRO PRINCIPLE 6: The most experienced practitioners inform advice and signposting 1 2 3 4 Micro System Considerations (relationships between professionals and CYP and inter-professional relationships) THRIVE Principle Measure used (where relevant) Level 1 Some way to go to achieving THRIVE-like Practice 2 3 Level 4 Practice is very THRIVE-like MICRO PRINCIPLE 7: THRIVE plans are used to help those managing risk Audit Case audit: 0-39% of CYP in the ‘Getting Risk Support’ needs based group have a THRIVE plan documented and up to date. Case audit: 40-69% of CYP in the ‘Getting Risk Support’ needs based group have a THRIVE plan documented and up to date. Case audit: 60-79% of CYP in the ‘Getting Risk Support’ needs based group have a THRIVE plan documented and up to date. Case 80-100% of CYP in the ‘Getting Risk Support’ needs based group have a THRIVE plan documented and up to date.