Improving Mental Health. Introduction 1.Kim Crowe – Executive Director of Service Development and Delivery 2.Mersey Care NHS Trust 3. Service User and

Improving Mental Health

Introduction

1. Kim Crowe – Executive Director of Service Development and Delivery

2. Mersey Care NHS Trust

3. Service User and Carer involvement

4. Contribution to improving patient safety

5. An example of service user involvement

6. Evaluation of service user and carer

involvement



3. Service user and carer involvement




involvement


• Specialist provider of Mental Health, Learning Disability and Addiction services to Merseyside in North West England.(weighted population of 1.4m)

• Medium secure service to Merseyside and Cheshire(weighted population size of 2.9 m)

• One of 3 providers of High Secure Mental Health Services in England covering North West England and Wales.(weighted population size of 6.9 m)

Demographics and Demand

• Some of the most deprived communities in the UK

• Higher than average unemployment rates

• Total population remains unchanged but proportion of Older People increasing

• Higher than average incidence of drug abuse and excessive alcohol consumption

• Demand for learning disability services forecast to increase over the next 10 years

Mersey Care Vision and Strategy

Vision

• To be recognised as a leading organisation in the provision of Adult Mental Health, Learning Disability and Substance Misuse care that has at its heart health and well-being.

Strategy

• To improve the quality and increase the value of services

• To enhance partnership arrangements to deliver a better range of integrated services.

• To consolidate, develop and expand the range of services provided.

• To become a better organisation by building on involvement with stakeholders and strengthening governance.

Services Provided By Mersey Care

• Inpatient and community based services for

- Adult and older peoples mental health - Addictions – drugs and alcohol services - Learning disabilities - Brain injury - Medium secure services

• Inpatient High Secure service

• 710 Inpatient Beds• 4,300 Staff• 35 Sites• Budget for 2011-12 £189m

www.merseycare.nhs.uk

http://www.merseycare.nhs.uk/







involvement

3. Service User and Carer Involvement

• Mersey Care established 2001

• Consultation process included service user and carer views

• Recruitment to Board level posts of new organisation included service users and carers.

• Service User and Carer Forum established

• Involving Service Users and Carers Policy

Current Examples of Service User Involvement

• Trust Board • All Committees of the Board • Annual appraisal for Directors and Consultant Pyschiatrists• Policy Formation e.g. Adverse Incidents, Suicide strategy • Recruitment - Mersey Care - 2825 Mersey Care posts recruited to

since 2003• Universities – recruitment and training programmes.• Training - induction and equality/human rights training • Service development• Incident reviews• Evaluations – SURE Group• Governance Checks for Clinical Business Units• Environmental Inspections

Mersey Care NHS TrustGovernance Structure

Making it Happen

• Data base of service users and carers

• Access to training opportunities

• Work experience

• Volunteer Policy

• Payment for contribution £12 per hour

(14 euros)







involvement

4. Contribution To Improving Patient

Safety • Performance Framework – quality and safety informed

by:

- National Policy

- Clinical Quality Commission - inspections

- Local Contract for services - core payment and quality premium

- Quality Account – locally determined priorities

Performance Framework

Quality Account Local Priorities

• Improve the care pathway• Improve patient environment • Improve stakeholder engagement• Reduce top 5 incidents and complaints

– Incidents – violence and aggression, falls and self harm

– Complaints – care and treatment, staff attitude

Director of Patient Safety

• Incidents

• Violence and Aggression

• Complaints

• Legal Claims

• Safety Culture

• Service users involved in all of the above







involvement

5. An Example of Service User

Involvement in Brain Injury Services • Service User & Carer Away day in April 2010:

– The need for a facility for service users and carers to drop in, meet, exchange information and provide peer support.

– The increased use and involvement of service users and carers in the development and delivery of Brain Injury Rehabilitation Services.

– Better access to timely information about Brain Injury and local services of support.

– Providing a regular opportunity to feedback for service users and carers to the Brain Injury Rehabilitation Service about how it is doing by questionnaire or telephone call or group.

Achievements to date …Confidence

boosterA chance to learn from others and

share experiences

Helps to discuss different

approaches to life

Opportunity to talk to

professionals and change

services

Makes you feel relaxed –stops

your worries and helps you help

yourselfForum for

ideas

What we have achieved so far…

• Personal:– Brought people together – Better understand myself and others with brain

injuries– Boosted confidence and people skills

• Group:– Raised awareness of brain injuries– Developed signposting ideas– Act as a Service User & Carer Forum– Linked up community and inpatient services– Service user and Carer committee to action and take

forward the issues highlighted at the drop in centre

The Future

• Improve Service User involvement:

– Act as service users representatives/consultants in all areas of the service

– To have a voice to shape the future of the Brain Injury Rehabilitation Centre

– Volunteer opportunities:• Sports Programmes – swimming, fitness • Mentoring/buddy programme on the ward• Group co-facilitators on education and ward programmes

• Service User and Carer Led drop-in centre







involvement

SURE comprises a small group of Service Users & Carers who have been trained to undertake audit,

research and service evaluations…

6. An Evaluation of Service User & Carer Involvement in Mersey Care

NHS Trust

Why Become Involved?Why Become Involved?

0

10

20

30

40

50

60

70

To give something

back

To change and

improve services

I wanted something meaningful

to do

Because payment is

offered

Expenses are

reimbursed

Other

63 64

51

2213

19

What were your reasons for becoming involved in Mersey Care?

A lot of positive difference

53%

Some positive difference

41%

No difference5%

A negative difference

1%

Has getting involved in Mersey Care made a difference for you as a person?

Mental Health and RecoveryMental Health and Recovery

Yes78%

No15%

Don't know7%

Has being involved in Mersey Care had any impact upon your mental health recovery and well being (service

users)?

Yes79%

No21%

Don't know0%

Has being involved in Mersey Care had any impact upon your mental health and well being (carers)?

010203040506070

7060 59

3646

22 17

What difference (if any) has getting involved in Mersey Care made for you?

Involved In CareInvolved In Care

Yes61%

No11%

Don't know28%

Do you feel service users & carers are more involved in their care and treatment than they were 3 years ago?

Changes SeenChanges Seen

A lot of positive difference

68%

Some positive difference

28%

No difference4%

A negative difference

0%

Has involving service users/carers in Mersey Care made a difference for you as a person?

0

10

20

30

40

50

60

70

Attitude Practice Other area

5661

30

Difference service user & carer involvement has made

Changes To AttitudeChanges To AttitudeWorking with service users and carers has had such a positive

change in my attitude. Would like to think I was always

caring/compassionate but in this role it has heightened my

sensitivity to the needs of others and inspired me to constantly

assess my values and opinions.

I hope that I always appreciated the qualities and

potential contribution of people using services, but this continues to be reinforced by

the capabilities and generosity that is shown by people I work

with in Mersey Care.

Made me focus on

what the job is all about.

Try to involve service users from older people’s

services - not on database but have a big group of

people with dementia and carers who have been

involved in service redesign in Liverpool CBU.

Increases my confidence in MCT as a whole due to the importance of service user/carer

involvement.

Become much more explicit

that involvement is a human rights issue.

It provides both a grounding and focus as to the purpose of the service we provide, and enables

challenge and constructive discussion to occur which

might not ordinarily flourish.

Makes the service focus at all times on what's at the

heart of our service - the people.

Changes To PracticeChanges To PracticeI am more

empathic as a person.

I think I have perhaps moved away from a slightly 'protective'

approach to people, which risked patronising

and underestimating them.

Service users now play an integral role in core business discussion, especially with any changes, and involvement on a day to day basis ensures that decisions are better informed.

Made me think a lot more about how I communicate with service users.

It has resulted in me thinking what additional information I can provide for hospital inpatients during their stay.

More clearly linking involvement of service users/carers to a human right based approach to healthcare.

There is no doubt that the comments and actions of service users and carers are currently helping shape future working practices.

Changes SeenChanges SeenIt is now expected that there will

be service user and carer involvement - whereas before it was not initially on the table. I feel now that it's not looked at

as 'something to remember' but it's now always on the agenda

with everything else.

Increased feelings of empowerment and

confidence in service users. This leads to

increased job satisfaction for staff

involved.I believe it really helps

address staffs' negative attitudes. Allows service

users to be seen in a more positive light and builds their confidence.

Bravo.I have seen service users giving their own presentations at

conferences, meetings and events(instead of

professionals speaking for them).

Improved reception area.

Improved service user information.

I think it has done a lot to promote the

concept of recovery when staff see living examples in front of

them.

Service user’s expression of empowerment, having

meaningful roles. Reduced anxiety amongst staff about

meaningfully engaging service users in Trust business. More positive attitude amongst staff

re involvement.

Having service user involvement within the

development of the clinical business unit has ensured the

direction of the CBU is measured, and balances the

strategic direction to meet service user needs along with

the challenge of value for money.

Conclusions

• Involving Service Users and Carers improves care delivery.

• Culture change takes time.

• Benefits are worth the investment

Documents

Improving Mental Health. Introduction 1.Kim Crowe – Executive Director of Service Development and Delivery 2.Mersey Care NHS Trust 3. Service User and