A brief summary of the focus of the work of the South of England Early Intervention in Psychosis (EIP) Programme in 2018-19 as we work across systems, organisations and teams to drive better quality and outcomes for people with early psychosis and their families.

1. South Region Early
Intervention in
Psychosis Support &
Assurance
2018-19
Nominee 2017

2. 2
Service Development and Improvement Planning3
Content
Our Support Offer
1
2017-18 College Centre for Quality Improvement (CCQI)
Ratings
4
Q & A5
Psychosis access, waiting time and quality standards

3. South EIP Programme

4. Governance Structure

5. Achievement of psychosis standards is one of the 9 ‘Must Dos’ in the Mental
Health Five Year Forward View Implementation Plan with funding support as
follows:
Source: NHS England, Mental Health Five Year Forward View Implementation Plan (Page 24)
Five Year Forward View

6. Early intervention in psychosis
standard
2016/17 2017/18 2018/19 2019/20 2020/21 Measured by
% of people receiving treatment
in 2 weeks
50% 50% 53% 56% 60%
UNIFY data collection
Moving to MHSDS as soon as
possible
Specialist EIP provision in line
with NICE recommendations
All services
complete baseline
self-assessment
All services
graded at level 2
by year end
25% of services
graded at least
level 3 by year end
50% of services
graded at least
level 3 by year
end
60% of services
graded at least level
3 by year end
Royal College of Psychiatrists College
Centre for Quality Improvement
(CCQI) annual quality assessment
and improvement scheme.
By 2020/21, ensure that “at least 60% of people with first episode psychosis [are] starting treatment with a NICE-recommended
package of care with a specialist early intervention in psychosis (EIP) service within two weeks of referral”.
Psychosis Waiting Time & Quality Standards

7. NICE Standards

8. www.england.nhs.uk
Measured Against the
Standards
Timely access
• At least 50% people start treatment within 2 weeks of referral
(moving to 53%)
Effective treatment
• Cognitive Behavioural Therapy for psychosis (CTBp)
• Family interventions (FI)
• Supported employment programmes
• Carer support & education
• Physical healthcare
Well managed service: Outcome Measures
• Recorded at least twice: HoNOS/HoNOSCa, QPR, DIALOG

9. www.england.nhs.uk
Effective Treatment: CBTp, FI, Supported Employment, Carer
Support and Physical health
9
• 81% of services are at level 2 or above for the “Effective Treatment” domain
• This domain provides a score for the NICE concordant elements of care and demonstrates progress since 2016/17
• In the South West – 12 of 14 teams are at level 2 (2 teams are at level 3).
• In the South East – 14 of 18 teams are at level 2 (2 teams are at level 1 and 2 teams are at level 3).
South East South West

10. Service Development & Improvement
PlanningNICEStandardfor Early Interventionin Psychosisas Mandatedin FiveYearForward Viewfor
Mental HealthImplementation Plan
EIP TeamA EIP TeamB EIP TeamC
1 2 3 4
Requires Significant
Improvement
Requires Improvement Good Outstanding
1. Referral to Treatment - Percentage of service users referred with suspected
first episode psychosis that were allocated to, and engaged with, an EIP care
coordinator within 2 weeks of receipt of referral in April 2018
80% 54% 100% <25% ≥25% ≥53% ≥60%
2. CareCoordinator to ServiceUsers Ratio 14 23 15 >20 16-19 ≤15 -
3. CBT for Psychosis - Percentage of service users with First Episode Psychosis
that received 2 or more sessions of Cognitive Behavioural Therapy for
psychosis (CBTp)
31% 26% 25% <12% ≥12% ≥24% ≥36%
4. Family Interventions – Percentage of service users with First Episode
Psychosis and their families that took up Family Interventions 26% 14% 10%
<10% ≥10% ≥20% ≥30%
5. Individual Placement & Support - Percentage of service users with First
Episode Psychosis not in employment who received 2 or more appointments
with an Individual Placement Support (IPS) specialist
100% 16% 9% <10% ≥10% ≥20% ≥30%
6. Physical Health- Percentage of service users with First Episode Psychosis
that have had all of the below physical health checks in the past year:
• Body Mass Index (BMI)
• Blood Pressure
• Glucose Regulation (HbA1c or fasting glucose or random glucose as
appropriate)
• Blood lipids
92% 55% 62%
<70% ≥70% ≥80% ≥90%
7. Smoking Cessation- Percentage of those who smoke who were offered
smoking cessation
100% 72% 77%
<25% ≥25% ≥50% ≥75%
8. Carer Education Programmes - Percentage of carers offered carer-focussed
education and support programmes
71% 96% 62%
<25% ≥25% ≥50% ≥75%
9. Outcome Measures – Percentage of service users with QPR, DIALOG
recorded twice or more since entering the service
35% 19% 34%
<25% ≥25% ≥50% ≥75%
10. Overall RcPsych Centrefor Clinical Quality Improvement (CCQI) Rating i.e. 1
(Requires Significant Improvement) 2 (Requires Improvement) 3 (Good) or 4
(Outstanding)
3 2 2
IN EPIC STP 1 EIP TEAM IS RATED 3 (GOOD) AND 2 TEAMSARE RATED 2 (REQUIRE IMPROVEMENT)
The above data is fictitious and used for illustration purposes only

11. # Element Agreed Action/s Who By When By Comments on Progress
1. Demand, Capacity & Investment 
2. CBT for Psychosis (CBTp) 
3. Family Interventions 
4. Medication Management 
5. Individual Placement & Support (IPS) 
6. Physical Health 
7. Smoking Cessation 
8. Carer Education Programmes 
9. Workforce Recruitment & Retention 
10. Data Quality (including MHSDS, SNOMED-
CT and Outcome Measures)

Risks
(Please identify any risks to delivery referencing
element relates to)
Mitigating actions Identify any additional
support needed?
Action Plan 2018-19

12. EIP SDIP Timeline
SDIP meetings should be arranged by providers with commissioners and involve finance and IT
managers
May 2018
Each provider received a comprehensive
CCQI report.
NHS England South issued notice to
commissioners to refresh SDIPs for
2018-19
Q3 Q4Q2Q1
June 2018
Providers need to organize SDIP meeting
with CCG mental health leads, IT and
Finance Managers with support from
SCN Quality Improvement Leads by end
of June 2018.
July 2018
Commissioners need to send refreshed
SDIPs to NHS England South via
england.mentalhealthsouth@nhs.net by
23rd July 2018
September 2018
Quality Improvement Leads and Assurance
Managers review SDIPs with support from
South EIP Programme using EIP Assurance
template - feedback to commissioners by
end of September 2018
December Onwards
25% of EIP teams in South of England
improve CCQI rating from 2 (Requiring
Improvement) to 3 (Good)

13. Element KEY LINES OF ENQUIRY YES NO COMMENTS
Investment&NICEConcordance
Has an agreed baseline funding position for 18/19 for the local EIP service been clarified in line with the relevant guidance?
Can the CCG confirm that the funding for the delivery of the EIP access standard has been identified and fully allocated from the CCG
baseline allocations?
Can the provider confirm that this same amount of funding has been allocated to the relevant EIP service?
Is there a robust SDIP in place setting out how the provider will prepare for and implement the standards and reach a rating of level 3 on
the CCQI audit?
Key elements should include:
a. Understanding demand – local incidence rates and profiles
b. Workforce development – understanding the baseline position and gaps in respect of staffing , skill mix and competency to deliver the
full range of NICE concordant interventions.
c. Optimisation of RTT pathways - engaging all potential referral sources, many of which will be internal in secondary care and which will
include CAMHS and acute services.
d. Improving data quality – this will include training for Clinical and IT leads, reviewing contracts with IT suppliers if Electronic Health
Records are not configured correctly, activating SNOMED-CT codes to capture interventions and automate reporting
Is the delivery of the SDIP in 18/19 on track against plan?
Is there a local implementation group in place within the locality to oversee progress on delivery of the EIP access standard?
If in place, does the local implementation group meet regularly?
Are there sufficient links between the local implementation group and the regional South EIP programme?
Are you confident that the additional investment will provide the necessary capacity in order to achieve the standard? If No, please
highlight any risks in the comments section.
Are there any further support/tools or guidance that would support implementation?
DataQuality
Is the provider currently submitting matching data to both UNIFY and MHSDS?
Is there a plan in place to reduce the variance between UNIFY and MHSDS?
Are there any technical challenges that remain to be addressed? (please specify)
Is there a plan to increase the recording of outcome measures i.e. QPR, DIALOG and HoNOS?
If appropriate, is there a risk mitigation strategy in place is respect of any remaining issues affecting data submission?
Has the provider engaged with the Intensive Support Team (IST) to resolve any data quality or reporting issues?
Does the plan have a timescale?
Workforce
Is there a good understanding of the baseline position and gaps in respect of:
●staffing- the levels of capacity required to meet local demand
●skill mix and competency to deliver NICE interventions including CBTp, Family Interventions, IPS, Physical Health Screening, Medication
Management (Clozapine) and Carer Education Programmes
●Has the team/provider secured training and if so do they have a plan to retain staff once they qualify?
Has a local workforce development plan (recruitment and training) been agreed?
Is delivery on track?
Does the plan include key workforce development challenges and risks?
Are there any risk mitigation strategies in place to address the above?
Is there sufficient confidence in these risk mitigation strategies?

14. 1. Purpose
Provide strategic and practical support to commissioners and providers so that they achieve both elements
of the early psychosis waiting time and quality standards.
2. Objectives
1. Support commissioners and providers to develop business cases for securing funding to achieve NICE
concordance and meet demand;
2. Improve the quality of EIP services to a rating of Level 3 (Good) or above with a particular focus on improving
physical health and employment prospects through Individual Placement Support (IPS);
3. Maintain quality improvement platforms so that teams have the space to share good practice and strategies to
overcome barriers to improvement;
4. Support workforce recruitment strategies e.g. using EPIC Minds, that use new roles and target new sources of
supply and innovations in the workforce;
5. Collaborate with national teams e.g. NHS England, Health Education England and NHS Improvement to ensure
the programme is fully aligned with national priorities, policy and strategy.
Support Offer 2018-19
4. Deliverables
1. EIP Matrix online analytics and visualization tool to give teams real-time feedback
2. Best practice forums including face-to-face support, workshops and webinars to drive improvements*
3. Service Development and Improvement Plans with clinical expertise and change management input
4. EIP Business Plan and Service Specification templates to minimize burden on commissioners
5. Annual report including achievements, good practice examples and case studies
*Organised with Quality Improvement Leads in Strategic Clinical Networks

15. EIP Matrix

16. Caseload Projections
*This projection is subject to change as it is based on the different acceptance criteria currently operating within the South of England e.g. acceptance or not of those aged over 35 and 3 year treatment or shorter
* Expected caseload assuming yearly accepted cases being the same as new cases taken-on in 12 months between 31st August 2016 – 31st August 2017. Projections assume retention of 80% of all new cases with 20% attrition
due to discharge, disengagement, relocation etc
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17. EPIC MINDS Resources
www.epicminds.co.uk

18. www.england.nhs.uk
For more information about the programme,
please visit
www.time4recovery.com
Thank You!
To access the EPIC MINDS resources, please visit
www.epicminds.co.uk
Commissioned by
South
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