DRAFT FOR DISCUSSION Greater Manchester iTHRIVE Dr Paul

DRAFT FOR DISCUSSION Greater Manchester i-THRIVE Dr Paul Wallis, GM i-THRIVE Lead Angela Daniel, GM i-THRIVE Programme Manager 1

DRAFT FOR DISCUSSION GM Children & Young People Mental Health Programme Chief Officer, GMHSCP Locality Assurance meetings Adverse Childhood Experiences (ACE) Themes Communities of Identity/ Equalities Growing the Voice of young people and families Working with VCSE and faith sectors CYP MH Board (Chairs: Dr Sandeep Ranote & Charlotte Ramsden Salford DCS) 4 x Transformation Fund programmes: • CYP MH communitybased access and crisis care programme • Perinatal and parentinfant MH programme • THRIVE and CYP workforce development programme • Mental and emotional wellbeing in education settings (up to age 18) project 6 x CYP Mental Health Non-Transformation Fund programmes: • ADHD • Eating Disorders • Transitions • MH of Looked after children (LAC) • MH and Youth Justice (in conjunction with Health and Justice Board) • CAMHS Tier 4 (Delegated Specialised Commissioning) 2

DRAFT FOR DISCUSSION Provider Federation Board Association of GM CCGs GM Mental Health Programme Implementation Greater Manchester Health & Care Partnership Board Joint Commissioning Board (NHS/ LAs) GMCA GM Commissioning Hub Dementia United Board Population Health Board MH Programme Delivery Board Health and justice Board CYP MH Board MH VCSE forum and reference group GMHSCP Performance and Delivery Board Adult MH Board GM Mental Health Network MH service user/ carer networks Enabling programmes: business intelligence, finance and contracts, workforce, estates, IM&T 3

DRAFT FOR DISCUSSION The THRIVE Framework 4

Current model of provision Tier 4 • Highly specialised CAMHS units and intensive community treatment services Tier 3 Tier 2 Tier 1 • Specialist multidisciplinary outpatient CAMHS teams • A combination of some specialist CAMHS services and some community-based services including primary mental health workers • Universal services consisting of all primary care agencies including general medical practice, school nursing, health visiting and schools Criticised even by its own developers for leading to a reification of service divisions

The THRIVE Framework Attempts at drawing a clearer distinction than before between: • • Treatment and support Self-management and intervention Developers are aware there a number of initiatives across the country who use “Thrive” in their title. Term used to reflect core commitment to young people “thriving” and to represent our commitment to provision that is Timely, Helpful, Respectful, Innovative, Values-based and Efficient.

Consideration of the Different System ‘Levels’ MACRO Consideration of Population Health Improvement How agencies work together and commission services for the population MESO Needs based groups of young people and the services/ teams that enable delivery of care according to those needs MICRO Ways of working with young people and their families, and how professionals can work best in a collaborative and integrated way

Identifying the Population Groups and Services within System Levels Macro System Young People Services Example All young people within a locality Commissioners (Health, Social Care & Education) Agencies that deliver care (Health, LA, Education, Independent & Third Sectors) CCG, Council NHS Trust Council Young Minds Meso System Needs based groups of young people who require care for a mental health concern. These are the 5 needs based groupings identified in THRIVE. The services that provide care for these needs based groups of young people. LAC, ADHD services, locality teams, school counselling services. Micro System Individual young people receiving care for a mental health concern The teams and individuals within those teams for provide care for young people in their services. Individual therapists giving CBT The members of the SPA assessment team in a particular setting

Taking an evidenced based approach to implementation with the Quality Implementation Framework • • • Self Assessment Prioritisation Implementation Planning Structural features of Implementation • Finalising Phase 1 Initial considerations • • Learning from Experience Sustainability • Normalisation • Process Theory Phase 4 Improving future applications Phase 2 Creating Structure for Implementation Phase 3 Ongoing Structure Supporting Implementation • • Implementation Plan Developing Implementation Teams Community of Practice Training Clinical & Professional Teams Measurement in place Ongoing Implementation Support Strategies • Making changes – • • use of QI Technical Assistance/Coaching/ Supervision Ongoing Training Process Evaluation Supportive Feedback Mechanisms

DRAFT FOR DISCUSSION GM i-THRIVE Aims Understanding the System Sustaining the System via Supervision & Consultation GM i-THRIVE Evaluation Enhancing the System via Training & Development Broadening the System for CYPF mental health 10

Deliverables – Impact of GM i-THRIVE Clearer Pathways for CYPF MH Improved Choice and Shared Decision-making Enhanced Agency Collaboration Enhanced system skill-base with ongoing training and supervision Enhanced support for complex needs and risk

From Theory to Practice Engaging System Leads Identifying local sector Champions Delivery of training – train the trainer Supervision and Consultation Ongoing Evaluation

Cross-system Core training modules Impact of Adverse Childhood Experiences (ACEs) Shared Decision-Making Getting Advice and Signposting When to Stop Treatment (letting go) Managing Risk Within Teams Managing Risk Across Agencies i-THRIVE Grids

What has happened so far? Investment Recruitment Plan • Transformation funding approved December 2017/Operational from April 2018 • Programme Manager, Project Support and Assistant Psychologist recruited • Consultant Lead and Programme Manager attending locality high level strategic boards to present i-THRIVE • Implementation plan drafted • Outcomes framework drafted • Communication and engagement strategy drafted • Initial intelligence tool circulated to all localities

NEXT STEPS September 2018 • Initial intelligence gathering tool completed and planning meetings held with all localities • Regular newsletter • Data collection and outcomes framework completed Dec 2018 • Locality implementation plans completed • Subject Matter Experts recruited Dec 2018 • Engagement workshops on i-THRIVE held in each locality • GM Community of Practice Event - 12 th December 2018 • i-THRIVE training modules begin Jan 2019