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