Localities do not need to use this template if they do not wish – it is intended as a guide. Commissioning to allow earlier intervention and responsive crisis services No. Action Led By Outcomes Summary progress against actions (include outcome measures relevant) (RAG) Matching local need with a suitable range of services 1 Plan a crisis concordat workshop involving partners from the Local Authority Ambulance Service Homerton University Hospital NHS Foundation Trust, Tavistock & Portman, City and Hackney MIND and Housing Services By 31st 2015 C&H CCG MH Programme Board Produce a draft Crisis Care Local Action Plan with input and agreement from local partners All work streams allocated to relevant partners for review and agreement Where gaps exist, clear recommendations are made to inform future discussions and commissioning plans complete Crisis Concordat workshop arranged for 11.11.15. Workshop will establish a draft Local Action Plan to be refined in subsequent meetings. 2 Provide a single point of access - City and Hackney Adult Mental Health Referrals and Assessment Service (CHAMHRAS), to all agencies wishing to refer into secondary mental health. complete East London NHS FT All agencies wishing to refer to Adult Mental Health Services will have contact details for a single point of access to refer patients to. This single point of entry will ensure appropriate triage, service delivery or referral on to another service where appropriate Complete – CHAMRAS operates as a single point of access. 3 Develop 24/7 crisis line On-going Expected date of ELFT and CCG All residents, health workers and local partners including police, local ambulance Crisis line went live in August 2015
11. People in crisis who access the NHS via 999 can expect need to be met properly On going City and Hackney CCG, Local Authority and local partners LAS and police can refer directly to HTT and CHAMHRAS Advice and support from in ED Proposed 24/7 crisis line Improved into LAS training Could be enhanced if OOH with LAS LAS and police can refer directly to HTT and CHAMRAS and HTT. There is advice and support on the phone in ED The Crisis line is live Direct telephone are being strengthened between 999, ELFT, HUH and OOH with warm transfers. 12. Develop communications plan around access June 2015 CCG and LA Regular updates from providers to primary care in order to keep GPs informed Websites services directory distributed to social care providers CCG services directory was updated to include Crisis line. ELFT Website updated to include crisis line GPs informed of changes Improving Partnership working in City and Hackney 13 Section 75 agreement with local authority providing joined up health and social care On-going ELFT and Local Authority Already in place Completed 2. Access to support before crisis No. Action Timescale Led By Outcomes Summary progress against actions (include outcome measures where relevant) (RAG)
19 People in crisis should expect that statutory services share essential information about their needs. August 2015 City and Hackney CCG and Local Partners Police liaison officer for forensic information Information accessed via CHAMHRAS or currently OOH via Duty Senior Nurse or HPM. Proposed crisis line used to share vital information Training initiatives such as PREVENT and Safeguarding in Access to LBH database No shared database with other services. There is a police liaison officer for forensic information Information is accessed via CHAMRAS or HPM The Crisis Line is in place and shares information Training initiatives are in place There is still no shared base of all information but MERLINs are shared. 20 Liaise with Police Mental Health liaison representative to review section 136 June 2015 City and Hackney CCG and Local Partners Section 136 Protocols in City and Hackney adhere to national standards and are followed appropriately on the ground. No use of police cells, place of safety fro assessments is outside A&E provision Section 136 protocols adhere to national standards operationally. Police cells are not used as a place of safety and there is a place of safety provided outside A&E provision by the HPM service. 21 All healthcare, local authority and community partners staff will have the right skills and training to respond to mental health crises appropriately On going City and Hackney MIND/ELFT via the primary care Professional mental health awareness training is available and accessible for all healthcare providers, local partners including police, local ambulance services, housing services and solicitors Home Treatment Team (HTT) has Training has been provided to the Police by ELFT however the Police also have their own training. No training has been provided to the ambulance service. The HTT has monthly teaching sessions and supervision. The HTT has a monthly systems review. Staff are trained in the recovery model.
induction/monthly supervision and teaching sessions HTT has monthly social systems case review Recovery training is rolled out to all staff Primary care contract with the CCG requires mandatory mental health training, including a module on risk and crisis The primary care contract now has a mandatory module on mental health risk and crisis. Improved training and guidance for police officers 22 ’Police are supported by health services, including mental health services, ambulance services and Emergency Departments On City and Hackney CCG, Local Authority and Police Homerton Psychological Medicine Section 136 suite AMHP service 24/7 Joint S136 protocol lays out response times and responsibilities of NHS/ Social Services and police. Under 18s sent to Coburn or Starlight unit HUH. Free Police training offered 15 by CCG Joint 136 protocol need to set out more clearly response times for police NHS Social services and police. Free police training is available 23 When people in crisis appear( to health or social care or to police, ambulance, fire services) to need June 2015 City and Hackney CCG and Local Partners AMHP 24/7 duty doctors during office hours, GOSH SpR/Consultant OOH. The AMHPs service is 24/7 however delays have been reported in the AMPHs service due to lack of capacity. There is a PREM to measure the assessment process however it does not capture all parts of the pathway.
urgent assessment, the process should be prompt, efficiently organised, and carried out with respect Improved services for those with co-existing mental health and substance misuse issues 24 Develop crisis pathways and crisis care plans for those with dual diagnosis of MH and substance misuse issues June 2015 City and Hackney CCG and HUH Close links established with Substance Abuse Unit, HUH substance misuse team, Lifeline. assessments in Emergency Department of intoxicated service users Treatment of substance misuse patients on par with those without substance misuse issues There are close links established between Substance Abuse Unit, HUH, substance misuse team and Life Line. However clearer pathways need to be developed for dual diagnosis and substance misuse. There are joint assessments in the ED Department It is not clear whether parity of esteem has been achieved. 4. Quality of treatment and care when in crisis No. Action Timescale Led By Outcomes Summary progress against actions (include outcome measures where relevant) (RAG) Service User/Patient safety and safeguarding 25 People in Crisis who need to be supported in a health place of On going City and Hackney CCG, HUH and Local Police Homerton Psychological Medicine S136s seen in ED if physical health problems Homerton Psychological Medicine department acts as a place of safety out of hours. S136s are seen in ED if there are physical health problems.