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North Tyneside - Improving outcomes for people experiencing mental health crisis
Jacqui OldDirector of Adult Social Services
November 2014
Life expectancy & disability-free life expectancy & premature mortality rates
Context• Children / Adult cover 65% of council budget• N. East - By 17/18 40% reduction resources• North East highest level of decrease in spending power• Worrying signs that gap could widen - impact of recession• Flaw in public spending is shown - NHS as an island • Local government & Benefits seen as easy for cuts • Consequences for NHS.• Trusts finances/ operational sustainability over next 5 yrs• Need for more granular information on the impact of
austerity
Challenges in North Tyneside
• Availability and access to
Place of safety beds• Joint training front line
police and mental health practitioners
• Supported Housing Offer
• Parallel Tracks• Separateness of each
imitative
• Excess use of police cells
for people with mental health problems
• Cliff-edge of lost support as children and young people with mental health needs reach the age of 18
• Out of hour access to crisis beds for young people (17+)
• Transportation of people with mental health problems in Crisis
Quality of Treatment & Care
Service data to track and assure
Beds readily available
Single commissioning budget
Access to support before crisis
Universal single point of access
- Thresholds, Gateways
Universal Services
Information and advice
Primary care
Recovery and staying well
- Early Intervention/Prevention
- Information and Advice
- Care and Connect
Urgent and Emergency Access to Crisis Care
136 Pathway /Crisis team/ MEAM
- Improved services for those with co-existing mental health and substance
misuse issues
Chronically excluded from services
AMPHS
-
Emergent Thinking
Access to support before crisis point
Access to support before crisis point
• Help this person to recover, become more independent and reduce care needs
• Maximise ways to promote prime interventions to support recovery
• Develop a clear political model of care which has promoting independence for citizens and find some of the care solutions from communities families and individuals
Access to support before crisis point• Phone for help- divert you to menu of options • Improve access to support via primary care• Awareness of local mental health and substance
misuse services and how to engage them• Focus on outcomes from our interventions• New compact with community• Work with ph to make every contact count
2. Recovery and staying well • Divert people away from formal care through good info
and advice services• Develop the right level of preventative interventions in
order to help people at the right time• Service model of the future will be radically different• Changing the model of care from one of paternalism and
protective interventions to one which promotes independence and manage risk with customers
• Instead of asking what is the matter with you - what matters to you.
• Carers
2.Recovery and Staying Well
• We will not assess person in crisis until we have given them the opportunity to recover/rehab
• Never make long term decision in middle of crisis• Develop the right set of interventions that prevent long
term placement• What is the practice and interventions that work• Is Reablement /recovery delivering cost effective
outcomes ?
3.Urgent & emergency access in crisis
136 Pathway• Process mapping workshops held with key partners
across all areas• Issues raised in the mapping workshops brought
together in partnership meetings to agree actions required.
MEAM• Improved services for co-existing mental health
substance misuse issues• Getting costs down before - not building costs up
4. Quality of Treatment and Care • Commissioning team with eye on the ball and team who are
much more forensic• Commissioning that allows for beds to be readily and locally
available in response to urgent need• Commissioning provision for under 18 year olds that
ensures local provision for young people in urgent need• Single budget- commissioning for adults.• Proper sense of partnership.
4. Quality of Treatment and Care • Effective joint performance framework – Create system that
gives clarity and purpose
• Sufficient amounts of service data info that we can track and provide assurance that services are working
• Build intelligence so we have an informed approach to strategic and operational decision making
• Response Timescales/Esculation/Bed avaiability/ AMHPs
• Focused on managing demand and cost- Know weekly if they are meeting need
So where we have got to ?• A shared perspective - joint statement about how public
services will work together• Agreed set of principles and good practice• Switched into different gear. Not the solution but good focus
and start.• Recognition that we can`t do this in isolation –
interdependency• Systems leadership
Thank-you