Action Notes of the meeting of the Wandsworth Mental Health Clinical Reference Group Held on 21 January 2014

Transcription

1 Action Notes of the meeting of the Wandsworth Mental Health Clinical Reference Group Held on 21 January 2014 Present: Tom Coffey (TC) (Chair) GP Mental Health & Jt.Wandle Lead Lucie Waters (LW) Director, Commissioning & Planning, WCCG John Morrill (JM) Project Manager, Voicing Views Sue O Connell (SOC) Service User Representative Mark Robertson (MR) Commissioner MH/LD, WCCG Jeremy Walsh (JW) Service Director, SWLSTG Mark Potter (MP) Associate Medical Director, SWLSTG Sarah Rushton (SR) Commissioning, Wandsworth Borough Council SW (SW) Wandsworth Carers Centre Graeme Markwell (GM) Public Health Ismat Nasiruddin (IN) GP Locality Mental Health Lead Aryan Lawe (AL) GP Locality OP Lead Christine Lewis (CL) Carer/Family Member EF (EF) Carer/Family Member Andy Cohen (ACo) Consultant CAMHS, SWLSTG Louise Wright (LW) Project Manager, Joint Commissioning Annie McDowell (AM) MH Provider Rep; Share Community Andrew Farqhuar (AF) Together Your Way (Item 3) Peer Supporter Together Your Way (Item 3) Gary Nuttall (GN) Project Manager, Joint Commissioning (Item 4) ` Apologies: Amanda Cranston; John Beckles; Peter Ilves; Alison Kirby; Elizabeth Noel; Service User Representative; Carlis Douglas; Dawn Warwick; Susan Hasler-Winter Ref Item Action 1 Welcome and Introduction Noted. The Chair welcomed AM to the meeting as a MH Provider representative. 2 Action Notes and matters arising from meeting on 12 March Accuracy of minutes agreed. The Executive summary of actions from previous meetings was noted. Items not on Agenda below; MH Act Assessment Activity this was raised previously in relation to potential increasing pressure on AMHP activity. Now monitored via S75 agreement. Data is still be refined via LA operational leads will be brought to March CRG meeting. IAPT/CMHT/GP Interface to be dealt with under SWLSTG update and Psychological Therapies review. Confirmation of SWLSTG emergency numbers to GPs to be completed, draft correspondence still in progress. SR/ SHW JW Page 1 of 7

2 3. Reablement Service Update (Presentation from Together) AF and Peer Supporter delivered presentation. Together Your Way hold a four year reablement contract with Council (50% funding input from WCCG). Presentation included: Three parts to service (6 week reablement; personal budgets; Peer Support and Community Network) Reablement includes building assets and skills; promoting natural support; resilience; lived experience led and practical support Practical support (accommodation; work; benefit and debt; friends; community involvement) Outcomes outlined paid employment; voluntary work; CVs; education & community activity access. Peer Support 8 week accredited training; 1:1 and Groups; reducing barriers and stigma; 12 of 20 supporters trained. Community Network Journey and goal setting Discussion on how to best develop better links with CMHTs and GPs. This also related to work of other Providers including Share Community. Partnership working seen as crucial. Agreed MR to provide list of all GPs to Together, Share and FA. Further agreed that MR provide links to 3x GP Locality meetings in order that Together, Share and FA can attend and give joint presentations. MR / Together /Share / FA Noted activities shaped through feedback from service users. Payment for activities and meals required but limited ( 7/meal). Mama Low free drop in with maximum attendance of 30. Training accredited by Middlesex University 30 points towards Open University qualification. Note that SR taking paper to WBC ASC Senior Management Team to consider extending reablement timeframe to 12 weeks. SR to report back on progress. SR 4. Mental Health CRG Work Plan 2013/14 The CRG noted the updated Work Plan document. Specific focus on: Primary Care Model of Care / Psychological Therapies Review. LW presented papers on Review of Psychological Therapies. Noted context around primary care model of care in the need to consider not just Mild to moderate, but more severe and enduring cases with Primary Care. A more proactive and systematic approach was needed. LW set out Project objectives including: Mapping need Set out evidence bases Mapping existing services Gap analysis Recommendations for future commissioning Page 2 of 7

3 LW commenced looking at options following initial feedback from commissioners. Access to IAPT noted as key consideration. LW currently visiting all in-scope providers to fully map what they do, who for and to received feedback on issues. Collaboration between GP s and Provider seen as key, with initial options scoped including SWLSTG developing IAPT within existing model or a new more decentralised model. LW to discuss further with GPs and SWLSTG. Further update paper to come to March MH CRG. LW (Agenda) Issues raised around what is achievable. Need to consider interfaces between GP, IAPT (core), Big White Wall, in-house practice based counselling. Comments from MH CRG on papers to LW/MR. 5. Perinatal Mental Health Review GN, Project Manager delivered Update Paper. GN gave overview of key recommendations from Independent Management Report including: Need to ensure comprehensiveness and equity Outreach GP accessibility Appropriate service provision for population Understood pathways The review is focussed on: Local needs Map current provision National best practice and recommendations from IMR Scope local service Gap analysis Initial progress noted, with further brief update to next MH CRG. Agenda 6. Francis Report SWLSTG update JW gave update to MH CRG. Key themes for SWLSTG: Safe and quality services Openness Involvement of service users and carers Trust Board involvement Specific recommendations developed include: Review Ward Manager roles Single In-Patient consultant model Hand washing Real time feedback Duty of candour Review of PaLS Key questions from the SWLSTG Board to be considered are developing Page 3 of 7

4 Listening in Action programme (staff), Transformation Programmes and use of Quality Assurance CQUIN indicators. JW also updated CRG on upcoming CQC inspection (Head of Hospital Inspectors). This is a new inspection and will commence at SWLSTG on 17 March A team of up to 30 Inspectors will be involved. All areas of the MH Trust will be looked at, include all I/P units and some Community Teams. The process will also include input from Peer Reviews. CL noted her role as Carer rep on Quality and Assurance Group and that the Trust were demonstrably seeking feedback and that robust governance structures and been developed. The need to ensure Service User and Carer involvement and co-production at the highest Board level was noted. JW highlighted Board 15 step visits, Place visits, use of Real Time Feedback & FT Governing Body membership as evidence of Board links to Service User and Carer involvement and feedback. JW agreed to take back to Board views that this involvement should continue to be strengthened and evidenced in clear Governance Structures. 7. Suicide Prevention Group Group met in December and is continuing to grow. Development of local draft Strategy, mapping pathways and services underway. Early indications highlight need for suicide audit (not refreshed for 5-6 years) and need to consider training for first attenders (Police and other Emergency services). Need to consider whether non-recurrent funding bids are indicated. GM to discuss with MR in order to develop potential bids by March GM/MR 8. SWLSTG s Foundation Trust application. SWLSTG reported back on the three improvement targets which were set in train in early Adult Rehab model of care review Tier 2/3 CAMHS re-configuration Patient and Carer experience. Progress update highlights noted: Rehab model of care January HOSC approved. SWLSTG now work to implement new model including development of Westmoor and Thrale; closure of Haydon House and further development of Community Rehab Team including employment advisers. CAMHS reconfiguration New service opened in early December Hub and spoke model. Initial roll-out for GP referrals only. New electronic referral form developed. Waiting list for Tier 3 only (10x individuals) Page 4 of 7

5 Patient and Carer experience Triangle of Care audit undertaken issue of recording highlighted. Service User Reference Group ongoing and dovetailed with Rehab service developments. MH CRG had agreed to recommend support to FT application subject to additional caveats, which had now been shared with SWLSTG for comment. The key themes were: IAPT waiting times Access to Recovery College for those discharged CMHT responsiveness (S75 commitments and evidence of Recovery goals) Carer involvement in care planning. Discussion on extending use of Kinesis system to SWLSTG. TC to discuss with Nicola Jones. JW committed to respond to CCG to work to develop SMART objectives under these themes. SWLSTG to make suggestions around time limits for Recovery College access for example. 9. Serious Incident Reporting TC JW JW presented paper on investigation in Self Harm as requested by MH CRG in November. Specific focus on I/P areas. As context, JW presented key national findings and drivers Psychosocial Assessment findings and NICE guidance (Care plans; interventions for self harm and treating associated MH conditions). SWLSTG recommendations include: Risk (YP risk assessments prior to leaving wards; practical risk solutions; recording; out of hours approaches) Referral (information gathering; level 3 searches for transferring prisoners) Policy/Procedure (Reviews; ward operational policies; care pathway for emergency PD) Carer involvement (use of information) Handover (shift co-ordination changes; end of day documented) MH CRG keen to see how SWLSTG benchmarks with others. To be updated at March meeting. JW / Agenda SI reporting continues to be monitored through Clinical Quality Review Group (CQRG). IN is Wandsworth representative and will link with MR to feedback. 10. Mental Health Joint Commissioning Strategy 2013 Progress update paper presented. Comments on draft received from MH CRG, JCE and MH Provider Forum. These have been recorded on Log of comments, which MHCRG noted. An Engagement event with Service Users and Carers due to take place on 29 January. Further draft to be completed for March CRG and taken to next available Health and Well Being Board for sign off. Agenda Page 5 of 7

6 11 Service User Feedback JM gave oral report. Key issues: Work commenced on developing Community Discharge pack. Collaborative work with SWLSTG to include Service Users and Carers. Update for March Update on discussions around Personal Budgets. Meeting held in December including TC, JM, Health Watch, SWLSTG, CCG commissioners and LA operational representatives. Agreement to look at information sheet outlined areas which PB s had been agreed for. Noted that new FACE system in place from December which should improve the process waits. Still some issues raised around accountability of data (how many PB s processed, how many rejected). LW agreed to discuss with Dawn Warwick and feedback. JM/JW LW 12 Carer Feedback Key issues raised through carers: 13 Locality Issues Support in Primary. Need to continue to work to ensure consistency. Potential to consider GP training programmes. Issues of dual diagnosis and how pathway develops around main diagnosis. Agreed that SWLSTG/IDAS need to continue to work together to improve interface. This could be developed through continuing engagement in the Substance Misuse/MH Forum being lead through DAAT. CL reported on discussions at Carers Group. There had been a focus on Risk Assessment and attitudes to risk with a representative from SWLSTG invited to discuss. The need to have a clear map and information around services was raised. Noted that the work being undertaken via the JCU in looking at the Carers contract may assist. Also work on Community Discharge Pack (see Item 11) should be able to provide detail for carers (as well as Service Users) on community resources. TC shared the information received from GP s in relation to SWLSTG performance as part of the FT assurance requirements. TC to meet with JW/MP to discuss issues raised and solutions. AL reported on work of Dementia Reference Group. Particular how to consider the links with the MH CRG. Noted that Health and Wellbeing Board Seminar to look at issues around Better Care Fund and integration. Agreed that AL produce short briefing report (use existing Board Report) for March MH CRG to include update on work undertaken and where the next steps are. TC/JW/ MP AL (Agenda) 12. Any other Business Advocacy services Issue raised around future and current position. SR to produce update paper for March meeting. SR Page 6 of 7

7 Item 18. FT Convergence update Context reminder - NTDA in charge of process and sets key milestones. One such is production of an Integrated Business Plan by FT applicant and this would be linked to a receipt of Commissioner support (convergence). Additional step subsequent to Francis Report is this new Hospital Inpsectors Inspection due for SWLSTG in March. Kingston CCG is leading on behalf of SW London commissioners in this process and ensuring that it is seeking the views of all CCGs. It is noted that each CCG will have it s own specific and local view and Kingston will collate these. Each LA will be separately asked to respond to NDTA also. Note as discussed in Item 8, Wandsworth CCG via the MH CRG have offered support with caveats. Next Meeting The next meeting of the MH CRG will take place on Tuesday 18 March 2014, 9.30am 12 noon, (Venue: Rooms 3A & 3B, Wandsworth Town Hall Extension, Wandsworth High St) Future meetings: Tuesday 20 May 2014, 9.30am 12 noon (Venue: Rm 2/3, Watershed, 90 Putney Bridge Rd) Tuesday 15 July 2014, 9.30am 12 noon (Venue: Room 6.2, 120 The Broadway, Wimbledon) Page 7 of 7