1. South West London Landscape
South West London: Mental Health Crisis Care Mental Health Crisis Care Leads: Tonia Michaelides
and Emma Whicher
3. Progress to date
A community hub model is being developed in SWL, combining physical and mental health care services in order to support acute hospitals.
Locality teams will also provide care to defined populations of 50,000 across the region, with greater emphasis on prevention and early intervention.
The Kingston and Richmond crisis and home treatment teams provide treatment to patients in an acute crisis in their own home as an alternative to hospital admission. The teams also work with other local services to allow early discharge from hospital.
Mental health street triage teams operate across the six boroughs in SWL.
There is work underway to build the South London Partnership across the three Trusts (SWLSTG, South London and Maudsley NHS Foundation Trust, and Oxleas NHS Foundation Trust), to identify more opportunities for collaboration to improve services and efficiency.
For more complex service users who present at Emergency Departments (EDs) in crisis, SWL have proposed the introduction of a psychiatric decision unit in EDs to assess and develop treatment plans. There will also be additional Crisis Cafés to divert mental health service users from EDs and improve appropriate choices for patients.
1. Local population
There are 1.45 million people living in South West London
South West London and St George’s Mental Health Trust (SWLSTG) is the main provider of mental health services in this area.
The population is ageing and up to a third of people are living with long term conditions, meaning more and better care needs to be provided out of hospital and closer to where people live.
Mental health services must be reshaped so that they achieve the highest possible standards and are focused primarily in the community.
In November 2016, SWLSTG launched an innovative new unit which will provide enhanced mental health assessments for patients who are experiencing a mental health crisis.
The lotus assessment suite is an innovative new unit which will help to improve the overall experience of mental health patients in crisis and help reduce the demand on A&E departments locally.
The unit provides a safe and calming environment for those in crisis away from A&E allowing mental health staff to undertake in-depth and informed assessments of more complex patients who are experiencing a mental health crisis.
2. Background
Commissioners and providers in South West London (SWL) are aware of the challenges around parity of esteem, and the need to respond by developing integrated approaches to mental and physical health.
This improves the wellbeing and life expectancy of people with severe mental illness and reduces the need for acute and primary care services for people with long term conditions.
To help SWL realise their vision for Urgent and Emergency Care (UEC) in 2019/20, the UEC Network have identified three priorities – this includes mental health. The mental health programme has a particular focus on:
6 Clinical Commissioning Groups
2 Mental Health Providers
6 Local Authorities
South West London Landscape
4 Acute Providers
4 Community Providers
6 GP Federations
4. STP objectives
Scope new models of care and pathways for community, acute, and crisis services
Develop activity and workforce baseline and gap analysis against mental health pathways
Work with primary care to better meet the needs of people with serious mental illness (SMI)
Undertake physical care assessments and implement interventions
Build on the ‘Stolen Years’ programme and tools released to support primary care
Develop activity and workforce modelling to define local requirements in order to address gaps and inform commissioning
Complete a local multi-agency suicide prevention plan by 2017
Commission services, integrated with other services and sectors
Health Based Place of Safety (HBPoS)
Developing a plan for joint working with the London Mental Health Crisis Care Group
Reviewing and implementing the Crisis Care Concordat