Mental Health Dashboard and Pathways Workshop 14 December

Mental Health Dashboard and Pathways Workshop 14 December 2017

IAPT in City and Hackney PCP logo to add

The City and Hackney Psychological Therapies & Wellbeing Alliance CCG funded initiative, established in 2015 Consists of 7 members – - East London Foundation Trust - PCPCS, Tavistock and Portman - Primary Care Psychology (IAPT), Homerton University Trust - Bikur Cholim Derman Mind in the City, Hackney and Walthamstow Volunteer Centre Hackney Aim of this Alliance Agreement is also work together towards the development of delivery of services by the providers to be seamless and patient focussed – ie no wrong door PCP logo to add

IAPT in City and Hackney - HUH • PCP was one of the first wave IAPT sites in 2008 and has around 60 staff • 5. 500 patients per year (7. 500 referrals received) • Stepped care model – 60% vs 40% • Step 2 – Guided self help, sleep & stress workshops • Step 3 - CBT, Behavioural Couple’s Therapy, IPT & EMDR • Challenges: Historic waiting list / waiting time standards / BAME communities PCP logo to add

Becoming an IAPT Service Anxiety: All VSOs employ 1 F/T IAPT CBT therapist Installation of IAPTUS Completion of NHS IG Toolkit Connection to NHS England Qualification of therapists (BACP /BABCP mandatory) Data collection systems Depression: All VSOs funded to train up to 4 staff in IAPT modalities inc: • Counseling for depression • Couples counseling • IPT Connection to NHS Digital Able to send / share information electronically & securely via NHS mail Collecting & storing patient information to NHS IG standards Provision of IAPT appropriate treatments Treatment of low to moderate level anxiety and depression in accordance with NICE guidelines PCP logo to add

IAPT in City & Hackney – Co-Provider Model Talk Changes (HUH PCP) Lead CCG funded provider (monthly target 470 entering treatment) www. talkchanges. co. uk Mind in the City, Hackney & Walthamstow (BAME) (monthly target 10 – 20+ entering treatment) Derman Turkish & Kurdish community (monthly target 10 – 20+ entering treatment) Bikur Cholim Haredi Jewish community (monthly target 10 – 20+ entering treatment) e. CBT via Silvercloud - Low Intensity IAPT treatment PCP logo to add

IAPT in City & Hackney – Referral Pathways Talk Changes (HUH PCP) Self Refer: www. talkchanges. co. uk Refer via GP: • Complete online referral via website • Complete PT&WA Referral form • Refer by telephone 0207 683 4278 Mind in the City, Hackney & Walthamstow Self Refer: City & Hackney Wellbeing Network www. chwellbeingnetwork. london GP: Complete PT&WA Referral form Derman Self Refer: City & Hackney Wellbeing Network www. chwellbeingnetwork. london GP: Complete PT&WA Referral form Bikur Cholim Self Refer: City & Hackney Wellbeing Network www. chwellbeingnetwork. london GP: Complete PT&WA Referral form e. CBT via Silvercloud Self Refer: www. talkchanges. co. uk Refer through IAPT provider organisation (as above) PCP logo to add

IAPT in City & Hackney – How are we doing? No. of referrals & No. of patients entering treatment 900 800 700 600 Referrals (self reported) 500 Entering treatment (self reported) 400 Linear(Referrals (self reported)) 300 200 100 0 янв-17 фев-17 мар-17 апр-17 май-17 июн-17 июл-17 авг-17 сен-17 окт-17 PCP logo to add

IAPT in City & Hackney – How are we doing? Referrals to Treatment – Conversion Rate - Referral to Treatment All Providers (%) 100 90 80 70 60 Conversion Rate % 50 Linear(Conversion Rate) 40 30 20 10 0 янв-17 фев-17 мар-17 апр-17 май-17 июн-17 июл-17 авг-17 сен-17 окт-17 PCP logo to add

IAPT in City & Hackney – How are we doing? Access rate for City & Hackney (against National Target 16. 8%) Combined Access Rate for commissioned IAPT Providers (Self Reported) 700 600 500 400 Comissioned Target Entering treatment (Self Reported) 300 Linear(Entering treatment (Self Reported)) 200 100 0 янв-17 фев-17 мар-17 апр-17 май-17 июн-17 июл-17 авг-17 сен-17 окт-17 PCP logo to add

IAPT in City & Hackney – How are we doing? Recovery Rates - All Providers 70 60 50 40 Baseline Recovery Rate Self Reported Combined Recovery Rate 30 20 10 0 янв-17 фев-17 мар-17 апр-17 май-17 июн-17 июл-17 авг-17 сен-17 окт-17 Increase in recovery rate for Turkish / Kurdish patients from 30% to 70+% PCP logo to add

Thank you for listening! Contact Breda on breda@cityandhackneypta. co. uk PCP logo to add

Crisis Pathway HPM/A&E Urgent Assessment Team/HTT CRISIS LINE Crisis Café SUN Project

Urgent Assessment Team • • 24 hours, 7 days a week Community Assessment 2 clinicians (1 + 1 on-call 22. 30 -8. 00) Refer via Crisis Line

‘Urgent’ 4 Hour Response… • • • Acutely suicidal with plans/intent Psychotic symptoms with risks to self/others Significant self-neglect Post-natal women in mental health crisis Carer of children with psychosis/suicidality/ anxiety impacting or likely to impact on child • Current acts of violence or access to weapons - 999

Emergency 999 • Service user or carer cannot maintain safety for 4 hours • Significant physical health concerns (e. g overdose/ deep lacerations/health problems due to self-neglect • Current violence/ access to weapons

Perinatal Mental Health Pathway

Adult Autism Assesment

CEG – Mental Health Dashboard Keith Prescott, Jo Tissier, Marian Priebe Clinical Effectiveness Group Centre for Health Sciences

Drivers for a mental health dashboard? NHS Five Year Forward View – which includes mental health n Parity of esteem – valuing mental health equally with physical health n Information reporting requirements - The dashboard will enable a more comprehensive view of management of mental health

n Equity and Vulnerability Relationship between physical and mental health – poor mental health linked with higher risk of physical health problems, and poor physical health linked with poor mental health

Indicators – BMI and Smoking Current smokers: General population 18% Current smokers: SMI 42% BMI 30 and over: General population 14% BMI 30 and over: SMI 31% Source CEG JSNA April 2017

Quality Improvement Rationalisation of data sources eg. LDP, JSNA, payment activity. For mental health alliance will have just one report to focus on. The dashboard will enable more detail analysis across organisations in a single dashboard. e. g funnel plot distributions, or grouping data by neighbourhoods n

The Mental health Dashboard Covers: SMI Depression Dementia EPC Antipsychotic medication n It will be updated on a regular basis – currently quarterly then monthly n

Dementia – looking at diagnosis rates Depression – looking at psychological (talking) therapies, Five to Thrive, Social Prescribing SMI – better physical health checks for people with mental illness Indicators in CEG dashboard will feed in to the NHSE mental health dashboard – CCGs clear performance goals

NHSE Requirements SMI patients who have received complete list of physical checks in last 12 mth -BMI -BP -Cholesterol -Hb. A 1 c -Alcohol consumption -Smoking status n Indicator measures assessment of not treatment for their physical health needs

How will this work in practice Neighbourhood model with a specialist clinician. CEG provide training on use of the tool n CCGs and Federations (payment page) n Individual practices can download tableau reader and use within practice clinical multidisciplinary meetings e. g with psychiatrists n

Payment Page for Dashboard