How community and primary care can support better mental ... · • Successful treatment is a co-operative journey, underpinned by patient buy in. • Continuity of treatment makes

How community and primary care can support better mental health outcomes

Transferring Lessons from Private Practice

NHS and private practice treat different patient Groups.

• NHS: highest acuity and ‘tip of the iceberg’ –those most at risk.

• Private practice: patients who are disabled by their condition, but who haven’t found treatment that works.

Key Learnings

• Successful treatment is a co-operative journey, underpinned by patient buy in.

• Continuity of treatment makes the difference –for both clinician and patient.

• Maximising patient facing time and ownership of progress.

• Understanding which patient groups can make the most progress, and how.

Practical Applications

• Give clinical staff the chance to see impact and benefit of their treatment.

• Build confidence and engagement.• Challenging the model of care – are we seeking

improvement or preventing destabilisation?• Role of the GP – reducing inequity in support.

Copyright 2013 Andrew MacPherson. The Strategic Projects Team.

The Kings FundImproving Mental Health How community and primary care services can support better mental health outcomes

Andrew MacPhersonManaging Director – The Strategic Projects Team


2 Million• 4.2 responses every minute• 253 responses every hour

Circa 6100 every day and growing….

The Friends & Family Test

Copyright 2013 Andrew MacPherson. The Strategic Projects Team. Hosted by the Greater East Midlands Commissioning Support Unit

Calculating the ScoreThe question: How likely are you to recommend our <ward / A&E department> to

friends and family if they needed similar care or treatment?’

Six possible responses categorised into:

•Promoter (Extremely Likely)

•Passive (Likely)

•Detractor (Neither Likely / nor Unlikely, Unlikely,

Extremely Unlikely).

•The proportion of DETRACTORS in the total number of responses is subtracted

from the proportion of PROMOTERS in the total number of responses.

•Don’t Know responses are not used in the scoring process, but are included in

the overall response rate calculation.

The Friends & Family Test


The Friends & Family Test - Timetable• April 2012, Midlands and East Acute Overnight Care• May 2012, Prime Minister endorses National roll out• March 2013, Department of Health hand Programme formally to NHS

England, NHS Strategic Projects Team appointed to manage delivery.• April 2013 National Acute Inpatients, Accident & Emergency• October 2013 Maternity Services – first published report January 2014• Primary Care: General Practices, Pharmacists, Opticians,

Dentists (December 2014)• FFT Review and six month validation – Reports Jan 2014• Fifty Two pilots concluded January 2014 - Whole system commissioner led

pilots February 2014• Roll out across all Pathways inc Mental Health & Community Services by

April 2015

Copyright 2013 Andrew MacPherson. The Strategic Projects Team. Produced by the Strategic Projects Team on behalf of NHS England

• Secure units within a MH Hospital• Prisons• Acute Inpatient – assessment treatment areas for adults

and older people including Psychiatric Intensive Care Units (PICU’s)

• Mother and baby units• Drug and alcohol Inpatient services• Crisis beds• Children and young people Inpatients.

Scope of FFT for Mental Health


• The ‘number of patients eligible to respond to FFT question’ (% Response Rate calculation)

• When to ask patients the Friends and Family Test Question

• Frequency of asking FFT Question

Mental Health -Technical Challenges


Mental Health

When to ask FFT question Trusts using various approaches

At point of discharge from care pathway/ at end of every episode of care.

1. At a Review2. On Transfer between services3. Snapshot in time4. Key ‘touch points’ –5. PBR clustering6. At any time suitable for the service or when the service user wants

to answer the question.


• The ‘friends and family’ part of the question in Mental Health may not be appropriate in some clinical cases.

• The current wording of FFT question might impact on MH patients recovery – potential clinical repercussions.

• The FFT question may not be appropriate for use in some Mental Health cases.

• Ensuring that the service is identified to which the patient is referring without identifying the patient

Mental Health FFT Challenges


The Friends and Family Test is:

• A catalyst for change.

• A ‘tin opener’

• The basis for a ‘new conversation’ ( real time )

• A mechanism for catching us doing things ‘right’

The Friends and Family Test


[email protected] @NHSSPT

Thank you

Transforming mental health services through digital

We know…

£105bn350mnow

1 in 4 impacted

75%untreated

How do we disrupt traditional service models…

pooraccess

75%untreated

nochoice

stigma

waiting lists

person

self-referral BWW professional referral interface

Add a SupportNetwork…

Professionallymanaged

24/7

Evidence-based self

managementresources

Clinical condition &

moodtracking

Peer support & networking

Talk therapy:

community group 1:1

Creative therapies

person

• Modular programmes

• Peer groups

• Personal learning space

• Track progress

• Counsellors on call 24/7

Add GuidedSupport…

anxiety

smokingcessation

alcohol &substance

use

weightmanagement

depression

person

• Choice of therapy and therapist

• Text, audio or video

• Date and time to suit from the comfort of own home

• Shared notes and rating

• Plug in your own clinicians

Add LiveTherapy…

person

Change the health journey...

from passive and alone…

…to active and supported

and achieve big results…

commissioned by organisations serving

22% of UK adults80%

95% £370

73% 58%

of members feel better

73% share an issue for the first time

self-manage

savings per member (to NHS)

recovery rate from BWW LiveTherapy• government

target: 50%• average achieved

46%

…for big organizations

Health Military Employers Government

International

Universities

Contacts

Nicky Runeckles

Director, Business [email protected]

Documents

How community and primary care can support better mental ... · • Successful treatment is a co-operative journey, underpinned by patient buy in. • Continuity of treatment makes