Yorkshire and the Humber Mental Health Network Liaison Mental Health Network 27 September 2017 • Dr Katie Martin, Network Clinical Advisor & Consultant Liaison Psychiatrist, TEWV MHFT • Rebecca Campbell, Quality Improvement Manager • Charlotte Whale, Quality Improvement Manager • Sarah Boul, Quality Improvement Lead • Twitter: @YHSCN_MHDN #yhmentalhealth • September 2017 www.england.nhs.uk
Housekeeping: @YHSCN_MHDN #yhmentalhealth www.england.nhs.uk
Welcome & Introductions Dr Katie Martin, LMH Clinical Advisor, Yorkshire and the Humber Clinical Networks and Consultant Liaison Psychiatrist, Tees, Esk and Wear Valley NHS FT www.england.nhs.uk
Overview • Update on national guidance UEC pathways • Aims & Actions from previous LMH network meetings – where are we now? • Workforce: Good Practice • Developing a LMH Practitioners Forum Y&H – all • Break (15 mins) • Transformation Bid Updates Waves 1, 2 and ‘wave 3’ • Small group discussions – what’s worked, what hasn’t and what do we do next? • Next steps and closing remarks www.england.nhs.uk
Update: Urgent & Emergency LMH services and upcoming national guidance on UEC Pathways Aims and actions from the last meetings – where are we now? Dr Katie Martin, LMH Clinical Advisor, Yorkshire and the Humber Clinical Networks and Consultant Liaison Psychiatrist, Tees, Esk and Wear Valley NHS FT www.england.nhs.uk
Policy Headlines • FYFV for MH - independent MH Taskforce report Implementing EBTP for UE LMH services for Adults • & Older Adults – Guidance on establishing, developing and maintaining LMH services • Upcoming national guidance on Urgent & Emergency Mental Health Care Pathways for all ages • Support local implementation of EB acute & crisis care • Examples of what good looks like around the country • Contain clear set of access and quality benchmarks • Quality Assessment & Improvement Scheme • Identify current levels of service provision & support local improvement • MHSDS will also provide increased transparency of activity across crisis and acute MHS – will aid assurance of data quality (CCG/ provider/ STPs) • CCGIAF – will include transformation indicators for U&E MH www.england.nhs.uk
What should the whole system of urgent and emergency mental health care look like? www.england.nhs.uk
Background to LMH TF Recommendation 18: By 2020/21, no acute hospital is without all-age mental health • liaison services in emergency departments and inpatient wards • At least 50% acute hospitals meet ‘core 24’ service standard as a minimum by 2020/21 (currently 10%, up from 7% last year) Spending Review 2015/6 • By 2020, there should be 24-hour access to mental health crisis care, 7 days a week, 365 days a year – a ‘7 Day NHS for people’s mental health’ • Transformation funding to aid development of LMH services in every hospital emergency department (over 4 years from 2017/18) – Wave 1 £30m, Wave 2 £90m www.england.nhs.uk
Transformation Fund – Wave 1 2017/8, Wave 2 2019-2021 Application for and acceptance of the one-year transformation pump prime funding constituted a local commitment to the following: • recurrent funding of the newly-expanded service in future years beyond the year of receipt of the transformation funding • provision of a 24/7, on-site, distinct service to an acute hospital with a 24/7 Emergency Department within one year of receipt of the transformation funding • provision of a 1 hour response to emergency referrals and 24 hour response to urgent ward referrals within one year of receipt of the transformation funding • staffing of the liaison service at or close to the recommended levels for core 24 as per bid www.england.nhs.uk
Summary of key elements of successful bids – local services • Clear, unambiguous CCG sign up to recurrent funding • Consultation/ direct input from liaison clinicians • Explicit statements about aims/ plans for additional funding • Data evidencing current/ projected savings from LMH • Commitment to collect EB outcome measures • Robust timelines and plans for next 24 months • Reasonable balance between current investment & requested £ • Rationale for any differences explained clearly • e.g. developing advance practitioner/ nurse consultant roles • Highlighting strengths of current model • e.g. incorporating existing D&A services/ expanding links with primary care/ integration with IAPT for MUS www.england.nhs.uk
Features of strong UEC LMH Core24 Transformation Funding bids (NHSE) www.england.nhs.uk
www.england.nhs.uk
Aims and Actions from the Last Meeting Dr Katie Martin, LMH Clinical Advisor, Yorkshire and the Humber Clinical Networks and Consultant Liaison Psychiatrist, Tees, Esk and Wear Valley NHS FT www.england.nhs.uk
Y&H LMH Network: Aims • Understand Y&H geography baseline of liaison services meeting the Core 24 minimum standard, including concerns, risks and good practice • Ensure clinical expertise in liaison, both adult and child & adolescent, drives the programme of work and adds appropriate local narrative to data • Using a regional (North) liaison mental assurance framework which includes appropriate links to the UEC, Primary Care and wider Crisis Care programmes, develop this into a bespoke framework for Y&H for local STP use • Troubleshoot problems and provide Y&H support and feedback to North region – disseminate guidance and information from national team • Provide an expert liaison mental health clinical and advisory voice to Y&H area, 3 STP Programme Offices, Y&H Mental Health & Dementia Programme Group & any associated sub-groups / T&F groups which may be established www.england.nhs.uk
LMH Network: Purpose • Work collaboratively across the Y&H localities to support CCGs and Providers to prepare for the release of funding from 17/18 onwards to expand/improve/develop liaison services to meet national standards • Collate and share a range of good practice models in liaison including national pilots and work with STPs ensuring learning and models are shared across the patch • Develop tools and guidance as necessary to support local understanding of the requirements, preparing for delivery, assessing baseline and gap analysis and understanding demand • Develop a process to undertake economic evaluations and evidence of a range of liaison services which includes patient and public review of effectiveness • Unite individuals and partners across Yorkshire and the Humber in a common purpose • Promote common understanding, joint working and prevent duplication • Work collaboratively to build capacity and capability for quality improvement in services. www.england.nhs.uk
Key concerns and proposed actions – feedback from LMH network meetings • National direction – does it lack vision? Too focussed on UEC pathway? • Acute trust colleagues – relationships, expectations, understanding roles • STPs – collaborative working difficult with each area’s differing needs • Workforce shortage – skill mix, staffing resource, development • Impact of UEC pathway – still pending… • TF Wave 2 – lessons learned, how to prepare, what does good look like? • CQUIN – A&E coding, information sharing/ IG issues • Smaller services – whatever do we do next? • Outcomes – what to measure and how? • Proposed actions: • Work collaboratively with acute trust colleagues – invited here today! • Online liaison practitioners’ forum • Region-wide training for liaison practitioners – develop LMH competencies and skills – draw on considerable expertise and local experience • Share experience of TF bids – process, bids, challenges • CQUIN – further guidance on tables, peer support • Continue to link in with UEC/ crisis care concordat groups www.england.nhs.uk
Where are we now as a region? www.england.nhs.uk
Wave 1 transformation funding Areas that currently have access to core 24 liaison services’ for Core 24 U&E MH Liaison Areas that have successfully bid in Wave 1 to meet core 24 liaison London services by the end of 2017/18* Areas that have successfully bid in Wave 1 to meet core 24 liaison services by the end of 2018/19* Areas with liaison services that are not yet at core 24 service level *at the time of publication, funding awards are provisional Wave 1 bidding process now complete: - 17 hospitals already at Core 24 (10%) - £30m funding to 74 acute hospital sites to achieve ‘Core 24’ from 2017-2019 - By 2019 – 81 aim to have achieved Core 24 standard www.england.nhs.uk
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