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2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
2014 03 13 bx bsc mental health redesign consultation document - final (2)
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2014 03 13 bx bsc mental health redesign consultation document - final (2)

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  • 1. Primary Care and Community Mental Health Service Redesign Consultation document March 2014
  • 2. What is a Clinical Commissioning Group (CCG)? Since April 2013, CCGs have been responsible for planning and buying NHS services for their local population. All of the GP practices in your area are members of your local CCG. The CCGs that provide services for Birmingham residents: What is this consultation for? The purpose of this document is to gather feedback from as many people as possible in relation to: • Personal experiences of using primary care and community mental health services. • Your views about the information that is currently available about primary care and community mental health services. • Access to primary care and community mental health services. • Your views on the model proposed. • Any further views as to how we can make primary care and community mental health services better. INTRODUCTION 2 A34 A38 A38 A452 A456 730,000 patients 250,000 patients 222,255 patients Birmingham CrossCity CCG Birmingham South Central CCG Sandwell and West Birmingham CCG
  • 3. Why do we want to redesign services? We have made many changes to mental health services since the launch of the ‘Better Mental Health for Birmingham’ Mental Health Strategy (2011-2016); however, we still have some further work to do to: • Improve people’s experience of services • Increase support for people when they no longer require specialist mental health services and are discharged back to their GP practice • Promote wellbeing • Help people to recover and live fulfilling lives • Make access to mental health services in the community easier and increase access to services • Improve access to information about the availability of mental health services in Birmingham • Improve partnership working between service providers to make things better for people What age groups are these services for? Generally, we are focussing on services for adults, which mean those people over 18 years of age. However, some services work with young people from 16 years of age, so those services are also included in the redesign. 3
  • 4. What services are we talking about? Talking therapies can help you work out how to deal with negative thoughts and feelings and make positive changes in your life. Currently two types of services are available; Improving Access to Psychological Therapies service (IAPT) and counselling services. The IAPT service is accessible for people who are experiencing depression and/or anxiety disorders. The service is currently delivered by Birmingham and Solihull Mental Health Foundation Trust and the service is accessible in GP practices, community venues and specialist mental health care premises. The service is delivered by therapists and psychologists who have to undergo specialist training to deliver the service. The counselling services are accessible for people who may feel stressed in connection with current or past life challenges and may experience depression. These life situations could include bereavement, domestic violence, cultural specific or gender specific issues, relationship breakdowns, pre and post-natal depression and work stress. These services are provided by third sector organisations by trained counsellors and volunteers who are trained, supported and supervised by trained counsellors. Your local CMHT service is provided by Birmingham and Solihull Mental Health Foundation Trust across locations within the community. A community mental health team coordinates your care if you receive community-based mental health care. This includes carrying out mental health assessments, planning treatment and delivering care. You are normally referred to a CMHT if you have more complex mental health needs and would benefit from the care of more specialist mental health workers such as psychiatrists, psychiatric nurses, social workers and occupational therapists. We currently buy a range of services from experienced third sector organisations to support more people in the community. These services support people who may be recovering from a mental health condition, people who may have developed a mental health condition but may not require specialist mental health care, and provide information to the general public. The services range from volunteering opportunities, mental health awareness training, learning new life skills, advice and support about wellbeing and lifestyle and a range of other community activities in order avoid people becoming socially isolated. 4 1. Talking Therapies 2. Community Mental Health Teams (CMHT) 3. Recovery, Enablement and Prevention Services
  • 5. 5 What do we already know? Following completion of a local needs assessment in Birmingham in 2011 we discovered: BACKGROUND It is estimated that 1 in 5 people in Birmingham aged 18-64 (1 in 4 people across all ages) experience mental health problems. There is a gap between the number of people expected to have mental health problems in Birmingham (140,582) and the number of people recorded by GPs as having a mental health problem (91,467). A person living in an inner City ward is twice as likely to experience mental health problems than someone in neighbouring affluent wards. Many mental health services are focused on delivering care for schizophrenia and more serious mood conditions. This does not cover the whole spectrum of population need. There has been a steady increase in prescriptions for anti-depressants, which raises questions about whether and how anti-depressants and psychological therapies are balanced in treatment pathways. 10.5% of women (out of 18,479) declared at the first maternity booking that they had experienced previous mental health problems. There is under representation of BME groups within mental health services. Of the services provided by Birmingham and Solihull Mental Health Foundation Trust; White, Asian and Black populations receive: 73.8% 11.1% White Asian Black 5.4%
  • 6. 6 A plan to shape Mental Health Services in Birmingham already exists. This is called The Joint Commissioning Mental Health Strategy ‘Better Mental Health for Birmingham’ (2011-2016). We consulted with people who use mental health services and their carers. The main issues they told us were: • More patient choice had to be included in commissioning new services. • They were worried about the lack of information in GP surgeries. There was strong support for: • a pathway approach to mental health services and mix of providers • improvement in quality of primary care mental health services • increasing the choices of psychological services as well as medical interventions, including greater choice more generally about mental health services and more culturally appropriate services • ensuring services meet the specific needs for asylum seekers and refugees • improving a single database of available services and making substantial improvements to a single access point.
  • 7. 7 We will be reviewing the following in each service area: Access, Patient experience, Outcomes, Value for money. What are the outcomes that we want to achieve and how will we know if we have made a difference? Outcome How will we know if we have succeeded? 1. Clearer pathways for service users, carers and referrers • Positive feedback from service users, carers, referrers, the public • Access to services is easier • Better information is available to all in relation to what services are available • Health professionals have clearer referral routes into services 2. Improved access to talking therapies (or psychological therapies) • A wide range of therapies are available to suit the needs of our local population including hard to reach communities • More people have access to talking therapies • More people recover following access to services 3. People will be better informed and will feel more able to manage their condition • More people feel that they have been involved in planning their own care and support • Better information is available to all in relation to available services • People tell us they feel better informed about mental illness, how to manage their condition, what help is available and where to find it 4. The right care at the right time • People are able to access the right service when they need it; appropriate care for people’s needs, care and support delivered by the most appropriate workforce, care and support is delivered at a variety of locations that is suitable for people • Better information is available to all in relation to what services are available in their community 5. People feel more supported in their community • Better information is available to all in relation to what services are available in their local community • Care and support is delivered at a variety of locations that is suitable for patients 6. Integrated support, incorporating wellbeing as well as treatment • Service providers are able to work more closely together to ensure that services are wrapped around people’s individual needs and all people receive a service 7. Localised services enabling recovery • Access to services are available at different locations across the city tailored to local needs • Feedback from service users, carers, referrers and the public is used to shape future services • All service outcomes are improved and recovery focussed • Positive patient experience feedback 8. Greater financial efficiency, resources are directed appropriately and to those in need • Quality services are delivered that are value for money • Access to services are available at different locations across the city tailored to local needs THE SERVICE REVIEW
  • 8. 8 The proposed primary care and community mental health model: Referral from GP / Health Professional Direct referral options still in place Single Point of Access and Triage GPs and health professionals will make a referral into the single point of access. Direct GP referrals for some services will still be in place. All referrals will go into one route and will be assessed by appropriate professionals. Talking Therapies Talking Therapies can help you work out how to deal with negative thoughts and feelings and make positive changes. Currently two types of services are available; Improving Access to Psychological Therapies service (IAPT) and counselling services. BSMHFT secondary care services Our local specialist mental health care services which are provided by Birmingham and Solihull Mental Health Foundation Trust include; Inpatient Services, Community Based Services and Specialist Services. Community support and wellbeing service Our vision is that people will be able to access local wellbeing services that will support the delivery of the outcomes. A team of community support workers will provide direct support in GP practices and community venues to help people to find and access the right services to suit their needs. The service will also have a strong relationship with local specialist mental health care services, third sector and statutory services. Social Inclusion To attempt to prevent people with mental illness becoming socially isolated we provide a range of services in order to help people with specific issues and to raise public awareness in relation to mental health issues. Some of these services are: advocacy and peer support; carer support services; mental health promotion and prevention programmes; day services in the community; employment, volunteering and education support services; domestic violence support; debt advice and guidance. Direct referral options still in place Direct referral options still in place Referral from GP / Health Professional Single Point of Access and Triage Talking Therapies BSMHFT secondary care services Community support and wellbeing service Social Inclusion
  • 9. 9 What will happen to the information that I provide? The information will be reviewed and shared with our communications team who will analyse all of the feedback received and put it together with other sources of information that we have collected as part of our pre-consultation engagement into a summary report. During the consultation process we will engage with: • the public • service users • carers • health professionals • providers of mental health services and statutory services including (but not limited to) • housing • probation • police • job centres • benefits agencies. THE CONSULTATION
  • 10. 10 Why have we suggested leaving the options for direct GP referrals in place? Some GPs are confident to make referrals into the right mental health services, including third sector services, for their patients and we feel where this good practice is in place it should continue. Why does the diagram state that only GP or health professional referrals are allowed? Following feedback that we have received, we are looking at how we can widen access to the referral routes. What is happening with child and adolescent mental health services (CAMHS)? We are aware that there are issues for some people moving from child and adolescent mental health services to adult mental health services; therefore we plan to redesign these services to improve the pathway and prevent disengagement from services due to transitions. We are currently working with young people, carers and families and mental health services to look at ways that the services can meet the needs of people from 0-25 years old. This is a separate process to the Primary Care Redesign. The new pathway for 0-25 year olds is to commence in October 2015. A 12 week Public Consultation is due to finish at the end of April You can find out more at www.bhamsouthcentralccg.nhs.uk/patient-and-public- engagement/0-25-mental-health-services What is happening with Attention Deficit Hyperactivity Disorder (ADHD) services? We currently commission a service from Birmingham and Solihull Mental Health Foundation Trust for people aged 16 plus. ADHD services are included in the CAMHS service consultation. What is happening with Dementia services? ‘Give me something to Believe in’ the Dementia Strategy for Birmingham and Solihull 2013-16 is now undergoing formal consultation (until 7th April 2014) through Birmingham City Council’s website Be Heard. Please follow this link to add your views: www.birminghambeheard.org.uk/adults-communities/ birmingham-and-solihull-dementia-strategy. The strategy will be formally launched on 19th May 2014 during Dementia Awareness Week. What are the future plans for Learning Disability Services? The Joint Commissioning Team is working closely with Birmingham Community Healthcare to remodel specialist healthcare services provided to people with learning disabilities. We are seeking to commission services that focus on supporting people in their own homes and local communities, and reduce reliance on inpatient assessment and treatment services for people with complex and challenging behaviour. To achieve this we are proposing to invest significantly in community outreach services in 2014/15. FREQUENTLY ASKED QUESTIONS
  • 11. 11 Term Definition Anti-depressants A type of medication used to treat depression or prevent it recurring. Attention Deficit Hyperactivity Disorder (ADHD) A group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness. Dementia A syndrome (a group of related symptoms) that is associated with an ongoing decline of the brain and its abilities. Enablement Supporting people to become as independent as possible; this may involve doing more for yourself or being able to make your own decisions. Learning Disabilities Affects the way a person understands information and how they communicate. Needs assessment This is a systematic process for determining and addressing needs by gathering specific information, highlighting the gaps and coming up with recommendations to improve current performance or to correct a deficiency. Outcome What is achieved by a service or intervention. Prevention The action of stopping something from happening or arising. Primary Care Services Services that are provided at the first stage of illness. Term Definition Single point of access One access route into a range of services. Specialist Mental Health Services In many parts of the country, mental health services are organised by specialist mental health trusts. Mental health trusts provide inpatient care, community and rehabilitation services and day clinics. Our Local Trust is Birmingham and Solihull Mental Health Foundation Trust. Statutory Services Services that are required to exist by law. Third Sector Service Provider Organisations who are ‘not for profit’ and/ or non-governmental. Sometimes these are charities or private organisations. Transitions The movement from one service to another, often when the person is a certain age. Triage A process for arranging people into groups based on their need for or likely benefit from medical treatment. Wellbeing The state of feeling healthy and content. GLOSSARY
  • 12. Please send feedback and requests for hard copies to: You can contact us to book a place at one of the events, request a copy of this document or send consultation feedback: WHAT HAPPENS NEXT? 12 Joint Commissioning Team, Zone 5, 1st floor, desk no: 1140, PO Box 16467, Birmingham, B2 2DR NHSBCCCG.BirminghamJCT@nhs.net www.birminghambeheard.org.uk 0121 675 8270 www.bhamcrosscityccg.nhs.uk www.bhamsouthcentralccg.nhs.uk www.sandwellandwestbhamccg.nhs.uk We want to hear your views and we are running three consultation events. Please come along and tell us what you think. You can book a place by visiting one of our websites, eventbrite, telephone or by email. Please see details below. Wednesday 26 March 2.30pm – 4.30pm Saffron Centre, 256 Moseley Road, Highgate, B12 0BS Tuesday 8 April 6.00pm – 8.00pm Midlands Arts Centre, Cannon Hill Park, Edgbaston, B12 9QH Saturday 10 May 1.00pm – 3.00pm Library of Birmingham, Centenary Square, Broad Street, B1 2ND Public event dates: You can book a place on these events by visiting www.eventbrite. co.uk and search for ‘Birmingham Primary Care Mental Health Events’ You can book a place on these events by visiting www.eventbrite. co.uk and search for ‘Birmingham Primary Care Mental Health Events’ You can book a place on these events by visiting www.eventbrite. co.uk and search for ‘Birmingham Primary Care Mental Health Events’ When the consultation closes on 6 June 2014 the consultation summary report including all of the feedback that we have received will be finalised and then considered by the CCGs in order to help them to make a decision on redesign plans.
  • 13. 13 1. Tell us about yourself, are you: A current or previous user of talking therapy services A current or previous Carer for someone who suffers with mental health problems A general member of the public who has not accessed the services A health professional A statutory service provider Other (please specify) 2. How did you find out about the services? Through your GP practice Through promotional materials, leaflets, magazines, radio, online Through recommendation by family Through recommendation by friends Through recommendation by community groups Other (please specify) 3. What was your experience of accessing the services? On a scale of 1-5; 1 being easy and 5 being hard Did not access the service (please explain why) 4. Where do you think would be a good place to receive these services? At the organisation’s offices Community venues (such as community centres, leisure centres, libraries or colleges) GP practices Other (please specify) 5. If you have personally accessed these services what do you think has worked well and what do you think could be improved? 6. Would you recommend these services to your family/friends if they experience mental distress? Yes No Consultation questions – please tear out these pages and return the form in the envelope provided. SECTION 1: We are particularly keen to find out your views in relation to: 1. Talking Therapies, Improving Access to Psychological Therapies service (IAPT) and counselling services
  • 14. 14 1. Do you know how to access your local service? Yes No Unsure 2. What was your experience of accessing the services? On a scale of 1-5; 1 being easy and 5 being hard Did not access the service (please explain why) 3. Have you had direct experience of using these services? No Yes (please explain what you think worked well and what could be improved?) 4. Do you have any other comments or suggestions about the services? 5. Would you recommend these services to your family/friends if they experience mental distress? Yes No 2. Community Mental Health Teams
  • 15. 15 1. Do you know how to access your local services? Yes No Unsure 2. What was your experience of accessing the services? On a scale of 1-5; 1 being easy and 5 being hard 3. Have you had direct experience of using these services? No Yes (please explain what you think worked well and what could be improved?) 4. Do you have any other comments or suggestions about the services? 5. Would you recommend these services to your family/friends if they experience mental distress? Yes No 3. Recovery, Enablement and Prevention Services
  • 16. 16 1. Do you think the single point of access model will help patients to access the right services more quickly? Please add your comments. Yes No 2. Do you think that the community support and wellbeing service will provide good support in the community to guide people to the right services? Please add your comments. Yes No 3. Do you think that it is important for the community support workers to be based in GP practices and community venues? Please add your comments. Yes No 4. Do you have any other comments or suggestions about the model? SECTION 2: The proposed primary care and community mental health model 1. How do you usually access information about mental health services? 2. Do you have any ideas about how we could make information about mental health services more available and accessible? SECTION 3: Information about mental health services

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