Preparing to implement the new access & waiting time standards - PDF document

26/01/2016 Preparing to implement the new access & waiting time standards Sarah Khan – Deputy Head of Mental Health (Policy & Strategy) Kevin Mullins – Head of Mental Health (Delivery) Kathryn Pugh - Programme Lead, C&YP Mental Health www.england.nhs.uk Welcome to the WebEx • Please ensure you are logged into the audio via a telephone as well as being logged into the visual on your PC/Laptop. • If you don’t receive a call back via the WebEx system call: 0800-9171950, using participant code 436 997 52 • Please mute your telephone line to help reduce the background noise. Please let the host know if you need support in doing this. Only unmute if you want to talk. • Use the instant messaging feature to ask for help if needed. • Please use the ‘raising hand’ feature if you wish to speak. www.england.nhs.uk 1

26/01/2016 This presentation 1. The new standards to be introduced from 15/16 2. Expectations of commissioners: i. Early intervention in psychosis ii. Liaison mental health services iii. Improving access to psychological therapies (IAPT) 3. Delivering Transformation in Child and Adolescent Mental Health Services (CAMHS) 4. Early thinking about distributing new funds www.england.nhs.uk MH 5YP: rebalancing the system  Prevention  Early intervention  Effective care  Recovery  Right care  Right time  Right setting www.england.nhs.uk 2

26/01/2016 The system is currently not in balance www.england.nhs.uk We are also missing opportunities to deliver better value care to individuals receiving treatment for a physical health condition If we are to improve outcomes and quality of life for individuals with physical health needs, then: a. Promotion of positive mental health as part of condition management b. Recognition of mental health needs c. Timely access to expert assessment and evidence based mental health care Will need to be integrated at every level of the physical healthcare system. a + b + c = reduced demand from repeat attendances in primary care, UEC and outpatient clinics = reduced acute length of stay = better outcomes at lower cost for individuals with long term conditions www.england.nhs.uk 3

26/01/2016 The 2015/16 planning framework From 1 April 2016: • More than 50% of people experiencing a first episode of psychosis will be treated with a NICE approved care package within two weeks of referral. • 75% of people referred to the Improving Access to Psychological Therapies programme will be treated within 6 weeks of referral, and 95% will be treated within 18 weeks of referral. • £30m investment is to be targeted on effective models of liaison psychiatry in a greater number of acute hospitals. www.england.nhs.uk The Financial Package The new standards for 15/16 are supported by an £80m funding package: • £40m recurrent funding to support delivery of the early intervention in psychosis standard; • £10m to support delivery of the IAPT; and • £30m to support delivery of the liaison psychiatry standard. In addition: • NICE (the National Collaborating Centre for Mental Health, NCCMH) has been commissioned to develop national resources to support implementation. • Funding has been made available to support regional EIP preparedness programmes (£200k per region). • System resilience monies are being used in many areas to support preparedness efforts across EIP and liaison psychiatry services. www.england.nhs.uk 4

26/01/2016 The Autumn Statement The Autumn Statement 2014 outlined the provision of additional funding of £30million recurrently for 5 years to be invested in a central NHS England programme to improve access for children and young people to specialist evidence-based community CAMHS eating disorder services . Part of this programme funding will be used to develop an access and waiting time standard. www.england.nhs.uk The Spring Budget The Spring Budget 2015 included an announcement of £1.25bn new mental health funding over the next 5 years (£250m per year) to improve access to mental health services for children and young people and for mothers experiencing perinatal mental illness. This will include continuing and expanding the CYP IAPT programme of CAMHS transformation, plus resources to build capacity. www.england.nhs.uk 5

26/01/2016 Finances Amount Purpose Recurrent? Held where? (15/16, £) 250m Improve access Yes TBC, but in 15/16 likely to to CAMHS be split between HEE and central programme. Moves to allocations by 19/20 40m Support EIP Yes CCG baseline waiting time standard 30m Eating disorders Yes Central programme, in allocations by 19/20. 30m Liaison No Central programme psychiatry 10m IAPT No Central programme www.england.nhs.uk The new standards to be introduced from 2015/16 www.england.nhs.uk 6

26/01/2016 The February guidance 1. Clarify the requirements of each of the new 15/16 mental health access and waiting time standards and associated expectations of CCG commissioners in line with the planning guidance. 2. Outline the intention to implement access and waiting time standards for eating disorders in community CAMHS from 2016. 3. Update stakeholders regarding the national programme of support for implementation of the new access and waiting time standards. 4. Signpost stakeholders to helpful sources of regional support for implementation of the early intervention in psychosis standard. i. Early intervention in psychosis Sarah Khan Deputy Head of Mental Health (Policy & Strategy) NHS England 14 NHS | Presentation to [XXXX Company] | [Type Date] 7

26/01/2016 Why set a standard? In 2011, No Health Without Mental Health , highlighted the effectiveness of EIP services. When delivered in accordance with NICE standards they help people to recover from a first episode of psychosis and gain a good quality of life. What are we aiming to do? To ensure that: • Anyone with an emerging psychosis and their families and key supporters can have timely access to specialist early intervention services which provide interventions suited to age and phase of illness. • Individuals experiencing first episode psychosis have consistent access to a range of evidence-based biological, psychological and social interventions as recommended by the NICE guidelines for psychosis and schizophrenia in children and young people CG155 (2013) and in adults CG178 (2014) and the NICE guideline for psychosis with co-existing substance misuse. • Care is provided equitably - taking into account higher rates of psychosis in certain groups who may experience difficulties in accessing traditional services. 8

26/01/2016 What is the standard • The new access and waiting time standard requires that, by 1 April 2016, more than 50% of people experiencing a first episode of psychosis will be treated with a NICE approved care package within two weeks of referral. • The standard is ‘two - pronged’ and both conditions must be met for the standard to be deemed to have been achieved, i.e.  A maximum wait of two weeks from referral to treatment; and  Treatment delivered in accordance with NICE guidelines for psychosis and schizophrenia - either in children and young people CG155 (2013) or in adults CG178 (2014). • Most initial episodes of psychosis occur between early adolescence and age 25 but the standard applies to people of all ages in line with NICE guidance. www.england.nhs.uk Approach to implementation National expert reference group, NICE ‘hosting’, highly 1. Bringing together the required expertise collaborative. 2. Developing the Specifying the dataset, developing the MHSDS and required dataset commissioning national clinical audit. 3. Publication of Service specifications, service model exemplars, staffing / commissioning guidance skill mix calculators etc Planning guidance, payment system development, 4. Design of levers & standard contract etc. Engagement with Monitor, TDA, incentives CQC. 5. Implementation Regional preparedness programmes, national events etc. support 6. Workforce Joint work with HEE development www.england.nhs.uk 9