MH practitioners are being embedded within custody blocks. They cover 7 days per week from 07:00 to 19:00hrs. Working from therse locations they are able to screen detainees and ensure that correct support is provided e.g. signposting to other services, calling MHA assessments etc.
Improvement in the service provided to vulnerable persons and improved decision making by police officers. There is a raised awareness amongst officers of mental illness, its impact and the medical resources available.
Organisation:
Dorset Healthcare University Foundation Trust
Project contact:
Simon Thorneycroft
Our vision is to achieve the best possible outcomes for people experiencing psychosis. We would like to see everyone experiencing psychosis receiving evidence based care at the right time and in the right place. Wessex AHSN are currently finalising a best practice pathway and Southern Health NHS Foundation Trust will now be the pilot for implementation. This will be a 2 year programme. Pathway development has been undertaken through the involvement of services users, carers and staff and by the use of intelligent data. We will be evaluating the work to identify it's applicability for spread. As part of this programme will also support the region in achieving the newly published access and intervention standards for psychosis.
Intended outcome; all people experiencing psychosis in Wessex receive evidence based care in a timely way to improve outcomes.
Organisation:
Wessex AHSN, Southern Health NHS Foundation Trust, Southampton Healthwatch, Janssen Health Care, Stripe Partners Inc.
Project contact:
Shanaya Rathod & Alison Griffiths
The overall objective of this project to deliver a new service offer for those individuals with a diagnosed SMI wishing to engage with stop smoking services, with a view to reducing the variation in outcomes in Dorset and to share the learning with other commissioners of stop smoking services across Wessex.
We found that SMI patients were more likely to be smokers 42% compared to 17.5% in the general population.
Although more likely to be given smoking advice, when accessing a specialised stop smoking service the success of the interventions for SMI patients is significantly lower 28.5% compared to 51% for the general population.
The project has now been taken over by Public Health Dorset. The following outputs are expected to be delivered
• Collate patient views on the service design
• Ensure that the enhanced service offer from the provider for those with complex needs is tailored to support individuals with a SMI.
• Establish training for upskilling staff in both mental health and stop smoking providers.
• Produce recommendations for Clinical Commissioning Groups (CCGs) across Wessex.
• Share literature review for SMI and smoking alongside these recommendations
• Promote the new service across the Dorset area
Organisation:
Public Health Dorset
Project contact:
Sue Airey (Wessex SCN) & Chris Ricketts (Public Health Dorset)
On Friday, Saturday and Sundays, 19:00-08:30 two Mental Health practitioners are on duty. One is based in police station to attend and conduct face to face interventions and the other is based in Force control room screening all police calls, offering advice and clinical information to patrolling officers. Both staff have access to RIO and Police Systems in order to provide a more complete picture, allowing officers to make better informed decisions and access to a range of options.
Improvement in service provided to vulnerable persons and improved appropriate decision making by police officers.
Organisation:
Dorset Healthcare University Foundation Trust
Project contact:
Dorset Healthcare University Foundation Trust
Development of an integrated enhanced pathway for people in cluster 10 - 17. The pathway includes intensive support for individuals to remain or return to independent community living , to support access to suitable and sustainable accommodation , to support landlords who provide accommodation for people with mental illness to prevent risk of accommodation break down, to empower people to take personal control of their lives and maximise recovery.
People on the pathway will have a reduced number of admissions and readmissions to acute psychiatric hospital, will engage in meaningful daily activities such as employment, training or voluntary work or accessing day services that promote well being and recovery, will experience a reduction in negative symptoms, will have access to suitable and sustainable accommodation and access to respite accommodation and support at times of crisis where appropriate.
Organisation:
IOW CCG, IoW NHS Trust, IoW Local Authority, Third Sector
Project contact:
Karen Kerley
Email:
karen.kerley@iow.nhs.uk
Ministry of Justice pilot scheme to minimise the number of victims of crime suffering from mental illness and to reduce the number of repeat victims suffering from mental illness. The pilot consists of education - this has been addressed by a multi-agency training day on 'staying safe'. Also to deliver one to one coaching. Compiling a strategic needs analysis regarding the above. Identification of individuals subject to multi agency support.
Reduction in victims and repeat victims with mental illness. Better understanding of victims with mental health perspective and needs. Improved education and learing across services.
Organisation:
NHS, Dorset Police, Dorset Mental Health Forum, Local Authority, Third Sector
Project contact:
Simon Thorneycroft
Following horizon scanning and hearing of evidence, the Senate Council developed recommendations for commissioners on what mental health services should be commissioned to ensure a safe and sustainable service.
survey of commissioners actions since these recommendations were published - planned not executed
Awareness training package for police officers including video containing Dorset Case Study. Question guide for operational staff and engagement model to assist them deal with individuals who have or may be suffering from mental illness. Awareness of police powers and national decision model delivered to AMHPs. Followed up by AMHPs shadowing the Force Control Incident Commander to learn how police grade responses based on NDM.
Improvement in service provided to vulnerable persons. Improved decision making by police and partners.
Organisation:
Dorset Police
Project contact:
Simon Thorneycroft
Work is being done in a GP practice in the Isle of Wight patients/carers to assess why admissions are happening and what needs to be in place to prevent avoidable admissions.
A reduction in avoidable admissions. Patients and careres with mental health issues feeling better supported and able to manage their condition and crisis appropriately.
Organisation:
NHS Isle of Wight CCG
Project contact:
Michelle Legg
Liaison and Diversion is an all-age NHS service, operating seven days a week for people with vulnerabilities who are alleged of a criminal offence.
Staff are embedded within police custodies and courts across Hampshire and IOW where we can engage with service users at the earliest opportunity. We identify and support with any unmet needs that may mitigate potential for reoffending. Vulnerabilities include mental health, learning disabilities, ADHD/Autism and trauma.
Specialist support is available for youths, women and veterans as we recognise there can be additional needs associated with these groups. Liaison and Diversion work with local stakeholders and partner agencies to assist service users to access necessary care and support.
Intended outcome: Offenders with mental health issues receive the appropriate care and ensure that the criminal justice system is aware of an offender's mental health issues.
Organisation:
Berkshire Healthcare Foundation Trust
Project contact:
Pauline O'Callaghan
The Recovery College in Southern Health offers a variety of courses related to Recovery and Self Management to people who use, work within and care for someone in Adult Mental Health services . There are specific courses that focus on times of Crisis; Managing a Crisis: planning ahead and WRAP seminar 1 - Building a WRAP which covers how to develop a comprehensive crisis plan. Further details of the courses can be found on the College website. The Trust also have a Recovery Toolkit, a website based resource.
To support people through all stages of recovery, from planning to stay well to coping in a crisis and learning from your experience.
Organisation:
Southern Health Foundation Trust
Project contact:
Kate Sault
The Crisis Response Service is an integrated multi-disciplinary team consisting of health care, social care and voluntary sector professionals who will respond to a referral within 4 hours and provide up to 72 hours of care and support to enable an individual to remain at home. The service is available 08:30 – 16:30, 7 days a week, to people over the age of 65 years, and is accessed through a single point of access in an Integrated Care Hub (111). The team undertakes a holistic assessment of the person, environment and support available in order to address the current crisis and to prevent future crisis by putting mitigation plans in place.
Three main outcomes:
• Avoidable hospital admissions, readmissions and/or long-term nursing and residential placements are prevented (Estimated 205 hospital admissions avoided in 2014/15)
• People will experience rapid access to high quality, seamless care and support delivered by a skilled workforce within their communities, enabling people to maintain their independence within their home environment
• The workforce experience a culture shift and behaviour across all organisations (private, voluntary and statutory) to support proactive integrated, personalised care
Organisation:
IoW CCG, IoW NHS Trust, IoW Local Authority, Third Sector
Project contact:
Yasmin Wills
Email:
yasmin.wills@iow.nhs.uk
Admiral Nurse Service initiative working across the Island, using a locality based model. This new service is supporting family and carers of people living with dementia and people with dementia that live alone or in a care home with expert advice and support.
A person-centred service, which empowers people with dementia and their carers to make informed decisions about care.
People living with dementia and their carers will be empowered to make informed decisions about care.
Organisation:
IoW CCG, IoW NHS Trust, Dementia UK
Project contact:
Sue Jones
Email:
Sue.jones@iow.nhs.uk
Using simulators to run in-situ simulations (hanging, cut wrists, strokes, asthma, illegal highs, and suffocation)
The staff develop skills in multi-disciplinary training, communication, leadership, teamwork and delegation. Working in the clinical environment provides important information about systems and processes in managing the acute physically unwell mental health patient. Practicing these medical interventions allows time to support and develop the staff to learn from real life events in a safe setting to develop coping mechanisms and improve patient care.
Organisation:
Queen Alexandra Hospital
Project contact:
Kirsty Harris
RAMPPS aims to create and provide a repository of simulated scenarios at the interface between physical and mental health. The focus is to expand awareness and reflect the multi-disciplinary approach to improve patient care. (Developed by Health Education Yorkshire and the Humber)
The staff develop skills in multi-disciplinary training, communication, leadership, teamwork and delegation. Recognition of the deteriorating patient and revision of the SBARD communication tool, A-E physical assessment and NEWS score or track and trigger systems. In order to provide patient safety and the patient health journey
Organisation:
Queen Alexandra Hospital
Project contact:
Kirsty Harris
Live actor simulation to raise awareness and knowledge of in patients with mental health disorders in the hospital setting for non-psychiatric health professionals.
Raise awareness and develop deeper knowledge of mental health. Develop an understanding of the impact of the mental health patient in the hospital setting (for staff and patients). Enhance knowledge of signs and symptoms of psychiatric disorders. Recognise when to call for specialist psychiatric support and how to access services.
Organisation:
Queen Alexandra Hospital
Project contact:
Emma Williams
Increasing access to qualified mental health practitioners (Liaison Psychiatry) based within the Emergency Department to ensure that people presenting with a mental health crisis or presenting with dementia are treated with the same urgency as those presenting with a physical health crisis.
Extending this liaison team to seven days a week will support the acute wards and A&E in rapid assessment, interface and discharge of patients whilst providing patient centred care to these vulnerable groups. The team consists of liaison for Learning Disabilities, Dementia and Mental Health (Including Self harm)
• Improved clinical outcomes
• Avoiding unnecessary admissions to medical wards with emphasis on diversion and discharge from A&E
• Facilitating early, safe and supportive discharge from general medical wards
The IoW is championing the use of E-Mental Health tools that people can access and use at their own convenience whether in the comfort of their own home, or when they are out and about.
On line psychological support is available for people experiencing symptoms of mild anxiety, stress and worry. Access to the support is open to all and it can be via self-referral or through their GP; all relevant ‘Apps’ are free to download and use.
The providers use various approaches so the individual can chose which one is the best for them.
Early Intervention, providing more people on the IoW with greater choice and support with mild anxiety and / or depression.
Reducing demand for primary and secondary services and escalation of symptoms by self-management
Organisation:
IoW CCG, Positive Mental Health, SilverCloud,
Project contact:
Sue Jones
Email:
Sue.jones@iow.nhs.uk
Specialist mentoring team led by a police officer and mental health clinician providing intensive support for mental health service users who are demonstrating high intensity crisis demand
A pilot has shown that an integrated mentoring approach had a positive impact on a reduction in crisis calls, reduction in ED attendance, response costs reduces, risk reduced, loved ones more confident, improved therapeutic relationships, service users refocussed and discharged from the service.
Organisation:
Hampshire Constabulary and IOW NHS Trust
Project contact:
Police Sergeant 20261 Paul Jennings – Mental Health Sgt
Serenity is a joint working initiative between the Isle of Wight NHS Trust and IoW Police that co-ordinates mental health nurses to respond alongside frontline police officers at crisis mental health incidents.
The aim is to provide the best possible response to people who are experiencing a mental health crisis. This is achieved through quick attendance of suitably trained police officer(s) and mental health practitioners at the scene enabling de-escalating of the situation with improved diagnosis and treatment leading to reduced hospitalisation.
Serenity Integrated Mentoring (SIM) focuses on those individuals who call on the mental health services of the IoW Police and IoW NHS Trust on a frequent basis; by providing dedicated and controlled support on a 1:1 basis the frequency of use of the services by these individuals has significantly reduced.
By working together, they have delivered improved outcomes for service users, increased team and partnership efficiencies and reductions in operational costs for both organisations.
Reduction in the number of Section 136 inpatient admissions, collaboration and improved communication, rapid assessment on scene, improved signposting and increased referrals, embedding drug and alcohol processes into Serenity systems to provide accurate and reliable data
Organisation:
IoW CCG, IW NHS Trust, Hampshire & IOW Police, IW Public Health (DAT)
Project contact:
Sue Jones
Email:
Sue.jones@iow.nhs.uk
Strategic Clinical Networks exist to bring about complex change across complex pathways of care. Wessex Health Lines will serve as a resource for individuals and organisations collaborating to improve care in Wessex.