1. New Care Models Update Vimbai Egaru- Head of MH Transformation
NHS England
20 June 2018

2. Aims of new care models
to delegate responsibility of commissioning mental health specialised services to providers or groups of providers.
intended to reduce lengths of stay and the number of out of area placements.
Use of the multi-disciplinary approach with providers taking ownership of their patient population (e.g. admission avoidance, shorter stays etc.)
Developing a wide range of therapeutic interventions across a whole pathway
Focusing on recovery through accommodation, community activities, social networks and employment advice
Working productively with the criminal justice system, Local Authorities and secondary care
Expanding both liaison support and community follow up provision
Developing local capacity and capability to manage all types of patients.

3. London NCMs
Wave 1 sites
• Oxleas FT (Lead Provider) with South London and Maudsley (SLAM) and South West London and St Georges (SWLSG) with the group known as South London Community Mental Health Partnership for Adult Secure Services.
• West London Mental Health NHS Trust (Lead Provider) with Central London North West London (CNWL) for CAMHS
Wave 2 sites
• Barnet Enfield and Haringey (Lead Provider) with Central North West London, North East London Mental Health Trust, North East London FT, East London FT and West London MHT for Adult Secure commenced 1st April 2018
• SLAM (Lead Provider) with Oxleas and SWLSG for CAMHS went live on the 1st October 2017
Other:
Starting to work on a NCL/NEL CAMHS NCM and Eating Disorders

4. Successes from Wave 1 CAMHS NCM (NWL)
Length of Stay – average has dropped from 107 days to 97 days at the end of Q3, aiming for 96 days at end of first year.
Keeping care close to home – baseline at start of the project showed average of 18 YP placed OOA after a month, by end of Q3 this is now 11.
Improved flow & experience between Tiers 3 \ 4
Greater trust, improved relationships and more joint working between clinical teams in NWL

5. Successes from Wave 1 CAMHS NCM (NWL)
Occupied Bed Days: for Acute & Eating Disorder admissions

6. Successes from Wave 2 CAMHS NCM (SLP)
CAMHS Tier 4 services for South London
Crisis care funding £420,000
8 additional PICU beds
Our aims
More treatment closer to home
Admission avoidance
Investment in Community Crisis Teams
Investment in Community Dialectical Behaviour Therapy Service
Strengthening of the community eating disorder pathway
Autism and learning disability support packages (TCP)
Integrated Commissioning Hub
Integrated Case Management
Transformation
Repatriation / Admission
Community alternatives to admission in place

7. Impact to Date
The Wave 1 sites have been operating in Shadow form and as such we are starting to quantify the financial or clinical impact on services.
Early indications from the Secure sites are that the repatriation of patients has started successfully, which will have a positive clinical impact on the patients as they will be treated closer to home.
The Wave 1 CAMHS sites are reporting reduced LoS with most YP being treated and supported locally
In the last month we noted a reduction of 16 YP in out of area beds from 53 patients to 37
The financial impact will be quantified as budgets are reconciled nationally.

8. Transforming Care
To date the TC cohort has not been included in the NCM due to the funding transfer arrangements and commitments made by NHSE, LA and CCGs to move money to LAs
Only 1 NCM nationally that has included TC and we are learning from them initially
Encouraging the NCMs to engage with their local TCPs to start planning integrated pathways and planning for the TC cohort to be part of the NCM in the long term
SLP have some staff that are supporting the TC in preparation for future integration however discussions need to be maintained and agreed with TCPs as to when this will happen
There are overlaps between TC and NCM for patients currently receiving care and treatment in a Non-LD bed the expectation is that the patients re repatriated closer to home within the NCM