1. Service Development Initiatives, Adult Mental Health & Learning Disabilities Division
This briefing is produced to support managers within adult mental health community to cascade updates on the Service Development Initiative to their staff.
January 2015

2. Challenges Difficulty in providing a response in a timely manner
Use of crisis service because of lack of capacity in community mental health teams
Long waiting times
High out of area inpatient care

3. Aims Better patient experience and access to service
Respond to feedback from GP’s and other stakeholders
Creating sustainable services within available resources
The initiatives are very much outcomes focused and over the next two years these are the changes that we expect to see.

4. Trust strategic objectives
Deliver safe, effective, patient-centred care in the top 20% of our peers
Partner with others to deliver the right care in the right place at the right time
Staff will be proud to work here, and we will attract and retain the best people
Ensure sustainability
As an organisation we have a set of objectives.
We are ambitious for ourselves and our patients and those who support them. But, we know that we can’t deliver in isolation. We need to partner with others to ensure the best experience for our patients.
The right care, right place, right time speaks to an efficient service that in itself will save us money as a by-product of improving the experience of our patients. This will help ensure that we are sustainable, as an organisation, and our services are too.

5. Method
- Establish clinical forum (GP Mental Health Leads, LA, LPT Clinicians)
Work with Mental Health Strategy
Core of the Mental Health workstream, Better Care

6. AMH & LD service development initiatives
Adult mental health Community Pathway
LD Community Pathway
Adult mental health Acute Care Pathway
The adult mental health & learning disabilities division has three service development initiatives.
This briefing focuses on Adult mental health acute and low secure, and crisis services particularly.
Acknowledging the interface with the other two, these will be mentioned but more information will be shared at future locality meetings.

7. Adult mental health Acute Care Pathway
Crisis Team Re-modelling - New referral criteria for SPA now in place (linked to whether there is a need to admit a patient within 24-hours) - New service model due to be implemented 23 Feb 2015.

8. Adult mental health Acute Care Pathway
Crisis House Development - Go-live date set for 26 January 2015 (for drop-in and telephone support element) and 23 February 2015 for residential beds

9. Crisis house 6 beds Short stay
Therapeutic environment with outdoor space
Accessed through the Crisis Response Team (CRT)
Richmond Fellowship have bought Box Tree Farm in Ratby. It is an alternative to acute hospital admission and will help reduce the need to send people out of county.
It will provide 6 beds for people in crisis.
We are currently engaging stakeholders and service users in the choice of a name. Last year’s mental health summit stated that the name ‘crisis house’ was an issue. Richmond Fellowship are proposing to keep the name of Box Tree Farm and we are testing this out.
There has been some controversy over the location. It was chosen because of the requests of service users for a therapeutic environment with outdoor space.

10. Improving patients’ flow
Housing Pilot - Service live and operational as from October 2014 Step Down Beds - Service live and operational as from 3 Nov 2014

11. - Improve access to Community Mental Health Services
Meeting the needs of the patient in a timely manner within a service model that is sustainable
- Improve access to Community Mental Health Services
Urgent referral (within 5 working days)
Freeing up consultant time to increase access by GP’s (Urgent Clinics)
Stable patients to be discharged to care of GP with quick access back if needed

12. LD community pathway
Improving access to services and good health through better integration with primary, social and secondary care services
Establish locality team model
Re-organise the Outreach Service to provide community based enhanced crisis support
Re-organise Autism service

13. Questions?