Agenda item

Kathryn Singh, RDaSH, to report

Kathryn Singh, RDaSH, gave the following powerpoint presentation:-

 

Adult Mental Health and Learning Disability Transformation

1.    Deliver improved outcomes and performance in the Improving Access to Psychological Therapies Service

2.    Improve Dementia diagnosis and support – continued focus on community

3.    Delivery CORE 24 Mental Health Liaison Services

4.    Transformation of the Woodlands inpatient ‘Ferns’ ward

5.    Improve Community Crisis and Home Treatment response and intervention in Mental Health

6.    Oversee Delivery of Learning Disability Transforming Care

7.    Support the development of Autism Strategy

8.    Support work of Public Mental Health Strategy including Suicide Prevention

 

What is working well?

-        Clear priorities for Service improvement and delivery in 2017/18 and 2018/19 which are achievable

-        Excellent place working across all the organisations e.g. Ferns, Core 24, Community Crisis

-        Moving from planning to delivery, CORE24, IAPT, Ferns (Phase 2), LDTCP

-        Planning for Community Crisis and Community Dementia follow-up

-        Joining up agendas e.g. CORE fidelity review with social care review of mental health Services

-        Clarity on oversight and assurance roles for work delivered through other structures e.g. TCP, Autism Partnership Board

 

What are our challenges?

-        Ensuring we remain focused on pathways transformation as well as Service transformation

-        Supporting the TCP with expected transfer of high cost LD Service users from NHSE commissioning to Rotherham – possible impact on budgets and available services

-        Ensuring project interdependencies are managed within the transformation group’s remit and within the wider Rotherham Place priorities and governance

 

What needs to happen (and by when)?

-        Ensure regional/ICS level funding flows into Rotherham priorities e.g. suicide prevention (Q1 2018/19)

-        Delivery of a 24/7 CORE24 liaison service (Q1 2018/19)

-        Completion of the CORE fidelity review and recommendations (Q4 2017/18)

-        To work with GPs and providers to raise awareness (and increase uptake) of health checks for learning disabled people (Q1 2018/19)

-        Agree the Ferns model and funding for 2018/19 (Q4 2017/18)

-        Agree post-diagnostic follow up for Dementia in primary care through the LES (Q4 2017/18)

-        Agree IAPT plan and trajectory (Q4 2017/18)

-        Continue to provide input, oversight and assurance to TCP, Autism and LD Strategy development

 

Focus on CAMHS – Working Well?

-        New ‘Advice and Consultation’ Service through the Single Point of Access (SPA) providing quicker and more focussed access to RDaSH CAMHS

-        Prioritisation of LAC referred to the CAMHS Service and close working with LAC Therapeutic Team

-        Locality Mental Health Workers who link directly with GP practices, schools, Early Help and Social Care Teams

-        CCG funding of 2 ‘Children’s Wellbeing Practitioners’ to provide early intervention for lower level issues

-        Nationally recognised Rotherham Parent Carers Forum (RPCF) providing direct support to families and co-production approach

-        Regular inter-agency dialogue between RDaSH, RPCF and Healthwatch, providing constructive dialogue for service development/improvement

-        Better support for children and young people diagnosed with Autism

-        CCG part funding of schools ‘CAMHS’ worker pilot

-        New initiative to roll out ‘whole school’ approach to primary schools

-        RCCG continues to fund year-on-year increase in CAMHS provision

 

Focus on CAMHS – Impact on Performance

Significantly reduced waiting times for children and young people

-        Assessment

September 2016 182 waiting and 30% seen in 6 weeks

November 2017 14 waiting and 100% seen in 6 weeks (93% in 3 weeks)

-        Treatment

September 2016 42% waiting less than 8 weeks and 73% less than 18 weeks

November 2017 84% waiting less than 8 weeks and 97% less than 18 weeks

Numbers waiting reduced from 376 (September 2016) to 38 (November 2017)

-        High proportion of young people have ‘goal set’ on entering service 94% report improving against goal

 

Focus on CAMHS – Next steps for Rotherham

-        Extension of Intensive Community support 8.00 a.m. to 8.00 p.m.

-        Integration of Crisis Service with Adult Crisis Team

-        Closer working between the CAMHS SPA and RMBC Early Help Service

-        Reducing waiting times for ASD and ADHD assessments and consultation with Parent Carers Forum/Healthwatch

-        Further development of outcomes monitoring

 

Discussion ensued with the following issues raised/clarified:-

 

·           The work across the whole system had been really positive.  The aim was to ensure there were links across the Integrated Rotherham Place Plan and the Health and Wellbeing Board with all the aspects of mental health being discussed

 

·           All targets were being hit with regard to the Improving Access to Psychological Therapies Service

 

·           ‘Ferns’ Ward had opened and proving very successful. This was about working as a partnership between the TRFT, Social Care and RDaSH making sure that people with Dementia/Delirium who required support got the support they needed in the right setting.  It was focussed around the needs of people with Dementia/Delirium that took them from the acute sector when medically fit and stable but still needed the help of enablement and reablement

 

·           The fact that there was the opportunity for all partners to take their share of responsibility for mental health was really important.  Mental Health was about good Mental Health as well as poor Mental Health

 

·           RDaSH was to have a Mental Health Worker in the Access Team one day a week which would make a real difference

 

·           Over the last 2 years there had been a change in the approach to Mental Health looking at the whole person and not a person with Mental Health

 

·           The link with Social Prescribing was important.  The evidence for the second year was again showing over 50% of Service users were eligible for discharge.  If it could be used to stop people from going into Service in the first place by way of low level interventions it would prevent high cost interventions

 

·           Was there something omitted from the Strategy with regard to the learning from deaths?  There was reference within Aim 2 of the physical health needs of people with Learning Disabilities but was there action where someone with Learning Disabilities prematurely died and whether it could be demonstrated that everything possible had been done and had not been penalised because of their disabilities.  It was felt that there was the opportunity in the Lead Programme to work on local delivery

 

·           Significant funding had been received via the CCG and National Crime Agency with regard to adult survivors of CSE involved in Operation Stovewood.  RDaSH were working with the CCG to put together a proposal on how they would support adult survivors going through the Court system

 

·           CAMHS had undergone a massive improvement journey over the past 2 years and had changed the way it delivered it services.  It had worked really well with consistency of approach for the organisation and very specific according to place.  One of the major achievements in Rotherham was that, where it used to take months in terms of the transition from CAHMS into Adult Services, a transition service was now delivered within 3 weeks

 

·           Work was being carried out with Service users and parents, Healthwatch Rotherham, voluntary sector and the Rotherham Parents Forum in terms of the kind of support and commitment given in terms of looking at the CAMHS pathways and trying to do something different

 

·           CAMHS now had an Advice and Consultation Service; a single point of approach meant not only seeing the right children but seeing them very quickly

 

·           There had been recent consultation on the Green Paper around Schools and the role of the Medical Practitioner in Schools.  There had been a real positive change in RDaSH’s relationship with Schools and regularly met with the Head Teachers to look at new ways of working

 

·           Healthwatch Rotherham had been commissioned to carry out a further piece of work looking at the improvement journey to ascertain if the changes RDaSH felt it had made were coming through

 

·           There had been much improvement but there was still work to do with regard to Pathways

 

·           RDaSH provided an Advocacy Service around CAHMS and was the main issue that members of the Public contacted Healthwatch Rotherham with regard to

 

·           With regard to prevention, there were areas within Aims 1 and 2 as well as the Green Paper referring to working with Schools in a much more co-ordinated way.  The Service was seeing a number of children that had been affected through cyber bullying and the need for discussions between organisations as to the role of the School Nurse and the first tier of intervention about positive Mental Health, what was and was not acceptable and start to build children’s resilience to some of the issues

 

·           The My Mind Matters website was available for young people and parents to access good quality information

 

Phyll Cole, NGHS England, reported that there was to be a Yorkshire and Humber event looking at feedback from NHS England’s Leder Programme hosted by England North.  They would be particularly interested in feedback on case studies around mortality reports and would welcome representation from Rotherham. 

 

Resolved:-  That the update be noted.