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S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it
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S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it

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Health and Care Innovation Expo 2014, Pop-up University …

Health and Care Innovation Expo 2014, Pop-up University

S211 – Day 1 – 1545 – What does parity of esteem mean and who can deliver it

Dr Caroline Dollery
Jo Powell

#Expo14NHS

Published in: Health & Medicine
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  • Priority 8 Promoting equality and inclusion through NHS services. Highlighting and reducing inequalities in health outcomes across all Outcome domains. This will include parity of esteem for people with mental health issues. Measured by Progress in reducing identified health inequalities on all indicators for which data are available
  • Specific focus on improving services through commissioning and the use of commissioning tools to improve health outcomesEncourage a discussion about business as usual and how it can be used to deliver POE
  • Transcript

    • 1. What does parity of esteem mean? Who will deliver it? Ms Joanna Powell, Domain Team Lead, Parity of Esteem Programme, NHS England Dr Caroline Dollery Mid Essex CCG GP lead Clinical Director East of England Strategic Clinical Network
    • 2. • How did we get here? • What is parity of esteem? • NHS England Parity of Esteem Programme – MH CQUIN – Everyone counts – Planning guidance 2014/15 – 18/19 • Who will deliver it? • Discussion and questions 2 Plan
    • 3. A few of our drivers 3
    • 4. 4 Health and Social Care Act 2012 • The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement – (a) in the physical and mental health of the people of England, and (b) in the prevention, diagnosis and treatment of physical and mental illness. NHS Mandate • By March 2015, we expect measurable progress towards achieving true parity of esteem, where everyone who needs it has timely access to evidence-based services • NHS England’s objective is to put mental health on a par with physical health, and close the health gap between people with mental health problems and the population as a whole • Every community to have plans to ensure no one in crisis will be turned away, based on the principles set in the MH Crisis Concordat Putting People First • Parity Included in Priority 8 on the NHS England Balanced Score Care • Deliverable 11 against key deliverable: Put mental health on a par with physical health, and close the gap between people with mental health problems and the population as a whole. Extend and ensure more open access to IAPT by March 2015, particularly for children and young people, and for those out of work Parity of Esteem – valuing mental health equally with physical health
    • 5. My family and I all have access to services which enable us to maintain both our mental and physical wellbeing. If I become unwell I use services which assess and treat mental health disorders or conditions on a par with physical health illnesses. “Person centred, coordinated care” The patient What parity will mean to me
    • 6. What Parity will mean to me Nowhere in the 21st century NHS will a person’s mental health needs be neglected, or professionals lack confidence in dealing with a patient’s emotional or psychological needs. Health professionals “Person centred, coordinated care”
    • 7. What parity will mean to me In our communities our attitude to a person with a mental illness will be exactly the same as a person with a physical illness. If we need to encourage our friends to seek help we will, and if we need help to improve our physical and mental wellbeing our friends and family are able to actively support us The community “Person centred, coordinated care”
    • 8. Whole Person Care – Royal College of Psychiatrists March 2013 ‘The overarching principle of the parity movement is equality – in access to care, in improving the quality of care, and in the way resources are allocated.… If we stay true to the principle of treating each person with dignity and respect in our health care system, then we should make no distinction between illnesses of the brain and illnesses of other body systems’ – US literature Action focused report which ’refers simply to achieving ‘parity’ in order that mental health has equal status with physical health http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/op/op88.aspx What is parity of esteem – other definitions
    • 9. The House of Care The House supports National Voices ‘I’ statements My goals/outcomes e.g. • All my needs as a person were assessed and taken into account Communication e.g. • I always knew who was the main person in charge of my care Decision-making e.g. • I was as involved in discussions and decisions about my care (including care planning) and treatment as I wanted to be Transitions e.g. • When I went to a new service, they knew who I was, and about my own views, preferences and circumstances Emergencies e.g. • I had systems in place so that I could get help at an early stage to avoid a crisis
    • 10. The House of Care Person centred, coordinated care at three levels: National: What can national organisations and policy makers do to enable construction of the House of Care at the next two levels. Local: How local health economies ensure that the House of Care involves a whole system approach, including ‘more than medicine’ offers Personal: How the House of Care gives professionals on the front line a framework for what they need to do for patients and ask local commissioners to secure for them
    • 11. • Facilitate NHS England to work to reduce the disparity which currently exists in health outcomes for those with mild, moderate or severe mental health illness • Support integration and personalisation by promotion of whole person care which values everyone’s mental and physical health needs equally Parity of Esteem Programme
    • 12. NHS England Parity of Esteem Programme - Priorities • Addressing and improving crisis Care • Data, Information and Intelligence • Development of capability and skills in commissioning – including focus on cultural change / behaviour of commissioners change • Delivering improvements to clinical services (including IAPT and increasing timely diagnosis and post diagnostic care for dementia) • Improving physical health for people with serious mental illnesses and learning disabilities Discrete improvement project – Business as usual – Collaboration with system partners
    • 13. Improving physical healthcare to reduce premature mortality in people with severe mental illness (SMI) Indicator 1: 65 per cent of funding for demonstrating, through a national audit process, full implementation of appropriate processes for assessing, documenting and acting on cardio metabolic risk factors in patients with psychoses, including schizophrenia. Indicator 2: 35 per cent of funding for completion of a programme of local audit of communication with patients’ GPs, focusing on patients on the Care Programme Approach (CPA), demonstrating by Quarter 4 that, for 90 per cent of patients, an up-to-date care plan has been shared with the GP Mental Health CQUIN The CQUIN guidance for 2014/15 has recently been reissued on NHS England website
    • 14. The following cardio metabolic parameters are assessed and actively managed; • Smoking status • Lifestyle (incl. exercise, diet, alcohol and drugs) • Body Mass Index • Blood pressure • Glucose regulation (HbA1c or fasting glucose or random glucose as appropriate) • Blood lipids Mental Health CQUIN
    • 15. Planning Guidance 2014/15 -18/19 Headlines • Outcomes drive everything we do • Significant financial challenge: no change is not an option • 2014/15 – transformation year in preparation for 2015/16 (Better Care Fund) What’s new? • Support available to support commissioners • Operational (2 years) strategic (5 years) plans • Integration / collaborative working a key feature – Monitor / NHS TDA (providers and commissioners) – Local authorities (Better Care funding) • Unit of planning to support Health and Social Care planning
    • 16. Six service characteristics 1. A completely new approach to ensuring that citizens are fully included in all aspects of service design and change and that patients are fully empowered in their own care 2. Wider primary care, provided at scale 3. A modern model of integrated care 4. Access to the highest quality urgent and emergency care 5. A step-change in the productivity of elective care 6. Specialised services concentrated in centres of excellence
    • 17. High quality care for all, now and for future generations • High Quality – ‘Driven by quality in all we do – our patients rightly expect the best possible service’ • For all – ‘…whether need is for mental or physical help and support. We must put the greatest effort in providing care for the most vulnerable and excluded in society’ • For now – ‘Need to get better at sharing good practice rapidly across the NHS’ • For future generations – ‘Strategic plans developed in partnership working between commissioners, providers and local government to deliver models of care that will be sustainable in the longer term’
    • 18. Parity of esteem Who will deliver it? Dr Caroline Dollery Mid Essex CCG GP lead Clinical Director East of England Strategic Clinical Network
    • 19. Physical health and mental health • People with SMI die prematurely of common physical health problems • People with physical health problems with co morbid anxiety and depression die prematurely of physical health problems • The planned and immediate care presentation of physical symptoms BECAUSE of common mental health problems drives costs up and quality down because of lack of screening, diagnosis and support • Many people with SMI or depression never access health services, but present elsewhere in system: need for bio psychosocial approaches
    • 20. HEALTH WATCH NHS England MONITOR CQC Clinical senate Clinical commissioning groups Commissioning support unit(s) Health and Well being Board Primary care Specialist services
    • 21. System enablers CCGs, social care and providers AHSCNs Strategic networks
    • 22. Levers: strategic • People with lived experience; personalisation; personal budgets • Health and Wellbeing Boards • Public Health and JSNAs • Strategic clinical networks; GP mental health lead networks
    • 23. Levers: strategic • Commissioning strategies: – assurance by NHS England and by Local Area Teams of CCGS; and of HWB integrated approaches: need consistent response across England • Provider strategies: acute and mental health trusts • Specialised commissioning and links to whole pathway: CYP, criminal justice • INTEGRATED APPROACHES • Better care fund
    • 24. Levers: operational/contractual • National CQIN for SMI physical health care • Local commissioning : CQINS in primary and secondary care; Local enhanced services • Leadership development networks via SCNS and AHSNS to develop an deliver quality improvement in this area • Provider led quality improvement programmes • Use of new forms of contracting e.g. Alliance contracting across whole systems
    • 25. Levers: integrated commissioning • Pioneer programmes • Frailty/long term conditions • Training and education of workforce across system • Examples: liaison work in A&E; primary care support; IAPT; employers; CAB and other third sector organisations; schools, councils, community assets
    • 26. Levers: integrated commissioning • Primary care hubs: comorbid conditions need to include parity of ASSESSMENT • PARITY OF FUNDING: money following patients: acute trusts vs MH trusts vs primary care • INFORMATION AND SYSTEMS CRITICAL, AND CURRENT BARRIER
    • 27. National • Recognition of parity of esteem: steering group • Urgent care review and concordat • Mental health outcomes framework • Mental health intelligence network • Leadership development • Political support • Long term conditions and frailty models: house of care
    • 28. What can you do? • REFLECT on what can be done in your circle of influence • USE your community support: put pressure on health and social care commissioners to implement this agenda • USE people with lived experience to demonstrate need and deliver local solutions • USE your public health consultants in local Authorities: to develop strategy and help commissioners to build business case
    • 29. What can you do? • LOBBY for better information and resources including shared data • LOBBY for parity of funding • MAKE SURE your Local Area Team has mental health as part of its assurance of CCGS and of Better Care Funds: parity of assessment and outcomes • MAKE SURE CCG Boards have built this into their 2 and 5 year plans
    • 30. Questions? • What other steps can you take after today? • What can we do to help you? • cdollery@nhs.net • Mobile 07900 715145 • Jo.powell2@nhs.net • 07876851756

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