Manchester CCGs Mental Health & Wellbeing Grant Improving Access to IAPT Enhancing Social Inclusion for People with Serious Mental Illness 25 th May 2016 Jane Thorpe - Head of Mental Health Improvement Programme and Mental Health Commissioning, Manchester CCGs Michael Salmon – Commissioning Manager Mental Health, MCC Sandra Castle - Clinical Lead Primary Care Mental Health Team (MMHSCT) Melissa Briscoe-Head of Psychological Therapies | Self Help Services Dr Ruth Thompson, GP and Mental Health CCG Clinical Lead
Overview • Context - Mental health needs in Manchester • Landscape of mental health and social care provision in Manchester • Strategic aims of commissioners regarding mental health in Manchester • Intended outcomes and objectives of the Grant Programme • Case Studies
Background to Wellbeing Grant… The Five Year Forward View for Mental Health (DoH, February 2016) reported that: � It is estimated that people with a diagnosis of schizophrenia will have up to 20 years less life expectancy � At least one in four people will experience a mental health problem at some point in their life and one in six adults has a mental health problem at any one time � Almost half of all adults will experience at least one episode of depression during their lifetime � One in five mothers suffers from depression, anxiety or in some cases psychosis during pregnancy or in the first year after childbirth. Suicide is the second leading cause of maternal death, after cardiovascular disease. � Sickness absence due to mental health problems costs the UK economy £8.4 billion a year � More women than men are diagnosed with common mental health problems (women 21.5%, men 13.5%)
Background to Wellbeing Grant… Manchester’s Joint Strategic Needs Assessment outlines: � It is estimated that between one in eight and one in ten Manchester adults are prescribed antidepressant medication � 6.9% of North Manchester patients over 18 have ‘unresolved depression’ compared to 5.8% for England In Manchester, 3,981 people are in contact with mental health services for every 100,000 of the population (1 in 25), compared to 2,176 nationally (1 in 46) � The Care Programme Approach (CPA) is a planning system for people with more severe mental illness and complex needs. In Manchester 685 people are registered with CPA for every 100,000 of the population, compared to 531 nationally. � Manchester has a significantly higher rate of suicide (14.5 people per 100,000 of the over 15 population) than averages for England (8.5 per 100,000). � For those using secondary care mental health services in Manchester, 78% are not in paid employment and 18% are not in settled accommodation
Mental Health Funding The three Manchester CCGs collaboratively commission Mental • Health Services, 2015/16 recurrent funding of c104m -Manchester Mental Health & Social Care Trust (MMHSCT),Psychological Therapies, Acute hospital and community services, Community mental health teams, Rehabilitation services, Independent Hospitals, -Central Manchester Foundation Trust (CMFT) deliver Child and Adolescent mental health services (CAMHS) and Learning Disability services. Third Sector organisations – Self Help Services, Survivors, Gaddam, LGBT, ACHMS, Age Concern, 42 nd st -First episode in psychoses service, and other mental health trusts in GM Manchester City Council Investment into Mental Health Services • 2015/16 recurrent funding of c£16m - MMHSCT (Social Care), Social Care Packages (Residential & Nursing, Home Care, Individual Budgets), Housing Related Support, VCS – Community based provision
Manchester’s Health & Social Care Locality Plan Mental health is a significant issue for Manchester- Mental health of • citizens is integral to its success Preventative • Accessible at the times needed to prevent worsening of symptoms and • especially to intervene early in crises. Integrated into the needs arising from and affecting physical health • Responsive to need and ‘recovery’ focussed ensuring people are • supported and encouraged to return to active working lives, where relevant Clear in its pathways of care for all users of services • The ‘system’ then, needs to ensure that it is effective, efficient, based on • ‘best practice and outcome focussed so that services are sustainable and provided as close to the users community as possible.
Manchester’s Health & Social Care Locality Plan – The 3 pillars A single commissioning system (‘One Commissioning Voice’) ensuring the • efficient commissioning of health and social care services on a city wide basis with a single line of accountability for the delivery of services; ‘One Team’ delivering integrated and accessible out of hospital • community based health, primary and social care services; and A ‘Single Manchester Hospital Service’ delivering consistent and • complementary arrangements for the delivery of acute services achieving a fully aligned hospital model for the city. The plan represents Manchester’s health and care partners’ agreed approach to managing a predicted ‘do nothing’ deficit of £284m by 2020/21.
Commissioners Position statement Transaction: services currently provided by MMHSC to transfer to a • sustainable provider who can provide clinical and financial sustainability. Preferred provider to be known in August 2016 NHS Planning Guidance ‘must do’s – parity of esteem (PoE): CCGs • are required to demonstrate in financial plans that they deliver PoE, by investing in mental health services in line with the allocation growth received in 2016-17 CCGs supported and approved increased investment into First • Episode in Psychosis, IAPT, IAPT waiting list clearance and Mental Health Liaison amounting to a total of £3,555k
Persistent challenges A system for managing acute and urgent mental health needs • Delayed access to talking therapies • Fragmented delivery of services across poorly-integrated providers • (mental and general/physical healthcare) The stigma of mental health • Hard for people to leave mental health services • Routes back into employment, education and independent • accommodation are not easy and can hinder a persons sense of well being
What is IAPT? From Talking Therapies: A Four Year Plan of Action (DoH, 2011): • � National programme to Improve Access to Psychological Therapies � Targeted at adults suffering from anxiety and depression � Developed so the first treatment option is not just medication � IAPT services have developed links with employment support services � Interventions offered based on NICE guidance- evidence base, more interventions now included Manchester is assessed as having 88,398 adults who maybe depressed or anxious and the national target • is for 15% access Target that 50% of those who access the service will recover • Step 2 Step 3 • • Computerised CBT (CCBT), Guided Self – CBT • • Help, Behavioural Activation and Graded Physical Exercise Couples Therapy • CCBT, Guided Self Help and Pure Self Counselling for Depression • • Help Brief Dynamic Therapy • Mindfulness CBT • Interpersonal Psychotherapy • EMDR (eye movement desensitisation • and reprocessing Mindfulness CBT •
Current IAPT information tells us… • Access should be 15%, for Manchester we anticipate an end of year around 9% • Recovery averages at 37.5% (N 32%; Central 35%; South 44%) • 6 week wait- 29% N, 33% C, 38% S • 18 week wait – 78% N, 73% C, 80% S
Why the grant? • More investment, service expansion • Need to increase access and improve recovery • How you deliver ‘IAPT’ is evolving, we need to make it work for Manchester and for the One Team • Deliver the interventions and support in a way which is meaningful for the people who need it • Communities and organisations are and can help mental health services deliver differently or in collaboration
Community Mental Health Teams • Community Mental Health Teams (CMHTs) are multi- disciplinary teams that provide health and social care assessment, care, support, treatment, intervention, advice, guidance and liaison for individuals with severe and enduring mental health problems with a high complexity of need • Friendships, socialising, occupation, being in control of personal finances, good housing and good physical health are crucial for mental wellbeing
Recommend
More recommend
