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Mental Health: Better, Faster and Earlier Help
Manchester4 March 2015
Mental Health, Dementia and Neurological Conditions
• Greater Manchester to control £6bn NHS budget• It is understood the councils will take control of local
NHS spending • Greater Manchester is to become the first English
region to get full control of its health spending, as part of an extension of devolved powers.
• Chancellor George Osborne said the £6bn health and social care budget would be taken over by the region's councils and health groups.
• Mr Osborne said it was a "really exciting development".
1957 Royal Commission on Mental Health Act
‘Most people are coming to regard mental illness and disability in much the same way as physical illness and disability’
Mental Health, Dementia and Neurological Conditions
What works in Healthcare?
Having a mindset of perfect care and dramatic increases or stretch goals as against incremental improvement
Zero Vision for suicide*Mindset
*Methodology* Marker
Mental Health, Dementia and Neurological Conditions
ZERO VISION FOR SUICIDE10 October 2018
South West England
Mental Health, Dementia and Neurological Conditions
TOPICSPerfect depression
Post discharge from hospitalPresentations of high risk to frontline staff
Hotspots High risk middle age men
Mental Health, Dementia and Neurological Conditions
NATURE OF INTERVENTION
IHI Breakthrough Series Collaborative model
National Suicide Prevention StrategyRegional Suicide Prevention Expertise
Follow the energy
Mental Health, Dementia and Neurological Conditions
Do safety measures reduce suicide rates?
0.
3.5
7.
10.5
14.
17.5
2003 2004 2005 2006
0-6 recommendations
7-9 recommendations
*
*Patient suicide
rate per 10,000
*
* = significant difference p<0.05
Source: National Confidential Inquiry, Lancet, 2012
The Zero Suicide Collaborative includes the following stakeholders:
People with lived experienceClinical Commissioning GroupsArea TeamsPrimary Care PhysiciansProviders Mental HealthServicesAcute Hospitals / ERThird sector organisationsSamaritansPolice serviceAmbulance serviceAcademic Health Science NetworksLocal AuthoritiesCoroner’s officePublic HealthChildrens servicesRoyal National Lifeboat InstitutePublic Health
Mental Health & Respiratory Disease
• People with mental health problems … die on average 16-25 years sooner than the general population.
• … have higher rates of respiratory, cardiovascular & infectious disease…
• Increased smoking is responsible for most of the excess mortality of people with severe mental health problems.
No Health without Mental Health
Smoking Rates & Mental Illness
Coultard, M., Farrell, M., Singleton, N. and Meltzer, H. (2000). Tobacco, alcohol and drug use and mental health. London: Stationery Office.
20% General population smoking rate 2014
Mental Health & Desire to Quit
Clearing the Air. King’s Fund 2006
Time After Stopping
20 minutesBP, HR & peripheral circulation improve
8 hours Nicotine & CO levels
Fall by 50%. PaO2 - N
24 hours All Nicotine eliminatedTaste & smell improved
48 hours CO & mucociliary clearance
normal, risk of MI falls
72 hours Breathing easier,
bronchospasm relaxesEnergy improves
2-12 weeks Circulation improves
3-9 months Cough & wheeze improve
1 year Risk of MI reduced by 50%
10 years Risk of CA bronchus
reduced by 50%. Risk of MI back to normal
15 years Risk of stroke back to
normal
Benefits of Stopping Smoking
PHE January 15The self-assessment tool breaks down the NICE guidance into four areas. The:
• systems required to implement the guidance • communication required
• training that will enable staff to successfully implement the recommendations • treatments that should be available to support staff and service users
ZERO VISION FOR SMOKING IN HEALTHCARE
11 March 2016South West England
Mental Health, Dementia and Neurological Conditions
Wider costs to the national economy in terms of welfare benefits, lost productivity at work amount to some £77 billion a year
Value in Health Care
•OUTCOME ACHIEVED RELATIVE TO COST
• Shift from volume to value
• Value defined around the patient
• Cost is total cost (not cost of individual service)
• Reducing cost may require increased spend on some services
Value based healthcare requires integration (but how much?)
USER VIEW
• Less symptom orientated
• More how do I function as a person
home
work
recreation
family/friends
Intelligent Commissioning ‘sperm to worm’
DATA
Mental Health, Dementia and Neurological Conditions
•Would you fly a plane on 2 year old
data?
A consultation on updating the NHS Constitution: Feb 15
• ‘You have the right to drugs, treatments and psychological therapies that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you’. (Annex 2, Change 7)
• Do you agree?
‘Change is the law of life. All those who look only to
the past or present are certain to miss the future’
JFK
Mental Health, Dementia and Neurological Conditions
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