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Sandeep Ranote
- 1. GM Devolution: CAMHSRevolution – Eating Disorders Leading the Way Dr Sandeep Ranote – NHSE Strategic Clinical Network Lead - CAMHS
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- 3. WHY, HOW &WHEN? 1 in 150 female YP – anorexia nervosa (AN) 1 in 25 female in lifetime – bulimia nervosa (BN) 90% female 1.6 million UK people directly affected – BEAT 2007 High rates of co-morbidity AN highest mortality of any psychiatric disorder Geographical variations in service provision still high Total annual UK cost £1.2 bn - £9.6 bn – BEAT review 2012 & 2014 Carer burden high and underestimated CAMHS use of tier 4 admission for ED high > 35% Often due to poor/no specialist community or ‘mini team’ provision
- 4. WHY, HOW &WHEN? Wigan pilot (> 200 families) demonstrates need > 90% families treated rated service 4/5 out of 5 > 90% families would recommend service (F & F test) > 85% improved outcomes 10-12% admission rate to Tier 4 Increase in admissions seen in 2013 with national picture
- 5. WHY, HOW &WHEN? Evidence base supports CEDS-CYP – community adolescent eating disorder service as most cost effective MDT integrated model recommended Partnership working Critical window for intervention 3-5 years Clear transition pathway Multimodal therapeutic package of care, person centred, evidence based, National clinical outcome measures (DATA!) EARLY INTERVENTION KEY – delay increases long term health costs Shared decision making Experts by experience to co-develop pathways Recovery Model More studies underway
- 6. ASPIRATIONS Education and trainingin primary care and schools Junior MARSIPAN in reach to paediatric ward / Junior MARSIPAN hub Day unit Tier 4 provision 0-25 or ageless service Peer Mentoring Parent Support Groups led by parents Primary care / schools link
- 8. WHAT NOW? £30m recurrentfunding – Autumn budget 2014 £150m in total over 5 years Transformation of services in England for children and young people with eating disorders up to 18 years old Development of CEDS-CYP Population minimum for service – 500k (all ages) Access and waiting time standards guide – July 2015 National whole team training curriculum – 2016 QNCC CEDS-CYP Standards - 2016
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- 10. Wigan Borough EDCQUIN Tier 4 Specialist Eating Disorder Unit
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- 12. CEDS SCHOOLS LINK WORKER CEDS PRIMARY CARELINK WORKER TIER 4 ED UNITS NON 5BP 5BP CAMHS General Community CAMHS Urgent Response Team Fairhaven 5 YEAR PLAN DEVELOP 2 SPECIALISED BEDS & DAY SERVICE SCHOOLS LA THIRD SECTOR COLLABORATION HALTON CEDS SPOKES SPECIALIST MDT WIGAN / BOLTON GM DEVO WARRINGTON ST HELENS KNOWSLEY PAEDS PSYCHIATRY CYP IAPT FAMILY THERAPY CASE COORDINATION CBT MOTIVATIONAL THERAPY DIETETICS OTHER EVIDENCE BASED THERAPIES THE HOUSE OF CEDS WWL PAEDS HUB GM DEVO CLUSTERS WHISTON PAEDS HUB
- 13. Community Eating DisorderService • Population-based: minimum 500K (all ages) so may span more than one CCG • Referrals for anorexia nervosa, bulimia nervosa, binge eating disorders and co-existing problems (e.g. anxiety and depression) • Min of 50 referrals per year • Enable direct access to community eating disorder treatment via self-referral, GPs, schools, colleges and voluntary sector Table 5: Whole time equivalent staff broken down by profession Number of referrals per annum Head of service (psychiatry/psychology) Clinical psychologists Eating disorder therapists (SFT-ED/MSFP-ED/CBT-ED) Nursing staff (nursing/home treatment) Speciality doctors (psychiatry) Assistant psychologists (SFP-ED/ MSFP-ED/CBT-ED support) Paediatricians (physical health) Dieticians Administrative staff
- 14. GM DEVO • Strategicpriority • 3 Clusters Pennine Salford/Central Wigan/Bolton • Networked approach
- 15. GM DEVO • GMED Network • Workforce training (National Programme - NHSE) • Sharing and learning • Best practice models • GM standards & public awareness • Shared digital solutions • Future development • Single site / 2 site Tier 4 “GM beds 4 GM kids” • Single site / 2 site day provision
- 16. GM DEVO • SharedVCS / University work • School / primary care work • Thrive • Minded 4 MCR • KPIs • Crisis • Service specification
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- 18. CLINICAL LEADERSHIP Collective leadership Creativetalent mapping Clinical voice and drive Clinical quality Clinical conduit
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- 20. Children & YoungPeople A third of our population BUT all Of our future @GMLSC_SCNs #time4CAMHS2Bseen&heard