The mental health team at London Health Programmes is delivering a programme of work commissioned by the London Mental Health Programme Group to support the NHS in London to respond to a number of priority areas identified at the beginning of the year.
A key aim across all the projects described in this bulletin is to disseminate learning and good practice across the capital in order to best respond to the needs of Londoners and best support the delivery of QIPP plans across the city.
We hope that you find this, and subsequent bulletins, helpful and informative and please do not hesitate to contact me or individual projects if you have any queries or suggestions or would like further detail on our work.
Regards,
David
We will be introducing you to all the projects within the mental health team at London Health Programmes, highlighting some of the work that has already been achieved and a giving an overview of what each team is currently working on. As this will be a monthly publication, we may not always have updates from each of the projects but we will endeavour to keep you up-to-date with all of our work on a regular basis.
The team currently consists of seven projects:
Also in this e-bulletin you will find an Important links and documents section highlighting work produced by some of the projects and links to websites containing more detail about some of the areas of work.
Shaun Crowe and Andrew Turnbull lead on this project workstream for London Health Programmes.
NHS and wider public services are changing rapidly and have the potential to affect the most vulnerable in society. NHS London recognises the importance of the issues surrounding Mental Health and Employment and has agreed it as a top priority for 2011/12 – in direct response to the NHS Outcomes Framework. Under the Executive Sponsorship of David Smith, Director of Health and Adult Services in Kingston and London Mental Health SRO, and Trish Morris Thompson, Chief Nurse for London, the Mental Health and Employment project has established an Executive Group to oversee this project workstream and the wider work of the London Mental Health and Employment Partnership (LMHEP). Michael Bell, Non Executive Board member at NHS London, is chairman of the Executive Group.
The LMHEP Executive Group, operating as a subcommittee of the London Mental Health Programme Group, met for the first time on 28th September. The next meeting on 9th December will provide expert input on the development of two complementary products that will inform and influence the commissioning decision-making process in the future. The first product will be a report capturing all existing data and research from a range of sources to help Mental Health services at risk of disinvestment, make a compelling case for re-commissioning. Building on the evidence made available by the report, we will also develop a Mental Health and Employment Needs Assessment to add value to Joint Strategic Needs Assessments as a supplementary chapter. The needs assessment will provide commissioners with a resource providing relevant information on local communities and demonstrate the wider impact of the reform agenda.
Clive Stevenson, Danijela Levarda and Robin Partridge are the leads for this project which takes forward elements of NHS North Central London’s QIPP Delivery Plan relating to mental health and will map existing dementia pathways in acute care, identifying where mental health liaison would best be utilised within revised pathways and support providers in implementation.
A workshop at St Pancras Hospital on 30 September brought together borough commissioner and acute provider stakeholder groups from across north central London, providing an opportunity to discuss issues around provision of effective services to people with dementia. Each of the five providers presented their current dementia care pathways and delegates considered opportunities for improvements to the whole system through mental health liaison. The workshop was well attended and positive feedback received.
Further exploration and analysis will continue through the coming months leading to revised commissioning intentions, delivering on QIPP and implemented contractually in north central London in 2012/13.
A report will be published by LHP at project close for the benefit of acute and mental health providers, commissioners and stakeholders across London.
The team leading on this project include Clive Stevenson, Danijela Levarda and Robin Partridge.
Primary care
The Medically Unexplained Symptoms (MUS) Project in 2010/11 focused on severe MUS presentations, i.e. managing persistent symptoms, in primary care. Following project implementation in GP practice pilot sites across London the mental health team published the MUS project implementation report.
Also published were:
A link to these documents can be found in the Important links and documents section.
The MUS whole systems approach was at the core of the project and provides examples of a range of effective approaches across the whole system to manage MUS including a Multidisciplinary Chronic Pelvic Pain Clinic, a Functional Neurology Clinic and the National Refractory Angina centre. A wide range of stakeholders contributed to the project including patients, clinicians from a range of service providers including primary and secondary care and commissioners.
The MUS education and training package was developed and delivered in the pilot sites and is now more widely available via the London Deanery Integrated Care Programme. A link to more details about the education package can be found in the Important links and documents section.
Secondary care
This project extends the learning from the work in primary care into secondary care with the emphasis on frequent presentations in acute hospital emergency departments. A workshop was held on 8 August 2011 that focused on understanding the issues and establishing the final form of the project including identifying pilot sites.
Education sessions for staff have taken place at two of the pilot sites. These sessions, facilitated by Professor Tom Craig from the Institute of Psychiatry, are based on similar workshops run during the primary care project and provide an overview of concepts and issues around MUS.
The project will go on to test and evaluate interventions for reducing attendance at emergency departments and will publish detail demonstrating clear cost benefits and the learning from the pilots on the most appropriate model of care.
Robert Hardy, Shaun Crowe, Andrew Turnbull and Becky Ozman are the Improving Access to Psychological Therapies (IAPT) implementation support team for London based at London Health Programmes and tasked with mainstreaming IAPT to new commissioning arrangements.
October saw 110 new cognitive behavioural therapy (CBT) trainees begin their training as part of London’s commitment to expanding the workforce in line with national expectations. CBT is a type of NICE recommended treatment for common mental health problems like anxiety and depression, based on a stepped care model and the least intrusive approach to care. It aims to help the user manage their problems by changing how they think and act. IAPT is committed to offering user choice of not just CBT but a range of other non CBT modalities like Brief Dynamic Interpersonal Therapy and Interpersonal Psychotherapy for Depression. London has commissioned 55 training places as well as further training in long term conditions and older people to widen access and help realise planned QIPP benefits. We are now in the fourth year of a six year national programme.
Arrangements have been made to allocate resources direct to London’s providers of psychological therapies this year via the SHA’s MPET budget and with the support of its workforce education commissioning team. New trainees are centrally funded in the training year, but local arrangements will need to be made to ensure that a fully funded once central funding ends. A similar model is proposed for 2012/13 with another 110 new CBT training places likely to be commissioned.
The team will be contacting clusters and local services about the Clinical Quality Assurance process ahead of the 2012/13 (wave 5) trainee intake. This will be organised by commissioning cluster between November 2011 and February 2012. Ensuring that ongoing salary costs are funded for all CBT trainees completing their training in 2012 has been set as a priority for the London Clinical Quality Assurance panel and will be a prerequisite for all IAPT services wishing to take on new CBT trainees in 2012/13.
The LHP Mental Health team have undertaken work to help co-ordinate a London response to the DH mental health strategy, ‘No Health Without Mental Health’.
The first Public Mental Health network took place in early October and the second is planned for later this year. The team have also drawn up a position statement/gap analysis of mental health activity across London in relation to the strategy.
The Mental Health Models of Care Implementation project team consists of Brendan McLoughlin, Sue Christie, Michael Corbluth, Amanda Patterson and Clara Lewis. The project team will support clusters with the implementation of the new models of care for Londoners with long term mental health conditions or experiencing a mental health crisis which were launched on 23 June 2011.
In consultation with a wide range of interested parties, including service users, carers, primary and secondary care clinicians, social care and providers, new models of care were developed to help ensure that people get help in the right place at the right time from the right people. Key to this is the coordinated care between all providers to ensure that the health and social needs of people with mental health conditions are met quickly and appropriately.
The project team are currently supporting London’s NHS clusters to implement the models of care until March 2012. Implementation support to the six commissioning clusters will be provided to enable them to incorporate this work into their local plans and contribute to the delivery of their local QIPP programme. Clusters will lead implementation at a local level to reflect their needs and available resources, building on existing good practice. Preparation for the implementation of mental health PbR is closely associated with successful implementation and the LHP team is supporting a coordinated approach across these workstreams.
The project team is also providing support to NHS London on the mental health part of the work to establish the 111 urgent care number for health services and the Directory of Services which will accompany it.
A link to the models of care along with other associated documents is available in our Important links and documents section.
The PbR and Outcomes project is supporting commissioners and providers with the implementation of mental health PbR and is a conduit for information between the Department of Health (DH) and London. The team members working on this project are Fionuala Bonnar, Heleno Ferraz, Amanda Patterson and Becky Ozman.
The main components of the project include: the Mental Health Commissioners Collaborative a commissioning led pan-London Mental Health PbR Steering Group regular facilitation of the London Currencies Development Board which brings together representatives from London’s mental health trusts to discuss issues around development of mental health PbR currencies and the allocation of service users to care clusters a web based information repository for key documents and resources on mental health PbR publication of the bi-monthly Mental Health PbR and Outcomes project e-Bulletin a survey of providers clustering status which led to the establishment of the PbR Project Leads group regular facilitation of the Mental Health Trust Deputy Directors of Finance Costing Sub-Group a borough demographics analysis for care clustering validation.
For more information on the work of the PbR team please see our Important links and documents section for a link to the Mental Health PbR and Outcomes project e-Bulletins. The October e-Bulletin contains important information on the latest PbR Draft Guidance 2012/13 re-leased by the DH in October. A link to the draft guidance and associated documents can be found under ‘Other publications’ in the Important links and documents section.
Mental health PbR and outcomes project
Mental health models of care implementation project
Improving access to psychological therapies project
Managing persistent symptoms project
Other publications
Clara Lewis for the: mental health models of care implementation project
Robin Partridge for the: managing persistent symptoms project and mental health liaison model for dementia project
Becky Ozman for the: PbR and outcomes project, IAPT project, mental health strategy implementation project and the mental health and employment project
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