and Referral Service 3. Urgent and emergency access to crisis care No. Action Timescale Led By Outcomes Summary progress against actions (include outcome measures where relevant) (RAG) Improve NHS emergency response to mental health crisis 3.1 Review with social services, police, and ambulance, what training should be developed. March 2017 AWP/MH Bristol Crisis training is being considered in 136 operational pathway group 3.2 Co-produce reviews of local crisis house provision to include quantitative data and experience information July 2017 Bristol CCG in partnership with Missing Link and St Mungos Broadway A safe, less restrictive, alternative to hospital admission for those in a mental health crisis. Review to be completed between February – July 2017 This will consider how we can maximise our resource as part of our local crisis pathway including whether additional beds can be commissioned. agency
from users and stakeholders 3.3 Investigate the need for a safe place for and subsequent MH assessment for people in MH crisis who are intoxicated 2017 Bristol Bristol Reduction in an inappropriate use of S136 suite and ED (Emergency Department), improves assessments Reduction in resources wasted by partner agencies ‘containing’ very intoxicated individuals This is being considered as part of the section 136 work across BNSSG (Bristol, North Somerset & South Gloucestershire) and Bath Swindon and Wiltshire. This work is expected to be complete by March 2017 but will in part be dependent on the availability of resources. 3.4 Improving Acute services/ED response to mental health crisis by high quality extended hours liaison psychiatry services Ongoing with ambition for core 24 by April 2018 Bristol CCG/UHB and North Bristol Trust Promote parity of esteem by establishing a high quality response to mental health crises presenting in ED (Emergency Department) and Acute hospital wards. Services are of a high quality by PLAN (Psychiatric liaison network) A bid has been made to start core 24 psychiatric liaison in April 2018 for UHB (University Hospital Bristol) and NBT (North Bristol Trust). We expect to hear the result of this in April 17 and use the intervening year to build up the service including improved data collection and crisis response in EDs (Emergency Department).
commissioning 3.9 Improve police, ambulance, acute hospitals and non-statutory staff awareness of mental health Ongoing Bristol Mental Health Service users experiencing a MH crisis are treated with greater sensitivity by all stakeholders involved in their pathway Providers of services in crisis pathway are better informed and supported to deal with people experiencing a MH crisis Crisis training is being considered ac part of the section 136 work. In addition Bristol Mental Health System Leadership have completed an initial evaluation of staff confidence and experience of crisis services and this could be repeated at a future point Improved services for those with co-existing mental health and substance misuse issues Review training within access teams and links with specialist substance misuse services. April 2015 AWP Safer Bristol Improve response to service users presenting with substance misuse or dual diagnosis crises. Reduce rates of inappropriate s136. Improve service user safety. To be started Mental health commissioners are closely involved in the City council’s re-modelling and of substance misuse services and are looking at opportunities to commission an improved service for people with a dual diagnosis 4. Quality of treatment and care when in crisis No. Action Timescale Led By Outcomes Summary progress against actions (include outcome measures relevant) (RAG)
4.1 Continue to develop our local crisis team through analysis and action planning from user experience work Ongoing Bristol CCG and MH Bristol A safe, less restrictive, alternative to hospital admission for in a mental health crisis. Ongoing The Concordat partnership will consider user experience information relating to the crisis team and identify actions. This should include the level of self or carer referral. 4.2 Continue work with CCG in reviewing the current provision and use, for mental health crises in AWP. Ongoing AWP (Avon & Wiltshire Bristol Less people have to go out of area to receive treatment Better experience for service users and carers Better outcomes for service and carers Avon & Wiltshire is continuing work to review and redesign their acute care pathway Bristol CCG has opened an step down ward ‘Larch’ which is designed to support improved flow through acute wards and improved capacity. In addition the CCG will be completing a project to reduce Delayed Transfers of Care for people leaving hospital to improve the number of beds available
No. Action Timescale Led By Outcomes Summary progress against actions (include outcome measures relevant) (RAG) 4.3 Assessment and Recovery teams to ensure all service users are offered time to complete a crisis, relapse and contingency plan or plan. April 2015 MH Bristol Improve interventions to prevent crises. By providing good quality Recovery orientated care crises will be reduced in frequency and/or severity. By intervening effectively in the pre-crisis stage mental health crises will be avoided This is monitored on a monthly Those on CPA (Care Programme Approach) have crisis plans and the teams are working to address those not on CPA (Care Programme Approach) now. We are expecting to be able to launch crisis cards for those within secondary services that will allow people to record information about what keeps them well, who supports them and who they can go to when they need help. 4.4 Psychiatric Liaison to develop personal support plans which are given to patients and sent to GPs 2015 2016 Psychiatric Liaison services at UHB (University Hospital Bristol) and NBT (North Improve opportunities for for those using psychiatric liaison services Provide potential of improved follow up for those using crisis services Work is ongoing as part of our review of mental health in EDs (Emergency Department). In addition we have been implementing specific support plans for repeat attenders at A&E in conjunction with the sanctuary and street triage services.