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Paul Jennings - What is SIM and the High Intensity Network?

Presentation by Paul Jennings, National Programme Manager, National Innovation Accelerator Fellow at Daresbury Park Hotel and Spa on Tuesday 26 March.

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Paul Jennings - What is SIM and the High Intensity Network?

  1. 1. Paul Jennings National Programme Manager
  2. 2. WHO IS THIS GUY?
  3. 3. WHAT PROBLEM DO WE TACKLE?
  4. 4. MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY REPEAT CALLER FREQUENT FLYER FAMILIAR FACE HIGH INTENSITY USER USA- SUPER UTILIZER AUS - REPEAT CONSUMER
  5. 5. A TRAUMA DRIVEN PROBLEM
  6. 6. TEMPERAMENT INVALIDATING ENVIRONMENT ADVERSE CHILDHOOD EXP ANXIOUS BEHAVIOURS AVOIDANT BEHAVIOURS DEPENDENT BEHAVIOURS INSECURE BEHAVIOURS OBSESSIVE BEHAVIOURS IMPULSIVE BEHAVIOURS MANIPULATIVE BEHAVIOURS ABUSIVE BEHAVIOURS AGGRESSIVE BEHAVIOURS GRANDIOSE BEHAVIOURS FLAMBOYANT BEHAVIOURS PROVOCATIVE BEHAVIOURS SELF MUTALATIVE BEHAVIOURS PARANOID BEHAVIOURS ECCENTRIC BEHAVIOURS DELUSIONAL BEHAVIOURS SOLITARY BEHAVIOURS HYPER- SENSITIVE BEHAVIOURS BEHAVIOURS PATTERNS START TO DEVELOP IN INFANCY/EARLY CHILDHOOD LEARNT – UNCONSCIOUS – INTRENCHED - HABITUAL GENETICS TEMPERAMENT INVALIDATING ENVIRONMENT ADVERSE CHILDHOOD EXP SKILLS DEFICIT No opportunity to regulate emotions LIFESTYLEEMOTIONS INTENSIFY EARLY MALADAPTIVE SCHEMAS Rigid ways in which we see ourselves, others and the world I am defective and unlovable No-one will be there for me You will abandon me All men are untrustworthy No-one tells the truth I am ugly BEHAVIOURS THAT HELP US AVOID WHAT WE BELIEVE TO BE TRUE BEHAVIOURS THAT MAINTAIN WHAT WE BELIEVE (PROVING THEM TO BE TRUE) BEHAVIOIURS THAT COMPENSATE FOR WHAT WE BELIEVE TO BE TRUE PATTERNS OF DYSFUNCTIONAL BEHAVIOUR HOW THE ENVIRONMENT RESPONDS
  7. 7. DEFINING ILLNESSES INTO CATEGORIES THIS HELPS WITH TREATMENT AGREED CRITERIA OR ‘CLUSTERING’ DSM (USA) ICD 10 (UK) PRESENTING MENTAL HEALTH PROBLEMS PERSONALITY DISORDERS ORIGINS IN FORENSIC PSYCHOLOGY TREATABLE! PROS AND CONS OF DIAGNOSIS 50% OF NEW NHS MH PATIENTS HAVE A PD MUST BE EVIDENCE OF PD MENTAL CAPACITY ORGANIC DISORDERS ORGANIC CONDITIONS BRAIN INJURIES EVOLVED BRAIN INJURY BIOLOGICAL CAUSES LEARNING & DEVELOPMENTAL DIFFERENCES IN THE WAY A PERSON UNDERSTANDS INFO DIFFERENCES IN THE WAY A PERSON LEARNS DIFFERENCES IN THE WAY A PERSON COMMUNICATES MAYBE AFFECTED BY A LIMITED I.Q MAYBE AFFECTED BY LIMITED ABILITY TO CONCENTRATE PHYSICAL HEALTH A CONTIUUM OF ABILITY
  8. 8. CLUSTER A ODD ECCENTRIC CLUSTER C ANXIOUS FEARFUL CLUSTER B DRAMATIC EMOTIONAL ERRATIC PARANOID PD SCHIZOID PD SCHIZOTYPAL PD EMOTIONALLY UNSTABLE PD ANTI-SOCIAL PD NARCISSISTIC PD HISTRIONIC PD DEPENDENT PD AVOIDANT PD OBSESSIVE- COMPLUSIVE PD
  9. 9. EMOTIONALLY UNSTABLE PERSONALITY DISORDER Unstable and intense interpersonal relationships alternating between extremes of over idealisation & devaluation. Identity disturbance unstable self-image/sense of self inc: sexual orientation, long-term goals or career choice, type of friends desired, preferred values. Impulsivity in 2+ areas that are self-damaging e.g. spending, sex, substance use, shoplifting, reckless driving, binge eating (do not include suicidal or self-mutilating behaviour covered. Transient stress-related paranoid ideation or severe dissociative symptoms IMPULSIVE SELF IMAGE REALITY? PEDESTAL/PIT Chronic feelings of emptiness or boredom EMPTINESS Extreme efforts to avoid real or imagined abandonment Inappropriate, intense anger or difficulty controlling anger e.g. frequent displays of temper, constant anger, recurrent physical fights. ANGER FEAR Affective instability due to a marked reactivity of mood e.g. intense episodic dysphoria, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days. MOOD Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour. SELF HARM
  10. 10. EMOTIONALLY UNSTABLE PERSONALITY DISORDER DEPRESSION ANXIETY PTSD
  11. 11. THE SIZE AND IMPACT OF HIGH INTENSITY TRAUMA (Using s136 MH Act 1983 as a data metric)
  12. 12. SURREY AND BORDERS NHS CENTRAL & NW LONDON NHS CAMB & PETERBOROUGH NHS 23 91 SW LONDON & ST GEORGES NHS OXLEAS NHS 52 HERTFORDSHIRE PART UNI NHS EAST LONDON NHS NORTH EAST LONDON NHS 69 31 NOTTINGHAMSHIRE NHS 42 84 70 62 146 184 231 238 104 145 SOUTH LONDON & MAUDSLEY NHS 47 155 91 NORTH EAST LONDON NHS 59 125 DEVON PARTNERSHIP NHS 34 87 2GETHER NHS 69%64 375 CAMDEN & ISLINGTON NHS 79 199 242 TOTAL PATIENTS TOTAL S136 Repeat patients Repeat s136 Total % of all s136 37% 34% 31% 31% 27% 40% 25% 25% 24% 23% 22% 22% 22% 545 364 833 752 638 419 575 712 394 280 736 763 1017 582 261 BERKSHIRE HEALTHCARE NHS 54 34%480 161 462 607 319 603 230 616 260 482 742 604 333 457 LIVEWELL NHS 43%39 148342233 CUMBRIA NHS 23 80 29%247230 TEWV NHS 21 60180142 33%Durham and Darlington Locality only NORTH WEST BOROUGHS NHS 12 38 23%166138
  13. 13. 58 MENTAL HEALTH TRUSTS 442 PEOPLE DETAINED s136 50 REPEAT PATIENTS 157 s136 ARE REPEATS 12% OF s136 PATIENTS 528 USES OF s136 POWERS 30% OF ALL s136 AVERAGE TRUST Data for: April 2017 – March 2018 Based on data provided by 17 Mental Health Trusts 69% 22% Population 933,000 Repeat Patients 2920 Repeat s136’s 9098 NHS ENGLAND Typical demand per MH Trust
  14. 14. 32x2 x3 x4 x5 x6 x7 x8 x9 x10 x11 x12 x13 x14 x15 16+ 9 4 5 Number of service users Numberofs136perserviceuser 0 5 10 15 20 25 30 35 40 45 498 PEOPLE DETAINED s136 50 REPEAT PATIENTS 5 13 32 HIGH INTENSITY/RISK/RELIANCE HIGHLY STIGMATISED? SEVERAL YEARS IN THE SERVICE? BEYOND ALL YOUR EFFORTS? COMPASSION FATIGUE HIGH STAFF SICKNESS YOUR NEXT SERIOUS CASE REVIEW VERY HIGH COST LEARNING A BEHAVIOUR? NEW TO SERVICE? PATTERN ESTABLISHING? BEHAVIOURAL WORK CRISIS PLAN THE FIRST REPEAT NEW TO SERVICE? REACTIVE TO AN EVENT IS A PATTERN ESTABLISHING? NEEDS IMMEDIATE CRISIS PLAN (BUT WE DON’T WRITE THEM) 296 NHS ENGLAND 744 1880 2920
  15. 15. THE COST AND IMPACT OF THE PROBLEM
  16. 16. 300 200 100 0 A&E 170 AMB 240 POLICE 292 s136 38 MH BED 246 986 CONTACTS £72,708 £70,042 £22,610 £42,218 £112,913 £320,492 13 PATHFINDER CASES 76 CONTACTS £24,653
  17. 17. POLICE DEPLOYMENT £249 AMBULANCE DEPLOYMENT £291 CRISIS CALL £10 CRISIS CALL £10 s136 £695 + TRANSFER FEE ACCIDENT & EMERGENCY £80-120 SCAN X-RAY BLOOD TEST MH ACT ASSESSMENT £200-700 MH BED 24HRS £450 ADDICTION SERVICES PRESCRIPTION MEDICATIONS UNEMPLOYMENT PHYSICAL ILL HEALTH CHILDREN & FAMILIES HEAR & TREAT £75 OUT OF AREA PLACEMENTS 24 HRS £700 MISSING PERSON £2415 SOCIAL CARE COSTS PICU BED 24 HRS £550 TIME
  18. 18. UH BRISTOL A&E FREQUENT ATTENDER PROJECT 100 PATIENTS Costs per HIU patient £36,293 £19,800 £24,653 £30,000 £28,000
  19. 19. Basic UK Calculations £28,000 a year 2920 cases £82 million x = ENGLAND 56 MILLION GLOUCESTER 1/9000 LONDON 1/17000 CAMB’SHIRE 1/28000 ISLE OF WIGHT 1/23000 PORTSMOUTH 1/14600 SURREY 1/78000 1 in 16,660
  20. 20. s136 stats from NWB NHS Pop: 709,000 132,000 325,000 210,000 275,000 128,000 149,000 3 5 19 27 REPEAT PATIENTS
  21. 21. PROBLEM 2: A HIGHLY MOBILE RISK
  22. 22. HOW DO POLICE RESPONSE STAFF REINFORCE THE CRISIS PATTERNS?
  23. 23. • EXTREME EFFORTS TO AVOID ISOLATION & ABANDONMENT • IMPULSIVE ACTS • THREATS TO SELF HARM • INTENSE, ENDURING LOW MOOD • CHRONIC FEELINGS OF EMPTINESS POOR UNDERSTANDING A LACK OF INFORMATION FEAR BASED DECISIONS UNRELIABLE CRISIS PLANS LACK OF ALTERNATIVES TO HOSPITAL INCONSISTENT DECISIONS UNCONFIDENT DECISIONS RISK AVERSE DECISIONS CALL RESPOND THE DECISION MAKER THE CRISIS BEHAVIOUR “WE ARE PROMOTING A REPEAT OF HIGH RISK BEHAVIOUR SARG!” “WE ARE REINFORCING MALADAPTIVE COPING STRATEGIES”
  24. 24. HOW CAN WE IMPROVE POLICE DECISION MAKING? THE DECISION MAKER
  25. 25. POOR UNDERSTANDING AND A LACK OF INFORMATION FEAR BASED DECISIONS UNRELIABLE CRISIS PLANS LACK OF ALTERNATIVES TO HOSPITAL INCONSISTENT RESPONSES UNCONFIDENT DECISIONS PLAY SAFE!! THE DECISION MAKER HIGH INTENSITY TRAINED POLICE OFFICERS WORKING WITH SERVICE USER RESPONSE PLAN COPRODUCED WITH SERVICE USER CONTENT OVERSEEEN BY SENIOR CLINICIANS RISK PROCESSES BASED ON QUALITY OF DECISION NOT OUTCOME IPOC CQC HMIC PSD SENIOR MNGT SUPPORTED NATIONALLY ADOPTED FORMAT SINGLE DIGITAL RESPONSE PLAN SYSTEM FOR POLICE AND AMBULANCE EVIDENCE OF IPOC SUPPORT FOR THIS TYPE OF DECISION MAKING PLANS ARE CRISIS & LOCATION SPECIFIC NATIONAL NETWORK TO SUPPORT ALL FORCES AND TRUSTS PROFESSIONAL LEVEL OF CLINICAL AWARENESS NON COMPULSORY/DISCRETION LED SUPPORTIVE OF DECISION MAKER REGARDLESS OF DECISION MADE
  26. 26. Principle 4 Harm can never be totally prevented. Risk decisions should, therefore, be judged by the quality of the decision making, not by the outcome. • It is in the nature of risk taking that harm, including serious harm, will sometimes occur • The fact that a good risk decision sometimes has a poor outcome does not mean the decision was wrong • Similarly, it cannot be assumed that a decision was right just because no harm occurred • A risk decision should be judged by how it was made, implemented and managed rather than by the outcome • Good risk management can to help reduce potential harms and increase potential benefits • Good risk-making tools can help to ensure quality decision making • All risk assessment is affected to some degree by imprecision and subjectivity 10 RISK PRINCIPLES
  27. 27. HOW CAN WE IMPROVE CRISIS CARE AFTER THE CRISIS? ! ! ! !
  28. 28. Treatment Social behaviour Bio-medical focus Community impact and risk Medical Quals Psycho-social Consent CoerciveClinical experience Legal Consequences Clinical knowledge Arrest Behavioural Compliance Rules Strict Authoritarian GREEN BLUE S35 TRO C.B.O VITAL INTERESTS PUBLIC TASK LEGAL OBLIGATION CRIMINAL OFFENCES Boundaries MENTAL CAPACITY ALLOWS A NEW MENTORING CONTRACT G D P R LAWFUL, PROPORTIONATE & NECESSARY Human Rights 10 RISK PRINCIPLES PERSONALISED CARE PLANS BORDERLINE PERSONALITY DISORDER POSITIVE RISK MANAGEMENT RELATIONAL RISK APPROACH CONTINGENCY METHODOLOGY Resilient
  29. 29. WHAT OUTCOMES DO SIM BASED TEAMS ACHIEVE?
  30. 30. 1. Reducing avoidable demand £19800 ISLE OF WIGHT 2013
  31. 31. 2. Reducing avoidable arrivals STREET TRIAGE RESPONSE AVERAGE 15.6 AVERAGE 12.8 AVERAGE 8.5 AVERAGE 5.33 AVERAGE 4.25 AVERAGE 1.33 s136 Mental Health Act 1983 STREET TRIAGE AVERAGE 1.66 2017 3655 64 105 154 186 Paris Electronic Records Paper Based s136 Forms
  32. 32. 3. Reducing the ‘Crisis Community’ TIER 1 De-escalate service users with high intensity behaviour. TIER 2 Early intervention of service users at risk of escalating. TIER 3 Supporting behavioural management, risk management, data sharing, investigation standards or effective partnership. 1 2
  33. 33. OVERALL: • 22% decrease in use of s136 powers • 17% decrease in missing person incidents • Frequent Attender project at Royal Surrey 33% reduction (CQUIN target is 20%) S136 None for 7 months A&E None for 6 months MH Beds Down by 11 Amb Savings £2000 S136 None for 7 months MH Beds 103 before 9 bed after S136 35 before 4 since MH Beds 0 in last 5 months MH Beds 2017 – 295 2018 – 0 5% National
  34. 34. Cost of providing staff for SIM model of care -£116,000 Through better crisis care of these service users, the team estimate that the following resources would have been used but have not been needed: Police Officers not deployed £117,640 s136 MH ACT 1983 detentions not used £52,250 Ambulances not deployed £2970 A&E’s not attended £1320 MH beds not occupied £327,952 TOTAL £502,132 NET SAVINGS TO LOCAL CRISIS TEAMS £386,132
  35. 35. Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Mental Health Police Ambulance A&E 12 months pre-SIM SIM commences SUMMARY Intensive discussion to ensure discharge Crisis behaviours have significantly reduced in intensity Regular engagement with SIM team Engaged with plan – agreed safe location plan Reconnected with family members Opening up about family issues - asking for advice Positive approach to social circumstances Engaging with employment specialist Making enquiries re housing situation. Attends Futures In Mind and Aspire course – self initiated Patient A
  36. 36. 12 months pre-SIM SIM commences Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 Mental Health Police Ambulance A&E SUMMARY More consistent, community based multi-agency approach Slowly challenging inappropriate behaviour • Reduction in suicide threats • Shifting away from self harm Patient B
  37. 37. Mental Health Police Ambulance A&E Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 12 months pre-SIM SIM commences SUMMARY Multi-agency approach to sort out social issues Managing complaints from patient and family about mental health services 65% decrease in inappropriate contacts Discharged in October 2018 due to change in diagnosis (bi-polar) Consultants nervous to support a strict boundary based approach when crisis behaviour likely to be psychotic. Patient C
  38. 38. Mental Health Police Ambulance A&E Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 Apr 18 May 18 Jun 18 Jul 18 Aug 18 Sep 18 Oct 18 Nov 18 Dec 18 12 months pre-SIM SIM commences SUMMARY Patient seen by SIM team to support GP in ongoing management Significant reduction in Police contact Ambulance and A&E contact is now appropriate – relating to physical health needs. Patient C
  39. 39. Mental Health Police Ambulance A&E 3-7 MONTHS Patient A-D
  40. 40. s136 5 0 Standard Bed Days 188 122 (Now out of hospital) PICU Bed Days 33 0 Ambulance Call 18 0 Ambulance Triage 1 0 Ambulance Attendance 13 0 A&E Attendance 24 3 Police Call 8 4 Missing Person 13 3 Total Cost £133,165.10 £52,829.40 12 Months Pre-SIM 4 Months on SIM • Team led confident discharge from ward despite best efforts to use consent as a discharge barrier • Team secured temporary accommodation • Team led re-engagement with community activity • Team led re-engagement with family and friends Quality of Life Outcomes so far Patient A
  41. 41. HOW CAN WE BEST DEPLOY THESE JOINT ‘GREEN/BLUE’ SKILLS?
  42. 42. MODEL 1 – ‘Rotation’ Model MODEL 2 – ‘Reallocation’ Model P P P MODEL 3 – ‘Supporting’ Model CC1 CC2 CC3 CC1 CC2 CC3 CC4 CC5 SU1 SU2 SU3 SU4 SU5 SU1 SU2 SU3 SU4 SU5 CC CC Dedicated police officer supports multiple care co-ordinators, perhaps across multiple clinical locations. Dedicated police officer works with dedicated care coordinator. They manage their own HIU caseload, taking patients off other care coordinators. Dedicated police officer works with dedicated care coordinator. They support care coordinators with their own HIU clients. MODEL 4 – ‘Community’ Model Police Officer from a neighbourhood team is trained and paired up with a local MH clinician to support one service user living within the neighbourhood. This work is adopted into his/her policing responsibilities for x hours a week. P CC SU IOW NHS Avon & Wiltshire NHS Camden & Islington NHS Solent NHS Derbyshire Healthcare NHS Leicestershire Partnership NHS DUTCH TEAM TEWV/Durham Police (Launching 2019) Essex Partnership University NHS Oxleas NHS SU1 SU2 SU3 SU4 Lincolnshire NHS/ Lincolnshire Police P CC SU P CC SU P CC SU COORDINATOR
  43. 43. WHICH MH TRUSTS AND POLICE FORCES ARE INVOLVED SO FAR?
  44. 44. SIM PILOT SITE Isle of Wight NHS July 2013 Leicestershire NHS (Independent/Data Partner) Oct 2016 Surrey & Borders NHS Mar 2017 Solent NHS (Independent/Data Partner) Jan 2018 Avon & Wiltshire NHS – Teams 1 and 2 April 2018 Camden & Islington NHS April 2018 South London & Maudsley NHS April 2018 SW London & Maudsley NHS April 2018 Oxleas NHS April 2018 Essex Partnership University NHS (Chelmsford) April 2018 Derbyshire NHS Sept 2018 Northamptonshire NHS Sept 2018 Rotherham, Doncaster & S Humber NHS Oct 2018 2Gether NHS (Gloucestershire) Dec 2018 Central & NW London NHS Mar 2019 East London NHS Mar 2019 West London NHS Mar 2019 Barnet Enfield & Haringey NHS Mar 2019 Avon and Wiltshire – Team 3 Mar 2019 Cumbria NHS April 2019 Norfolk & Suffolk NHS (Suffolk) May 2019 NE London NHS June 2019 Bedfordshire/ELFT June 2019 Hertfordshire NHS June 2019 Essex Partnership University NHS - Team 2 (Southend) June 2019 Lincolnshire NHS 2019 Cambs & Peterborough NHS 2019 Norfolk & Suffolk NHS (Norfolk) 2019 Tees, Esk and Wear NHS (North Yorkshire) Tees Esk and Wear NHS (Cleveland) Humber NHS Midlands Partnership NHS North Staffs Combined Healthcare NHS Coventry and Warwickshire (Warwickshire) Devon Partnership NHS Livewell NHS NTW NHS Tees, Esk & Wear NHS (Durham) Navigo Lancashire NHS West Yorkshire STP Northern Boroughs NHS Nottinghamshire NHS Kent & Medway NHS Oxfordshire Healthcare NHS Berkshire Healthcare NHS Worcestershire Health & Care NHS Southern Health NHS LIVE MENTAL HEALTH TRUST TRUST SETTING UP TEAM IN 2019 TRUST LIKELY SETTING UP IN 2019 IN CONVERSATION INDEPENDENT (SAME SIM DESIGN) 50% of MH Trusts SAME MH TRUST/DIFFERENT COUNTY OR POLICE FORCE SAME TRUST WITH MULTIPLE POLICE STAFF 9 LONDON TRUSTS See Page 2
  45. 45. Supported by: LIVE TEAM TEAM LAUNCHING BY JUNE 2019 ALL OTHER FUTURE TEAM LOCATIONS
  46. 46. WHO BACKS THIS AT THE TOP?
  47. 47. Senior Supporters Chief Constable Mark Collins Mental Health Portfolio Lead Prof Peter Fonagy UK Leader in the Study of Personality Disorders UCL – Harvard - Yale Geraldine Strathdee National Clinical Director Mental Health 2012-2015 POLICE LEAD RESEARCH LEAD PROJECT MENTOR
  48. 48. NHS Innovation Accelerator
  49. 49. Coroners “This is the quality of care that Coroners have been looking for” Coroners Office Manager Gloucestershire
  50. 50. LIVE TEAM ON NETWORK SETTING UP TEAM LIKELY FUTURE TEAM POSITIVE EARLY CONTACT SIM PILOT SITE Isle of Wight NHS July 2013 Leicestershire NHS (Independent/Data Partner) Oct 2016 Surrey & Borders NHS Mar 2017 Solent NHS (Independent/Data Partner) Jan 2018 Avon & Wiltshire NHS April 2018 Camden & Islington NHS April 2018 South London & Maudsley NHS April 2018 SW London & Maudsley NHS April 2018 Oxleas NHS April 2018 Essex Partnership University NHS April 2018 Derbyshire NHS Sept 2018 Northamptonshire NHS Sept 2018 Rotherham, Doncaster & S Humber NHS Oct 2018 2Gether NHS (Gloucestershire) Dec 2018 Barnet Enfield & Haringey NHS Mar 2019 Central & NW London NHS Mar 2019 East London NHS Mar 2019 NE London NHS Mar 2019 West London NHS Mar 2019 Norfolk & Suffolk NHS (Suffolk) Mar 2019 Lincolnshire NHS 2019 Hertfordshire NHS 2019 Cambs & Peterborough NHS 2019 Norfolk & Suffolk NHS (Norfolk) 2019 Bedfordshire/NELFT 2019 Black Country NHS 2019 Tees, Esk & Wear NHS (Durham) 2019 Tees, Esk and Wear NHS (North Yorkshire) 2019 Humber NHS 2019 Navigo 2019 Midlands Partnership NHS 2019 Cornwall NHS Devon Partnership NHS Livewell NHS Birmingham Women’s & Children NHS Lancashire NHS Cumbria NHS Sheffield Health & Social Care NHS Nottinghamshire NHS Tees, Esk and Wear NHS (Cleveland) North Staffs Combined Healthcare NHS Isle of Man Health and Social Care 7 NATIONALLY ADOPTED INNOVATIONS 2018-2020
  51. 51. CONNECTING AND SUPPORTING TEAMS
  52. 52. LIVE TEAM ON NETWORK SETTING UP TEAM LIKELY FUTURE TEAM POSITIVE EARLY CONTACT SIM PILOT SITE Isle of Wight NHS July 2013 Leicestershire NHS (Independent/Data Partner) Oct 2016 Surrey & Borders NHS Mar 2017 Solent NHS (Independent/Data Partner) Jan 2018 Avon & Wiltshire NHS April 2018 Camden & Islington NHS April 2018 South London & Maudsley NHS April 2018 SW London & Maudsley NHS April 2018 Oxleas NHS April 2018 Essex Partnership University NHS April 2018 Derbyshire NHS Sept 2018 Northamptonshire NHS Sept 2018 Rotherham, Doncaster & S Humber NHS Oct 2018 2Gether NHS (Gloucestershire) Dec 2018 Barnet Enfield & Haringey NHS Mar 2019 Central & NW London NHS Mar 2019 East London NHS Mar 2019 NE London NHS Mar 2019 West London NHS Mar 2019 Norfolk & Suffolk NHS (Suffolk) Mar 2019 Lincolnshire NHS 2019 Hertfordshire NHS 2019 Cambs & Peterborough NHS 2019 Norfolk & Suffolk NHS (Norfolk) 2019 Bedfordshire/NELFT 2019 Black Country NHS 2019 Tees, Esk & Wear NHS (Durham) 2019 Tees, Esk and Wear NHS (North Yorkshire) 2019 Humber NHS 2019 Navigo 2019 Midlands Partnership NHS 2019 Cornwall NHS Devon Partnership NHS Livewell NHS Birmingham Women’s & Children NHS Lancashire NHS Cumbria NHS Sheffield Health & Social Care NHS Nottinghamshire NHS Tees, Esk and Wear NHS (Cleveland) North Staffs Combined Healthcare NHS Isle of Man Health and Social Care
  53. 53. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  54. 54. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  55. 55. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Video Calls 3 Day Training Course NHS Digital NRL Integration: COURSE 1 - LAUNCHED JANUARY 2019 COURSE 2 - LAUNCHED APRIL 2019 Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  56. 56. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  57. 57. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  58. 58. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: HEALTH & JUSTICE TEAM CONNECTION NATIONAL RECORD LOCATOR STREET TRIAGE CONTROL ROOM TRIAGE LIAISON & DIVERSION HIGH INTENSITY SUPPORT TEAMSTeam Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  59. 59. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: APRIL TO DECEMBER 2019 Prof Peter Fonagy UK Leader in the Study of Personality Disorders UCL – Harvard - Yale Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  60. 60. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  61. 61. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits 3rd Sector Project Support International Teams Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  62. 62. Digital Team Set Up Resources AUG - Online Training Course SEPT - UCL Research Programme NOV - Quality, Safety and Legal International Connections SEPT - Team Webinars 2017 2018 MAY - Launch SIM LONDON 2019 SEPT - Patient Data Portal 136 DIGITAL Project HI-TRACK National Case Mngt Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team to Team Webinars 3 Day Training Course NHS Digital NRL Integration: Team Support Visits International Teams 3rd Sector Project Support Digital Set Up Resources Online Training Course UCL Research Programme Quality, Safety and Legal Team Support Visits 3 Day Training Course NHS Digital NRL Integration: International Teams 3rd Sector Places of Safety Team to Team Video Calls
  63. 63. @SIMintensive paul@highintensitynetwork.org www.highintensitynetwork.org Paul Jennings National Programme Manager

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