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Grainne Eloi & Dr Sarfaraz Shora
- 1. You & YourCare www.bdct.nhs.uk
- 2. You & YourCare www.bdct.nhs.uk Case for change – 2014 • OOH services only to known MH patients at restricted hours • IHTT high number of crisis calls • Inpatient bed base over capacity and regular use of OOA area acute treatments • A+E’s reporting patients presenting in health and SC crisis • Police detaining people in cells for long periods • GPs reported multiple referral routes and poor access • AMHP’s overstretched • Rates of stay in acute care too long • Negative feedback from patients
- 3. You & YourCare www.bdct.nhs.uk How the whole system developed • BDCFT set up FRS & redeveloped Acute Care • LA redesigned Social Care, AMHP + DTOC • Police support services + training developed • Third sector partners set up alternatives • Housing options redeveloped • Criminal Justice brought into FRS • Crisis care Concordat driver for change and accountable for actions
- 4. You & YourCare www.bdct.nhs.uk Partnership with the Police • MH training for all officers • Joint planning and mtgs • Criminal Justice Liaison • ASB & community links • Health & Social Care staff in Police Control room • NHS Community constables
- 5. You & YourCare www.bdct.nhs.uk Summary of benefits – 2016 • First Response 24hr Crisis service • NHS & Social Care Intensive Home Treatment • Integrated A and E Liaison team linked to ‘Haven’ • Police Hub team & Police Triage response • MIND Sanctuary Project & The Haven • Social care respite and housing integrated into service • MH & PH parity with the Bradford Tool
- 6. You & YourCare www.bdct.nhs.uk Sanctuary • The Sanctuary is operated by Mind in Bradford, in partnership with ‘Sharing Voices’ and ‘First Response’. This service is open 365 days a year from 7pm – 1am • The Sanctuary is open to people 18 years and over • Experience anxiety or panic attacks • Suicidal thoughts and feel unsafe, but do not intend to end their life • Have self-harmed but do not require medical attention • Are disassociating • Are intensely depressed • Hear voices but know that the voices are not real • Experience Post Traumatic Stress Disorder • Feel overwhelmed and unable to cope • www.crisiscareconcordat.org.uk/.../the-sanctuary-at-mind-in-bradford/
- 7. You & YourCare www.bdct.nhs.uk Haven • Haven is a new 365 day a year service at the Cellar Trust • Opens 10am – 6pm • Aim: A&E diversion • Gate kept by FRS • IHT Duty sit within the service • Emphasis on peer support from people with lived expertise • Aim is to support people in distress and work with them to develop their plans to stay well and cope better with distress in the future • www.thecellartrust.org/client-services/haven
- 8. You & YourCare www.bdct.nhs.uk Safer Spaces • Safer Space CYP service plan to stay for one night • Available seven days a week, 365 days a year, from 10pm to 10am • Offers support for young people under 18 years of age, in crisis and struggling with emotional distress living in Bradford, Airedale, Wharfedale or Craven • Gate kept by FRS • http://www.bdct.nhs.uk/ss
- 9. You & YourCare www.bdct.nhs.uk Outcomes and Improvements • No Acute OOA placements 22 months • Reduction in MH attendance at A and E • Reduction in use of s136 • Reduced average length of stay • DTOC to zero for 7 months • Diversion from custody + reduced use of cells
- 10. You & YourCare www.bdct.nhs.uk Lessons Learnt • Relationships and trust are vital • Communication and Involvement • Having a clear agreed vision underpinned by partnership agreement • Integrated services are key to success • Shared ownership and responsibility when things go wrong. • Shared ownership and responsibility when things go right. • Constant reflection, evaluation and planning.
- 11. You & YourCare www.bdct.nhs.uk Mental Health Liaison • Core 24 • Integrated and partnership approach • Expansion on In reach into Acute Hospital • Training for ED Clinical Staff • Front door triage