Service users receiving a review (those on CPA for 12 months or more)

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1 Definitions and rationale for the indicators in the website scorecard. Indicator 1 Maximum of 13 week wait for treatment from point of referral The Trust serves six different Primary Care Trust areas. The performance of this measure is shown as the number of areas that have met the 95% target level of performance as defined below. Number of service users receiving treatment within 13 weeks of the Trust receiving the referral Number of service users receiving treatment s seen within 13 weeks will have improved health outcomes. It has been shown that patients that originally present with mild to moderate mental health issues may have an exacerbated condition if there is excessive delay from being referred to being treated. Indicator 2 Care Programme Approach follow up within 7 days of discharge The Trust serves six different Primary Care Trust areas. The performance of this measure is shown as the number of areas that have met the 95% target level of performance as defined below. The number inpatients discharged to be followed up within 7 days of discharge, phone or face to face The number of inpatients discharged This indicator supports the reduction in the rate of death by suicide as research has shown that patients are most vulnerable in this period following discharge. In addition to reducing risk, it also reduces social exclusion and improves the care pathway.

2 Indicator 3 Service users receiving a review (those on CPA for 12 months or more) The performance of this measure is shown as the Trust level percentage aiming to equal or exceed the target level of 95%, as defined below. The number of service users on CPA in the who have received a review of their care and treatment in the last 12 months The number of service users on CPA who have been open to the Trust for 12 months or more Care planning and the delivery and regular review is core to the successful delivery of integrated and effective care to service users. Reviews should be timely and at intervals dependent on need but at a minimum annually. Reviews involve all relevant parties to the care of the individual to ensure any changes to a care plan take all relevant information, service user views, carer views and clinical evidence in to account. Indicator 4 Minimising Mental Health delayed transfers of care The performance of this measure is shown as the Trust level percentage achieved aiming to be less than the target level of 7.5% as defined below. The measure excludes delays attributable to social care. The number of non-acute patients whose transfer of care was delayed summed over the quarter The number of non acute patients admitted to the trust summed across the quarter This indicator measures the impact of community-based care in facilitating timely discharge from hospital and the mechanisms in place within the hospital to facilitate timely discharge. People should receive the right care in the right place at the right time and mental health trusts must ensure, with primary care organisations and social services, that people move on from the hospital environment once they are safe to transfer. The indicator seeks to encourage organisations to work in partnership to minimise the number of patients remaining in hospital settings who are ready for discharge.

3 Indicator 5 % of Admissions (18-64 years) gate-kept by Crisis Resolution & Home Treatment teams The performance of this measure is shown as the Trust level percentage aiming to equal or exceed the target level of 90%, as defined below. The total number of admissions that were assessed by the crisis service prior to admission The total number of admissions A crisis resolution team (sometimes called a crisis resolution home treatment team) (CRHT) provides intensive support for people in mental health crises in their own home: they stay involved until the problem is resolved. It is designed to provide prompt and effective home treatment, including medication, in order to prevent hospital admissions and give support to informal carers. CRHTs are available to respond 24 hours a day, 7 days a week and are required to provide services to specified fidelity criteria while also demonstrating that the teams in place are functioning properly as a gateway to inpatient care and also facilitating early discharge of service users. If clients are admitted without referring to the Crisis Team, then it may their services are bypassed risking that those who don't require admission are not provided with more appropriate services.

4 Indicator 6 No. of new cases of psychosis in Early Intervention Services The Trust serves six different Primary Care Trust areas. The performance of this measure is shown as the number of areas that have met their share of the overall number of new cases. Performance as defined below. Data source Definition Total number of new cases of psychosis in early intervention services. A cumulative year to date measure aiming to reach an annual target of 182 new cases Trust wide. These teams work with service users and their families to provide expert assessment, treatment and support at an early stage in their psychosis, with a view to being able to minimise its impact on their lives and avoid longer term need for mental health services. Typically service users are aged 14 to 35 and will this will be their first episode of psychosis and they will receive up to three years support. This target is one of a series set for mental health trusts to demonstrate the implementation of the National Service Framework for Mental Health since Three specialist services must be provided in each local area: Assertive outreach Crisis resolution Early intervention Each PCT area has targets for new assessments, caseload and activity. In addition, each specialist service has to meet minimum quality standards, called fidelity criteria, as set out by the Department of Health.

5 Indicator 7 No. of people receiving assertive outreach services - number of areas meeting locally agreed standards The Trust serves six different Primary Care Trust areas. The performance of this measure is shown as the number of areas that have met their share of the overall Trust s caseload. Performance as defined below. Data source Definition Total number of service users on the team caseload (the Trust's share of the national target is 535 cases) measured as a caseload snapshot at month end. Assertive Outreach is a mental health service taken to service users, through which staff with small caseloads deliver practical support, care co-ordination and advocacy. Its approach is holistic, with an intensive focus on needs. This target is one of a series set for mental health trusts set to demonstrate the implementation of the National Service Framework for Mental Health since Three specialist services must be provided in each local area: Assertive outreach Crisis resolution Early intervention Each PCT area has targets for new assessments, caseload and activity. In addition, each specialist service has to meet minimum quality standards, called fidelity criteria, as set out by the Department of Health.

6 Indicator 8 Data Quality - completeness of identifier fields The performance of this measure is shown as the Trust level percentage aiming to equal or exceed the target level of 99%. Data completeness for core fields of the Mental Health Minimum Data Set (MHMDS): ethnicity, NHS number, GP, name, date of birth, gender, postcode and marital status. Calculated as set out below. Number of service users who have received services with all the relevant fields completed Number of service users who have received services The MHMDS is a nationally defined framework of data held locally by Mental Health Trusts on their adult patients. Each record in the data set describes a Mental Health Care Spell. The MHMDS is central to the development of information on mental health, notably for clinical audit and for the assessment of patient outcomes after intervention. MHMDS data completeness enables the monitoring of outcomes for individuals in terms of morbidity, quality of life and user satisfaction with services.

7 Indicator 9 Data Quality - completeness of outcome fields The performance of this measure is shown as the Trust level percentage aiming to equal or exceed the target level of 50%. Data completeness fields for employment status, accommodation status and HoNOS assessment. Calculated as set out below. The number of service users who have received services and are on Care Programme Approach (CPA) with a valid entry across the three core outcomes in the past 12 months Number of service users who have received services and are on CPA The MHMDS is a nationally defined framework of data held locally by Mental Health Trusts on their adult patients. Each record in the data set describes a Mental Health Care Spell. The MHMDS is central to the development of information on mental health, notably for clinical audit and for the assessment of patient outcomes after intervention. MHMDS data completeness enables the monitoring of outcomes for individuals in terms of morbidity, quality of life and user satisfaction with services.

8 Indicator 10 Access to Healthcare for People with Learning Disabilities The performance of this standard is measured through self assessment against six specific criteria set out in Healthcare for All If any standards are not met the performance will be scored as red. Data source Self certification Definition NHS Trusts make self assessment against six criteria for meeting the needs of people with a learning disability which are based on recommendations included in Healthcare for All (2008). These are set out in summary below: 1. Identification and flagging of patients with learning disabilities 2. Providing readily available and comprehensible information for patients with learning disabilities 3. Protocols in place to provide suitable support for family and carers who support patients with learning disabilities 4. Having arrangements to routinely include training on providing healthcare to patients with learning disabilities for all staff 5. Protocols in place to encourage representation of people with learning disabilities and their family carers 6. Arrangements in place to regularly audit its practices for patients with learning disabilities and to demonstrate the findings in routine public reports Equality in access to healthcare is central to the delivery of healthcare. The Independent Inquiry into Access to Healthcare for People with learning Disabilities, led by Sir Jonathan Michael, published its findings Healthcare for all on 29th July The inquiry was ordered following Mencap's Death by indifference' report, which told the stories of six people with a learning disability who died while in NHS care. The Inquiry sought to identify the action needed to ensure adults and children with learning disabilities receive appropriate treatment in acute and primary healthcare in England. Central to the development of these performance indicators is adherence to the Human Rights Act 1998 and the Disability Discrimination Act 1995, to ensure equality of access and equity for all people with learning disabilities and that a human rights approach is adopted by the NHS and that reasonable adjustments are made in the delivery of services to reduce health inequalities. This indicator responds to the recommendations made in the Inquiry report for providers, specifically around the collection of data and information necessary to allow people with a leaning disability to be identified and the arrangements trusts have in place to ensure the views and interests of people with learning disabilities and their carers are included in the planning and development of services.

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