Access to S136 bed or year olds Delayed response times reported Options appraisal for a strengthened response for children and young people in mental health crisis TBC Jan 15 B4 All should have the right skills and training to respond to mental health crisis appropriately SWASFT have clinical guidelines for patients presenting with MH problems Police offer 1-2 training days per month, which will include key topics such as Mental Health AWP working in partnership with Weston Hospital and Somerset Community Partnership to up skill more staff in recognising and supporting the management of mental health problems. Limited training Develop a plan for local training programme in mental health AWP (Anita Hutson) April 15 SWASFT limited to 1 day training per year per member for all clinical areas SWASFT scoping web based training as part of the introduction of their new electronic patient record to support delivery of additional training SWASFT – Partlow) TBC B5 People in crisis should expect an appropriate response and support when they need it IST 4 hour response target Access to 24 hour support via PCLS and IST Variety of acute beds available depending on needs of service user Crisis plans are in place for known service users Placements for patients younger than 18 are Limited step down beds for service uses Mental health placement project will incorporate need for step down facilities CCG (Angela Kell NSC (Alison Stone) April 16 Cross – agency access to crisis plans is an issue SWASFT to consider use of care summary record and enhanced care summary record Availability of longer term placements for people close to 18
commissioned on an ad hoc basis according to need B6 People in crisis in the community where police officers are first point of contact should expect them to provide appropriate help. But the police must be supported by health services, including mental health services, ambulance services, and Emergency Departments Place of safety - S136 Suite jointly commissioned at Southmead Hospital SWASFT currently unable to report if meeting the 30 minute target for ambulance response for a MH crisis. Manual work-around process in place to collect data, which is to be reported alongside other SWASFT metrics SWASFT (David Partlow) ? The management of intoxicated patients is an issue when it may not be clear if there are mental health needs also To scope feasibility of street triage project with dedicated mental health nurse resource to support emergency services by rapid mental health assessment and response A&S Police (TBC) CCG (Angela Kell) AWP (Suzanne Howell) March 15 There is some 'hidden' demand - police will take people elsewhere rather than to SMH POS There are many cases where police are staying at POS Evaluation of S136 suite within one year of implementation, and will include information on whether custody suites are still being used as POS in any circumstances and whether police are released promptly on handing the service user over to the S136 staff CSU on behalf of CCG (Andew Keefe) March 15 B7 When people in crisis appear (to health or social care professionals or to the police) to need urgent assessment, the process should be prompt, efficiently organised and carried out with respect Community assessments in situ Anecdotal reports that mental health act assessments are occasionally being delayed when local inpatient beds are not available. Currently this data is not collected or reported Undertake review MHA assessment processes, response data capture, and reporting. Formulate an action plan based on outcome March 15 NSC (TBC)
Regional inconsistencies in S12 practice Region wide review of S12 Doctors CSU on behalf of CCG March 15 B8 People in crisis should expect that statutory services share essential 'need to know' information about their needs Information sharing protocols and information governance policies in place for each organisation Barrier to more efficient information sharing is use of different IT systems No current to address this B9 People in crisis who need to be supported in a health place of safety will not be excluded Health based place of safety is S136 suite at SMH Close links with alcohol liaison service and psychiatric liaison service with Emergency departments Efficacy of pathway for intoxicated people is currently unclear Evaluation of S136 to include management of intoxicated individuals CSU on behalf of CCG March 15 No place of safety in Weston Reconsider need for and viability of as part of the S136 suite review and NS bed review. CCG (Angela Kell March 15 B10 People in crisis who present in Emergency Departments should expect a safe place for their immediate care and effective liaison with mental health services to ensure they get the right on going support Access to 24/7 psychiatric liaison service via ED (provided by IST out of hours). ED staff offered training to ensure effective screening for MH problems B11 People in crisis who access the NHS via the 999 system can expect their need to be met appropriately Clear clinical guidelines and protocols in place within SWASFT for management of MH patients SWASFT scoping development of in-house MH expertise in SWASFT. SWASFT (David Partlow) April 15 No street triage service (fast police response accompanied by RMH in place, despite Police to scope financial and practical feasibility of this (also B6) A & S Police (TBC) CCG (Angela Kell) April 15
Robust and trust wide performance and quality monitoring processes in place AWP implementing safewards (incorporating least restrictive care strategies) Recent AWP CQC inspection highlighted numerous local and trustwide quality concerns and with some compliance notices Development of local and trust wide action plan to address areas of non-compliance and concern noted in partnership with CCG and Local Authority AWP (Suzanne Howell) Oct 14 Implementation of Quality Improvement Group with strong North Somerset representation AWP (Alan Metherall) Oct 14 C3 When restraint has to be used in health and care services it is appropriate AWP implementing ‘Safewards’ (incorporating restrictive care strategies) Clear provider protocols and policies in place Staff training and supervision within main MH providers closely monitored by commissioners Not known what policies and procedures are in place at Weston Hospital re restraint and managing difficult behaviour, or at other independent provider units. Review policy for restraint and managing difficult patients with Weston Hospital, and work with them to develop an action plan if appropriate CCG (TBC) 15 C4 Quality and treatment and care for children and young people in crisis CAMHS service in place, but under increasing pressure with increasing wait times for assessments Responsive and flexible local response, particularly for those in crisis Scope options for service enhancement to offer improved crisis response, in collaboration with adult services CCG (TBC) CAMHS (TBC) AWP (TBC) March 15 D Recovery and staying well/ preventing future crises Crisis completed on initial assessment. Crisis plans reviewed at CPA Care co-ordination in situ Strong partnerships with