1. Brighton and Hove Wellbeing Service Data flow from non-NHS Providers
Joanna Hillier – Clinical Lead

2. Context Brighton and Hove Wellbeing Service – operational since 2011.
Collaboration between providers in the city to ensure that primary care mental health services are locally led
May May 2017 service was adults only – IAPT, MIND Support services and primary care mental health practitioners (OT, Social work & CPN)

3. June 2017
New contract - Different requirements of IAPT and PCMHP service
Additional adult advice and information open access service (MIND)
Additional CYP service delivering 1500 completed treatments to year olds with mild to moderate mental health difficulties
YMCA Downslink group and other 3rd sector providers had established online and face to face counselling services but not part of NHS contracts
New contract service specification not linked to MSHSD requirements

5. So how does it work?
The Service is accountable to board made up of all collaborators – Here is the lead contractor
Operational and Clinical Leads working within an integrated Governance structure applied across all partners

6. Primary Care Mental Health Workers
CYP Wellbeing Service
(4-25)
CYP triage with CAMHS
(4- 18)
Primary Care Mental Health Workers
(18+)
Advice, information and employment support
(18+)
IAPT – step one and step 2
(18+)
Administrators and Data Analysts work across service
Systm1 and Power BI – Access to Carenotes

7. What do we know about IAPT?
Psychology Sausage factory?
We could all do that if we had all that investment
Only offers CBT…..
Fine if you fit into the IAPT box
Data and target driven

8. What matters in IAPT Recovery (50%)
PHQ9 and GAD 7 and disorder specific scales
Access (16.8%)
% of anxious and depressed population accessing service – rising to 20% in 2020
Waiting Times
6 week and 18 week plus local 4 week target
And for Brighton and Hove – Reliable Improvement National target – 64%
(B&H 70%) Significant measurement of change

9. What is used in IAPT Stepped model of care Evidence based practice
Outcome measurement
Demand and capacity modelling/monitoring and forecasting
High Demand and high throughput
IAPT add on’s – Long term conditions, SMI, perinatal period, employment workers

11. But what about the CYP service?
The ultimate challenge

12. CYP Journey
In June 2017 CYP triage and service opened. Tuped staff from other non-NHD organisations to YMCA Downslink Group
No IT infrastructure
No COIN connection
Staff had very limited experience of using electronic patient records and high levels of suspicion
Bespoke solutions needed to be found for specific pieces of CYP clinical work – LGBTQ counselling
Admin solutions used in adult service were not transferable
75% staff turnover (honorary staff)
No data to model on and CAMHS and schools services also redesigning

13. Mobilising
Multiple treatment types – canine counselling, digital interventions, group programme, play therapy etc.
Multiple bases
Combined triage (CAMHS and CYP service)
Problematic pathways
8 WTE – 26 staff
Incidents and waiting lists
Access to Open Exeter Portal already established (N3)

15. Staff engagement and Leadership
New leadership team
Partnership commit all of clinical lead time
Focus on team needs
Use the data in everything we do
Move influencers into team
Work with CCG on what they need
Work through the data with the CCG

16. What made the difference?
CCG provided extra investment for MHMDS to be prioritised
Started with a data cleanse and audit
Focus on what activity was being recorded already – booked appointment focus

17. SystmOne – unique challenges
Relied on booked appointments giving activity data
MHMDS turned this on its head
Mandatory or not mandatory????
Building of new templates to collect data

18. Ongoing Ongoing
Monthly review of all cases discharged with no activity recorded
Continued communication with all clinical staff in CYP and understanding why it matters
Refinement to templates and further engagement on what is mandatory
Development of reports with outcome measurement

19. And the future
A world without waiting
Staff engagement – culture change & time
IST and CCG engagement in challenges
Quality of data flow
CAMHS and schools
Digital interventions and MHMDS
CYP participation in data informing choice

20. Jo Hillier
Clinical Lead
Anna Williams
Operational Manager
Sarah Weston
Head of Wellbeing and Therapeutic Services
YMCA Downslink group