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The Leeds Managed Clinical Network Developing confidence whilst living with uncertainty.

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Presentation on theme: "The Leeds Managed Clinical Network Developing confidence whilst living with uncertainty."— Presentation transcript:

1 The Leeds Managed Clinical Network Developing confidence whilst living with uncertainty

2 The Clinical Network One of 11 DH funded national pilot sites 2004 – community services One of 11 DH funded national pilot sites 2004 – community services National Evaluation by Imperial College – “Learning the Lessons”. National Evaluation by Imperial College – “Learning the Lessons”. Local Evaluation by University of Chester Local Evaluation by University of Chester Six-monthly DH Monitoring including service user commissioners Six-monthly DH Monitoring including service user commissioners Service and User generated measures Service and User generated measures

3 The Clinical Network Model Staff from a range of agencies and disciplines, funded from a single source to achieve common aims which no single agency could achieve. Staff from a range of agencies and disciplines, funded from a single source to achieve common aims which no single agency could achieve. BUT … BUT … Great effort needed to make partnerships, multi- agency work and care pathways feasible or satisfactory. Great effort needed to make partnerships, multi- agency work and care pathways feasible or satisfactory. Added complexity when attempting to capture outcomes. Added complexity when attempting to capture outcomes.

4 The Network Model Leeds Partnerships NHS Foundation Trust Leeds Partnerships NHS Foundation Trust Community Links Community Links Touchstone Touchstone Leeds Mental Health Advocacy Group Leeds Mental Health Advocacy Group Leeds Survivor Led Crisis Service Leeds Survivor Led Crisis Service Leeds Adult Social Care Leeds Adult Social Care PD institute PD institute Shared aims and principles Shared aims and principles Shared commitment Shared commitment Individual agency/discipline roles and responsibilities Individual agency/discipline roles and responsibilities Service User Involvement and Collaboration Service User Involvement and Collaboration

5 Resources 24.8 WTE 24.8 WTE Clinical Service Manager Clinical Service Manager Clinical Lead Clinical Lead Clinical Team Manager Clinical Team Manager Practice Development Lead Practice Development Lead Care Co-ordinators Care Co-ordinators Health Care Support Workers Health Care Support Workers Occupational Therapists/Technical Instructor Occupational Therapists/Technical Instructor Psychological Therapists Psychological Therapists Service User Consultants/Involvement Lead Service User Consultants/Involvement Lead Pharmacist Pharmacist Accommodation Support Accommodation Support Voluntary Sector Support and Inclusion Voluntary Sector Support and Inclusion

6 Services Assessment and Formulation – 8 weeks Assessment and Formulation – 8 weeks Care co-ordination – 100 weeks Care co-ordination – 100 weeks Case consultation – sessional Case consultation – sessional Diverse Pathways – 24 months Diverse Pathways – 24 months Journey Day Programme – 24 weeks Journey Day Programme – 24 weeks Dialectical Behaviour Therapy Skills Groups – modular Dialectical Behaviour Therapy Skills Groups – modular Pear Tree Partnership Pear Tree Partnership Training/Facilitated Learning Training/Facilitated Learning

7 CRISIS RESPONSE ACCOMMODATION SUPPORT OCCUPATIONAL THERAPY AND OASIS CONSULTATION JOURNEY 2 DAY TRAINING PROGRAMME DIVERSE PATHWAYS ALTERNATIVE TO ADMISSION INDIVIDUAL THERAPY IN-PATIENT SERVICES 4 PATHWAY DEVELOPMENT SERVICE INFORMATION AND ADVICE EMERGING CARE PATHWAY FOR PERSONALITY DISORDER SERVICES, LEEDS ORDINATION CARE CO DBT SKILLS GROUP

8 Activity 7000 face to face contacts per year 7000 face to face contacts per year Any given week – 82 places available for direct work Any given week – 82 places available for direct work 12 in assessment/formulation 12 in assessment/formulation 28 in care co-ordination 28 in care co-ordination 16 in Diverse Pathways 16 in Diverse Pathways 10 in Journey 10 in Journey 16 in DBT skills 16 in DBT skills

9 Involvement? Involvement lead and two user consultant posts Involvement lead and two user consultant posts Service User group and newsletter Service User group and newsletter Volunteers at Pear Tree Partnership Volunteers at Pear Tree Partnership Delivering training and conference workshops Delivering training and conference workshops Survivor led crisis post Survivor led crisis post Satisfaction survey Satisfaction survey Evaluation of services Evaluation of services

10 Outcomes … Service use pre-Network and one year later Service use pre-Network and one year later Medication review 2007/audit 2009 Medication review 2007/audit 2009 Journey evaluation and focus groups Journey evaluation and focus groups DBT CORE outcomes DBT CORE outcomes Day TCs national review Day TCs national review Service User involvement initiatives, satisfaction survey Service User involvement initiatives, satisfaction survey Acute in-patient audits 2007 and 2008 Acute in-patient audits 2007 and 2008 NFA Review 2008 NFA Review 2008 Regional Training Programme – 600 staff Regional Training Programme – 600 staff Award winning allotment – Pear Tree Partnership Award winning allotment – Pear Tree Partnership

11 Cost analysis – NHS savings per service after PDCN care coordination Service Area /Intervention Annual use 1 year prior to PDCN (total) Annual use 1 year during PDCN (total) Reduction/Rise in use of Service/ Intervention Calculation based upon PSSRU Unit Costs in Health and Social Care 2006 Cost Savings to NHS Based on 22 clients A&E admissions % [£101 x 20] - [£101 x 16] £404 PICU admissions %-- PICU nights % £528 x 54 £28,512 Acute Ward admissions %-- Acute Ward nights % [£201 x 675] - [£201 x 294] £76,581 Day Hospital admissions 06 + infinity -- Day Hospital days infinity £59 x 76 -£4,484 Crisis Resolution Direct contacts % [£364 x 28] - [£364 x 19] £3,276 Crisis Resolution Indirect contacts %-- Total NHS Savings £104,289

12 Average scores Journey 1, 2 and 3

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16 SERVICE USER FEEDBACK “The group was helpful in offering possible solutions” “The group has been helpful in gaining control of myself and realising that I can’t fix everything, I am able to tolerate my feelings instead of ‘becoming’ them” “I‘m glad I came…I didn’t want to…” “I like attending and feel like I’m treated like a ‘human being’” “I find the skills really useful. I keep my skills folder next to my chair where I sit at home so it’s there to look at when I need/want to”

17 Service User Satisfaction Survey What is good about the service you receive? Meets my individual needs with flexibility Meets my individual needs with flexibility Very defined, kept to time, feel safe Very defined, kept to time, feel safe There are other service users just like myself There are other service users just like myself DBT – great staff, small group. Has changed my life over the last two years. More aware accepting of my illness. Diverse Pathways – more challenging in a positive way. DBT – great staff, small group. Has changed my life over the last two years. More aware accepting of my illness. Diverse Pathways – more challenging in a positive way. Very clear about how and when groups run Very clear about how and when groups run The fact that I’m in prison and you guys come and visit me The fact that I’m in prison and you guys come and visit me The DBT groups are extremely helpful as the skills related to all the problems that I’ve encountered in my life. It is beneficial to be able to listen and talk to the other group members who have the same problems as me. Also being able to repeat modules if is thought that it will help is good. The DBT groups are extremely helpful as the skills related to all the problems that I’ve encountered in my life. It is beneficial to be able to listen and talk to the other group members who have the same problems as me. Also being able to repeat modules if is thought that it will help is good.

18 What is not going well or could be improved? I miss having a Care Co-ordinator now I’ve been discharged. I have difficulty getting out to join groups etc. now I’ve been discharged as I can’t afford taxis and can’t use public transport. I miss having a Care Co-ordinator now I’ve been discharged. I have difficulty getting out to join groups etc. now I’ve been discharged as I can’t afford taxis and can’t use public transport. I would have liked to have been told about other services within the Network instead of picking up bits here and there from other group members. I would have liked to have been told about other services within the Network instead of picking up bits here and there from other group members. Everything is put down to being Personality Disorder rather than me being seen as an individual. I don’t feel part of this group. Everything is put down to being Personality Disorder rather than me being seen as an individual. I don’t feel part of this group. More information about other areas and how to access them. More information about other areas and how to access them.

19 New Developments 2009/10 Understanding of PD and responsiveness across Primary Care Mental Health Teams Understanding of PD and responsiveness across Primary Care Mental Health Teams NSPCC Project NSPCC Project Younger People and developing personalities Younger People and developing personalities Short term occupational interventions on acute in-patient areas Short term occupational interventions on acute in-patient areas Social Inclusion initiatives Social Inclusion initiatives Creative Personalities Project Creative Personalities Project Partnership with PDi Partnership with PDi Implementation of NICE Guidance across Leeds Implementation of NICE Guidance across Leeds KUF Training Programme KUF Training Programme


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