Camden Crisis Care Pathway Options for Development Prof

Camden Crisis Care Pathway – Options for Development Prof Steve Pilling, Dr Steven Reid and Douglas Mc. Kelvie 1 July 2015

Crisis Care Review Development, dissemination, implementation and monitoring of an integrated multi-agency crisis pathway. • Development of pathway as a dynamic system which responds effectively to people in crisis and is based on the best available evidence on service configuration and the principles of pathway re-design. • Developed by representative group of providers and service users. • Resources - project manager and data analyst for a limited time period. 2

Crisis Care Review and enhancement of staffing and service specification of the Crisis Resolution Teams comprising: • Establishment of 24 hour crisis helpline (Live from July 2015). • Extension of Crisis Resolution / Home Treatment teams (CRHTT) to provide a full 24 hour response. o Extending cover to 24 hrs. o Increase capacity to deliver more home treatment. o Adjusting the skills mix including increased medical time. 3

Crisis Care Review and enhancement of Psychiatric Liaison Services in the Emergency departments. • Move to the recommended CORE 24 model across both EDs in Camden. • Provide 24 hour service with additional medical staffing. • 30 additional staff. 4

Crisis Care Review Develop and establish a community-based drop-in service (CDIS). • Crisis Drop-In to provide alternative to ED or CRHTT operating out of hours (18. 00 to 23. 00) 7 days per week as primary provider of short-term support and working closely with other services. 5

Crisis Care Review capacity of community services to support people at risk of crisis. • Enhancement of Community Support – increased staffing required for community services to contribute to a reduction of people presenting in crisis is difficult to estimate. • Needs fuller review of current capacity of community services and consideration of current cost pressures on community services. • Simulation modelling of increased community staff suggests discernible impact. 6

Crisis Care Review Restructure community services and provide practice-based community teams aligned to primary care. • Practice-based teams providing: o single point of entry o advice, consultation and management of mental health crisis in primary care, linked to IAPT o assessment and interventions for complex mental health problems integrated with non-statutory, social and housing services o effective links with physical health services and specialist mental health services (e. g. CRHTT, early intervention in psychosis (EIP), in-patient services). • Developed from a re-structuring of existing services: o Agree whether to integrate drug and alcohol services or not, with a view to offering multidisciplinary, NICE-compliant treatments in line with Access and Waiting Time Programme. 7

For more information please contact: UCLPartners 3 rd Floor 170 Tottenham Court Road London W 1 T 7 HA 020 7679 6633 www. uclpartners. com @uclpartners 8