Croydon Mental Health Crisis Concordat Action Plan 2015-2016 Updated October 2015 Commissioning to allow earlier intervention and responsive crisis services No. Action Timescale Led By Outcomes RAG/Comments Matching local need with a suitable range of services Governance 1 Development & Implementation of a Crisis Care Concordat Steering Group March 2015 Grose Crisis Care Concordat action plan’s goals and aspirations have appeared on agenda items on Mental Health sub groups. These include the Partnership Board, Strategy Steering Group and A&E/Urgent Care meetings. Feedback from these groups continue to inform progress against the plan. Complete and ongoing 1:a Group convened and stakeholders secured 2015 Grose & Sian Kirk ICU Met and engaged with identified stakeholders in order to develop the action plan. Ongoing governance is overseen by the Partnership Board, Strategy Steering Group and A&E/Urgent Care meetings. Membership of these meetings include social care, primary care, secondary care, voluntary sector, crisis services, Public Health, carers and service user representatives, BME Forum and is chaired by a GP. Follow up meetings with the wider range of stakeholders involved is being planned for December 2015 to update on progress achieved to date. Complete and ongoing 1:b ToR’s and membership confirmed, including clinical leadership for oversight 26th May 2015 Susan Grose ICU ToR’s in place for the partnership board and MH Strategy Steering Group. A further steering group has been identified as required with A&E and urgent care departments, which has now been established and meets monthly, with ToR’s agreed, from August 2015 onward. Complete 1:c GP Leadership as Chair secured March 2015 Susan Grose ICU Dr Dev Malhotra continues to chair the MH Strategy Steering group and Dr Bobby Abbott continues to chair to partnership Complete
board meetings. Both are GP’s with special interest in Mental Health. 1:d Establish sound local governance arrangements in relation to the concordat. May 2015 Susan Grose ICU Ongoing governance is overseen by the MH Partnership Board (meets quarterly), the MH Strategy Steering Group (meets monthly) and is informed further through the A&E/Urgent Care Meeting (meets monthly) Minutes from all meetings are made available to the MH Partnership Board. Complete 1:e Need to ensure that CAMHS beds and pathway is included in approach and consideration understood as to impact March 2016 Clare Brutton – ICU CAMHS Commissioning Lead CAMHs Commissioner is now part of the A&E/Urgent Care monthly meeting to ensure that children’s crisis care and the transformation plan are coordinated with adult mental health services. An action plan for children’s services has been developed and will continue to be progressed against throughout 2015/16 Started but further scoping required 1.f Revisit MH Strategies Modelling Paper to benchmark current provision, current requirement for crisis services March 2016 Susan Grose ICU Information will be shared taken from the PLN team, Urgent Care and A&E services to understand the crisis care pathways and major presenting issues. Commissioners and operational staff are developing a better shared understanding. This will continue with a 4 borough partnership focus with Southwark, Lewisham and Lambeth to maximise the best use of resources across the 4 boroughs. Started but requires further development Improving mental health crisis services Core Contract / Quality QRS 2:a Ensure the establishment (and continuity of success identified in the Street Triage Pilot) of the 24/7 hr Telephone Crisis Line. 28th February 2016 Nicholl (SLaM) The 4 borough CCG’s (Croydon, Lewisham, Southwark and Lambeth) lead MH Commissioners have secured recurrent and enduring funding to continue the successful Street Triage Pilot in each borough. This has enabled the Street Triage service to continue past the pilot stage and continue to be available to front line police officers. Further service redesign has been undertaken and an implementation plan is in place for the expansion of the Street Ongoing - Funding secured and work continues to transform service into 24/7 Crisis Line
services to stabilise and support in crisis. The service will enhance G.P links. With an easy in, easy out approach, to increase discharge and readmission by removing unnecessary barriers. 4.g Review of Voluntary Sector Provision that can provide peer and support services across the borough. December 2015 Stephen Waters ICU - Mental Health Partnership Board Initial review of the voluntary sector has place. Croydon CCG now working with Croydon Council to ensure the approach is fully integrated. This will inform commissioning intentions for 2016/17. Progressing on target 4.h Establish a monthly based at CUH with CCG and SLaM attendance which reviews Mental Health Attendance at A&E June 2015 Anna Rose Roberts Croydon CCG Achieved through monthly A&E meetings Completed Improve access to and experience of mental health services 4.i Pathways of key services mapped Key Adult Mental Health pathways mapped by January 2016 Neil Turney ICU & Fran Bristow SLaM SLaM are leading on a pathways mapping exercise and this is ongoing. Ongoing – requires further work to complete 4.j Improved support to MH users who are a victim of crime March 2016 Neil Turney ICU Identified as an area of further investigation by the MH Strategy Steering Group. Further detailed actions to be developed over the coming months. Not started yet 3. Urgent and emergency access to crisis care No. Action Timescale Led By Outcomes RAG Improve NHS emergency response to mental health crisis
. 5.e Explore issues with local crisis services and develop further agreed actions to work towards. December 2015 Neil Turney &Sian Kirk CCG Follow up meetings with the range of stakeholders involved is being planned for December 2015 to update on progress achieved to date. Ongoing Social services’ contribution to mental health crisis services 6.a Ensure that development of local services have fully integrated with mental/physical health/social care services From Mental Health Strategy Steering Group 1st August 2015 Neil Turney CCG & Paul Richards Croydon Council This is being achieved in Croydon through the Local Authority and CCG working together as the Integrated Commissioning Unit (ICU). In practical terms the Head of Social Care is a member of the MH Strategy Steering Group and Partnership Board meetings, and Public Health are integral to all boards sub groups and steering groups. Ongoing 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 RAG 7.a Review restraint, & police attendance at MH wards etc. 2016 Grose, CCG This remains an area of crisis care that requires further development and will form part of the work of the A&E working group. More detailed actions to be developed. Yet to start
7.b Develop a local pathway with British Transport Police to have access to Crisis Line as currently restricted to MPS 28th February 2016 Nicholl SLaM Inclusion of the British Transport Police as a group to have direct access to crisis line support has been agreed and included in the 24/7 Crisis Line service specification. The provider is currently working to ensure all health professionals that require access can do so within their existing structures. It is expected that when the service is fully operational (February 2016) that the British Transport Police will have direct access independently. Currently the service is only available to the Metropolitan Police Service. Progressing on target 7.c Explore access to advocacy March 2016 ICU Managers comprising from both CCG and LA Advocacy services have been reviewed and a report developed, with recommendations being taken forward by an integrated project team comprising of both LA and CCG Commissioners. The advocacy services being reviewed will include learning disabilities, older people, long term conditions and mental health. This work is scheduled to begin November 2015. Progressing on target Improved information and advice available to front line staff to enable better response to individuals 8.a Review restraint procedures for all agencies that practice restraint including SLaM to ensure they are in line with national guidance March 2016 MH Strategy Steering Group Reducing restraint has been identified as an area to review in the Mental Health Strategy 2014-19. This will be further forward at the MH Strategy Steering Group which will be responsible for the implementation of the MH Strategy which is expected to be a 5 year transformation plan Yet to start Improved training and guidance for police officers 9.a Croydon to continue to work with MPS Borough Mental Health Liaison Officer Actions Agreed by Crisis Care Concordat Meeting on Neil Turney CCG, Borough Mental Health Liaison Officer Through the Crisis Care Concordat work MH Commissioners have strengthened relationships with other service areas. This has included attending AMPH forums and presenting on progress at the safer neighbourhood board. Work will continue to build on the progress and further influence and align the work of all services supporting people at times of MH crisis. Ongoing
12th May 2015 Improved services for those with co-existing mental health and substance misuse issues 10.a Review liaison and diversion services in relation to people with Mental Health and Substance Misuse issues January 2016 Bernadette Alves Public Health & Shirley Johnston ICU Liaison and diversion services have been identified as an area for the Mental Health Strategy Group. Further action to be developed. Yet to 4. Quality of treatment and care when in crisis No. Action Timescale Led By Outcomes RAG Review police use of places of safety under the Mental Health Act 1983 and results of local monitoring 11.a Improved use of care plans and contingency planning March 2016 Derek Nicoll, SLaM Mental Health Service to have increased awareness of need for a crisis plan and to be central to the development and ownership of their plan Ongoing – requires further work Service User/Patient safety and safeguarding 12.a Use monthly borough specific Croydon CQRG & additionally 4 borough CQRG. These meetings review incidents, accidents and complaints. From 31st January 2016 Susan Grose CCG To monitor and ensure progress towards a reduction of; The overall number of incidents, SUI’s and reportable events with SLaM. Development of Physical Health CQUIN to ensure better physical health care with secondary care settings has now been completed. Monthly CQRG meetings have taken place and continue to address this issue. Progressing on target Staff safety