Transforming mental health services for adults and older people the next 3 years

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Transforming mental health services for adults
and older people - the next 3 years

• Claire Newman - Strategic Commissioner Adult
  Mental Health
• Margaret Cooney - Programme Manager Mental Health
  Commissioning
• Kathy Caley - Strategic Commissioner Older
  Peoples Mental Health

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Context Adults

• High levels of SMI in the City (0.95 total
  population on Primary Care SMI Register the
  highest serious mental health needs index (MINI
  score) of the 8 LITs making up the South Coast
  SHA)
• Deprivation linked to poor mental health and is
  high in the east of the city (Brighton and Hove
  ranked 4th most deprived of the 67 areas in the
  South East)
• High suicide rate (1.7 X national rate)
• High drug and alcohol misuse leading to crime,
  admissions and poor life expectancy and health
  (Brighton and Hove has the highest rate of
  problem drug users in the South East Region 1.9
  of the adult population)

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Older people

• Applying national prevalence rates approximately
  3,000 people aged 65 years and above with
  dementia
• Only approximately 1000 diagnosed with dementia
• 29 will have severe dementia
• 10-15 of all older people have depressive
  symptoms equating to between 3,900 and 5,900
  older people and 400-2,000 with a more severe
  depressive episode

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Priorities in the New Horizons document

• Prevention
• Stigma
• Early intervention
• Personalised care
• Multi-agency commissioning/collaboration
• Innovation
• Value for money
• Strengthening transition

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National priorities in the National Dementia
Strategy document

• Public awareness campaign
• Memory assessment services
• Support and information
• Improved training for workforce
• Peer support
• Increased community support
• Support for carers
• Improved care in general hospital, intermediate
  care and care homes
• Housing and telecare options

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Vision

• Improve mental well being and mental health for
  all adults in the city through commissioning
  services to meet peoples needs earlier,
  effectively and wherever possible in a community
  setting.
• We will do this by commissioning a much greater
  number of services for low level need and we will
  do this by reinvesting money from efficiencies
  elsewhere in the system.

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Local Authority context

• Joint Commissioners with PCT
• Developing choice and self directed support
• Value for money for social care input in the
  integrated teams
• Accommodation review
• Increasing Direct Payments
• Increasing carer assessments and reviews

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• Spend 2007/8

Adult Mental Health Commissioning
Older Peoples Mental Health Commissioning
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Developing our adult commissioning plan

• Background document of service analyses
• Multi agency and user and carer steering group
• User and carer stakeholder strategy development
  group - LIVE project (and ongoing meetings set)
• Mental Health Voluntary sector network
• Staff in SPFT
• Online consultation to public, GPs, carers and
  staff

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Key outcomes from theconsultation process

• Make best use of resources
• Services based on need and not age
• Positive mental well-being to address social
  inclusion reduce stigma, ensure access to
  vocational support across all levels of need
• Improved access through reducing waiting times
  for assessments and start of treatment
• Effective treatment pathways including access to
  all levels of psychological therapy
• Improved flow of care with improved care
  co-ordination
• Greater range of primary care and community
  services
• A skilled and diverse workforce
• Support for carers including self directed
  support opportunities
• Increasing interagency working between health,
  housing, vocational support, leisure and
  education services

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Work streams to deliver on outcomes

• Improving outcomes through focusing on wellbeing
  and prevention services
• Providing an efficient and effective gateway and
  triage system into services
• Developing care pathways for people with
  identified need from mild , moderate to severe
  need
• Developing primary and community care services
  that maintain people in recovery

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Improving outcomes through wellbeing and
prevention

• Social marketing to reduce the harmful affects of
  alcohol and risks of suicide
• Brief interventions for alcohol and substance
  misuse
• Alcohol screening in primary care
• greater role for the third sector
• increased involvement of general practice
• more personalised support with a focus on
  supporting people to stay in/return to work

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2. Providing an efficient and effective gateway

• Piloting a new referral management gateway into
  mental health services for all non urgent
  referrals
• Improvements in access to emergency and urgent
  treatment services
• Introducing a single assessment process for
  substance misuse

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3. Developing care pathways

• Realigning the commissioning and provision of
  mental health services on the basis of need not
  age
• Improving access
• Reviewing of day care provision
• Meeting the needs of people with complex mental
  health needs
• Reviewing the number of acute beds across Sussex
• Interface between primary and secondary care
• A focus on the workforce
• Improved co-ordination of care across the whole
  pathway

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4. Developing primary and community care

• Enhanced role for primary care in the recovery
  stage
• More personalised services
• Introducing a SMI LES to support the discharge
  from the mental health services into the
  community
• Developing a range of community initiatives for
  choice, self directed support and personalisation
• Reviewing and realigning the range of services
  including day and homecare support, support to
  carers
• Improving links between primary and secondary
  care

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OPMH Planning Framework 2009 - 2012

• Ratified in March 2009
• Developed in line with National Dementia Strategy
• Priorities for the next 12 months
• Memory assessment service
• Peer support network
• Workforce training
• Primary care support

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Questions

• 1. What do you feel about the 4 areas?
• overall direction of proposals
• potential benefits
• weaknesses
• areas for development
• 2. What further work do we need to do with
  providers and the public to engage the plans?