Final - 7th June 2002
Mental Health National Service Framework - Autumn 2002 Position Statement
Self-Assessment Framework
GUIDANCE FOR COMPLETION
(1)
The framework should be discussed and a response agreed within the LIT.
(2)
The framework has descriptive statements for each of the lines on the scoring sheets. Circle ‘green’, ‘a
amber’ or ‘red’ as
appropriate for the statement which most nearly matches the situation in your locality. Five questions in the framework also ask
for the elements to be specified which contribute to your response. There is provision for this on the scoring sheets.
(3)
If the situation varies within the LIT area as regards different progress in neighbouring PCT or LA areas, circle ‘a
amber’ or ‘red’
to reflect the poorest level of progress within the whole locality. Only circle ‘green’, if this is the situation across the whole
locality.
(4)
Except where the statement explicitly states otherwise, the situation should be scored as at September 2002. This does not
imply any change to deadlines for achievement of NHS plan or NSF targets - the self assessments aim simply to give a local and
national picture of the current position.
(5)
The shaded lines on the scoring sheets identify indicators which are substantially or wholly unchanged since last year.
(6)
Please complete the framework as openly and honestly as possible. It is expected that all returns will contain a number of ‘red’
assessments, and that few returns will contain a majority of ‘green’ assessments.
(7)
There are guidance notes for reference at the back of the framework.
Final - 7th June 2002
Mental Health National Service Framework - Autumn 2002 Position Statement
Self-Assessment Framework : SCORING FOR LITs
KEY SERVICES
1. Assertive outreach
2. Crisis resolution
3. Early intervention in Psychosis
4. Secure places
5. Women’s services
6. Carers’ services
7. Black & minority ethnic people’s services
8. 'Gateway' workers
9. New graduate primary care workers
10. Primary-secondary interface
SMI registers
Referral protocols X
Information exchange X Primary care based services
11. Acute inpatient services – Acute Care Forums
12. Acute inpatient services – Ward Organisation
X
Ward Forum Named Clinician Named Consultant
13. Prison (MH) Services
CARE PLANNING
14. Care programme approach – Access to Care Plans
15. Care programme approach – Information Sharing
Protocols
16. Care programme approach – Comprehensive
17. Care programme approach – Carers' Plans
18. NHS Direct
19. Transition Protocols
Children
Older people
LOCAL PLANNING
20. Planning process
X
R
A
A
A
A
A
A
A
A
R
R
A
G
LIT Name:
Salford
Contact Name:
Hilary Wensley
X
A
A
X
A
Telephone No:
R
A
0161 743 2023
A
R
A
A
E-Mail:
hilary.wensley@salford-pct.nhs.uk
X
A
X X
Priorities Needs Assessment
Measurable
Targets Timescales/Milestones Responsibility
21. Commissioning - Planning
22. Commissioning – Health Act Flexibilities
23. Local strategic partnerships
SERVICE INTEGRATION
24. Provision – CMHTs
25. User Led Services
26. Voluntary sector
UNDERPINNING PROGRAMMES
27. Recruitment and retention
28. Workforce planning
29. Education and training
X
A
A
A
R
A
A
A
A
A
Final - 7th June 2002
30. Representative workforce
31. Link to LIS
32. Integrated MHER
33. Local directory
34. Funding
OTHER PRIORITIES
35. Single sex accommodation
36. Mental Health Promotion
37. Specialist services
X
A
A
R
G
A
R
G
A
X
Sensory impairment Eating disorders
Mother & baby
38. Section 135/136 - Places of Safety
39. Mental Health Act 1983 - Board reports
40. Mental Health and Learning Disabilities
41. Dual diagnosis – LIT/DAT Interface
A
A
A
A
Thank you for completing this document. Please send it to your Strategic Health Authority Mental Health Lead.
Final - 7th June 2002
Mental Health National Service Framework - Autumn 2002 Position Statement
Self-Assessment Framework
KEY SERVICES
1. Assertive Outreach
2. Crisis Resolution
RED
There is no service available which meets the
Policy Implementation Guide definition of
'assertive outreach'.
AMBER
There is some level of assertive outreach
provided which meets the Policy Implementation
Guide criteria
- but is provided only at a level which is
in-sufficient to meet local needs.
Community-based services which provide
assessment and intervention at times of crisis
are available 24 hours a day, 7 days a week, as
defined by the Policy Implementation Guide but
at a level which is insufficient to meet local
needs.
There is some level of early intervention in
psychosis which meets the Policy
Implementation Guide criteria
- but is provided only at a level which is insufficient to meet local needs.
There are some deficiencies in the availability of
medium and low secure beds for local residents.
GREEN
There is an assertive outreach service
available which meets fully the Policy
Implementation Guide definition, and which is
provided at a level which is sufficient to meet
local needs.
Community-based services which provide
assessment and intervention at times of crisis
are available 24 hours a day, 7 days a week
which fully meet the definition within the Policy
Implementation Guide and at a level which is
sufficient to meet local needs.
There is a service available which meets the
Policy Implementation Guide definition of 'early
intervention in psychosis' and which is
provided at a level which is sufficient to meet
local needs.
There are no deficiencies in the availability of
medium and low secure beds for local
residents.
There are no women-only community day
services for the local residents.
There are some women-only community day
services for local residents.
There are sufficient women-only community
day services for local residents.
There are no plans or plans are in-sufficient to
ensure the delivery of this target by April 2004.
Plans are being developed for the recruitment of
staff to ensure that there are increased breaks
available for carers and carer networks are
strengthened sufficient to achieve ‘Green’ status
by April 2004.
There is evidence that data is being collected in
accordance with the guidelines (EL(94)77) but
no reports/action plans arising from its usage
and hence no integration with governance
arrangements.
There is already a sufficient number of staff in
post to meet local needs and ensure that
breaks are available for carers and that carer
support networks are fully developed.
Community-based services which provide
assessment and intervention at times of crisis
are not available 24 hours a day, 7 days a
week as defined by the Policy Implementation
Guide.
3. Early Intervention in Psychosis
There is no service available which meets the
Policy Implementation Guide definition of 'early
intervention in psychosis'.
4. Secure Places
There are significant deficiencies in the
availability of medium and low secure beds for
local residents.
5. Women's Services
6. Carers' Services
7.
Black and Minority Ethnic
People’s Services
There is no evidence that collection of data in
accordance with the guidelines (EL(94)77) is
being reported to the boards of local services
and hence integrated into governance
arrangements.
Please refer to guidance notes for further details
Data is collected and integrated into
governance arrangements at board level.
Reports and action plans produced include
specific targets and user and carer monitoring
of the plans.
Final - 7th June 2002
8. `Gateway’ workers
9. New graduate primary care
workers
10. Primary-secondary interface
11. Acute Inpatient Services – Acute
In-patient Forum
12. Acute Inpatient Services – Ward
Organisation
13. Prison (MH) Services
CARE PLANNING
RED
No or inadequate plans have been developed
to incorporate `Gateway’ community mental
health workers into mental health services by
2004.
There are no local plans concerning access to
appropriate training, education and supervision
within primary care, and no consultation has
been undertaken on where they will be based.
AMBER
Plans are being developed to ensure that
`Gateway’ community mental health workers
are in place by 2004.
GREEN
A `Gateway’ community mental health worker is
now, or will be in place by March 03, to make
explicit links with at least one PCT.
Only preliminary plans are in place to secure
appropriate education, training and supervision
or further work needs doing locally to agree on
where they will be based.
Sparse coverage - only one or two of the
following systems in place (please specify)

SMI registers

Referral agreements (protocols) reviewed
to ensure they are operating effectively

Protocols on exchange of information

Systems for delivering specialised services
on the primary care site (out-posted clinics,
primary care liaison teams, etc).
An Acute Care Forum is not currently
established.
Moderate coverage – three of the following
systems in place (please specify)

SMI registers

Referral agreements (protocols) reviewed
to ensure they are operating effectively

Protocols on exchange of information

Systems for delivering specialised services
on the primary care site (out-posted clinics,
primary care liaison teams, etc).
An Acute Care Forum has been established
which is developing its terms of reference and
remit/appropriate policies.
None of the following are in place:
Regular service user and ward staff forum
on each ward
Named clinical and professional leads
responsible for ensuring regular multidisciplinary input to the wards
Named consultant psychiatrist lead for
each ward
There are no strategies or systems in place to
identify local residents with mental health needs
due for release from prison and link them to
local services.
One or two of these in place, (please specify):
Regular service user and ward staff forum
on each ward
Named clinical and professional leads
responsible for ensuring regular multidisciplinary input to the wards
Named consultant psychiatrist lead for
each ward
There are some strategies or systems in place
to identify local residents with mental health
needs due for release from prison and link them
to local services but they are not operated
consistently and effectively.
Care plans can be accessed 24 hours a day but
are not held on a central database.
Access to appropriate education, training and
supervision can now, or will be provided by
March 03, to support new graduate workers.
Local agreement has been secured concerning
their location.
Good coverage – all four of the following
systems in place

SMI registers

Referral agreements (protocols) reviewed
to ensure they are operating effectively

Protocols on exchange of information

Systems for delivering specialised services
on the primary care site (out-posted clinics,
primary care liaison teams, etc).
An Acute Care Forum has been established in
line with guidance and with the involvement of
all key stakeholders and is working to an
agreed plan of action.
All of these in place:
Regular service user and ward staff forum
on each ward
Named clinical and professional leads
responsible for ensuring regular multidisciplinary input to the wards
Named consultant psychiatrist lead for
each ward
There are strategies or systems in place to
identify local residents with mental health needs
due for release from prison and link them to
local services which are operated consistently
and effectively.
Care plans are held on a central database
which is regularly updated and available 24
hours a day.
Care plans cannot be accessed 24 hours a day
by staff providing direct care to users.
14. Care Programme Approach –
Access to Care Plans
Please refer to guidance notes for further details
Final - 7th June 2002
RED
15. Care Programme Approach –
Information Sharing protocols
16. Care Programme Approach –
Comprehensive
17. Care Programme Approach –
Carers' Plans
18. NHS Direct
19. Transition Protocols
Information sharing protocols have not been
discussed between local agencies.
The local enhanced CPA system does not enable
recording of assessment and care plans for all of
the following:
Employment or other occupation; housing; welfare
benefits; crisis plans, including 24 hour access
arrangements.
All regular carers of people on enhanced CPA do
not have their own written care plan which
addresses their caring, physical and own mental
health needs
No protocols are in place between NHS Direct and
local statutory crisis services.
The arrangements for both of the following are
inadequate or ineffective:
- transition of service users’ care between child
and adolescent services and adult services
- transition of service users’ care between adult
services and services for older people.
The local planning process meets only two or
fewer of the following standards: (please specify)
- there is clear agreement within the LIT as to
20. Planning Process
local priorities for action
- local action plans are based throughout on
local assessment of need
- most or all local targets can be readily
measured
- timescales and milestones have been agreed
for most or all local targets
- clear responsibility for implementation has
been agreed for most or all local targets.
Joint (Primary Care Trust and Local Authority)
commissioning structures are not in place for
21. Commissioning - Planning
mental health services. Commissioning activity
does not reflect the LIP.
Please refer to guidance notes for further details
LOCAL PLANNING
AMBER
Discussions have been initiated between local
agencies but information sharing protocols have
not yet been agreed.
The local enhanced CPA system does enable
recording of assessment and care plans for all of
the following:
Employment or other occupation; housing; welfare
benefits; crisis plans, including 24 hour access
arrangements
However:
There are significant deficiencies in services
available to meet assessed needs
NO AMBER OPTION
Protocols stating referral routes to local crisis
services are in place with NHS Direct but there is
no referral agreement in place to enable direct
referral by NHS Direct, where clinically indicated,
to local crisis services.
The arrangements for only one of the following are
adequate and effective: (please specify)
- transition of service users’ care between child
and adolescent services and adult services
- transition of service users’ care between adult
services and services for older people.
The local planning process meets three or four of
the following standards: (please specify)
- there is clear agreement within the LIT as to
local priorities for action
- local action plans are based throughout on
local assessment of need
- most or all local targets can be readily
measured
- timescales and milestones have been agreed
for most or all local targets
- clear responsibility for implementation has
been agreed for most or all local targets.
There is a joint commissioning structure in place
but some commissioning activity exists which is
not reflected in the LIP.
GREEN
There is an agreed information sharing protocol
between local agencies.
The local enhanced CPA system does enable
recording of assessment and care plans for all of
the following:
Employment or other occupation; housing; welfare
benefits; crisis plans, including 24 hour access
arrangements.
This information is always recorded and there are
sufficient services available to meet assessed
needs.
All regular carers of people on enhanced CPA
have their own written care plan which addresses
their caring, physical and own mental health
needs.
Protocols are in place between local specialist
mental health providers to enable fast access in a
crisis.
By agreement with local services direct referrals by
NHS Direct, where clinically indicated, will be
accepted for assessment by local crisis services.
The arrangements for both of the following are
adequate and effective:
- transition of service users’ care between child
and adolescent services and adult services
- transition of service users’ care between adult
services and services for older people.
The local planning process meets all of the
following standards:
- there is clear agreement within the LIT as to
local priorities for action
- local action plans are based throughout on
local assessment of need
- most or all local targets can be readily
measured
- timescales and milestones have been agreed
for most or all local targets
- clear responsibility for implementation has
been agreed for most or all local targets.
There is a joint commissioning structure in place
and all commissioning activity is reflected in and
drawn from the LIP as the comprehensive
commissioning plan for mental health services.
Final - 7th June 2002
22. Commissioning – Health Act
Flexibilities
23. Local Strategic Partnerships
SERVICE INTEGRATION
24. Provision – CMHTs
25. User led services
26. Voluntary Sector
RED
No pooled budgets are in place across health,
PCT and LA for the commissioning of the
following:
a) New Services
b) Some current discrete services
c) All adult MH services
LSP infrastructures in all or most LSP localities,
(within the LIT planning area) have not yet
focussed on the needs/circumstances of people
with mental distress.
CMHTs (including specialist functional teams)
are not fully integrated as regards management,
policies and systems.
There are no services within the LIT area run
exclusively by service User(s) or led by Users
within a host provider setting (with agreed
funding streams).
AMBER
There are pooled budgets in place across
health, (PCT) and LA for the commissioning of
either of the following
a) New Services
b) Some current discrete services
GREEN
There is a pooled budget covering the
commissioning of
c) All adult MH services within at least one LA in the
LIT area
LSP infrastructures in all or most LSP localities,
(within the LIT planning area) have focussed on
the needs/circumstances of people with mental
distress, but there has been no clear impact of
this to date.
LSP infrastructures in all or most LSP localities,
(within the LIT planning area) have focussed on the
needs/circumstances of people with mental distress,
and this has resulted in positive action being
commissioned/proceeding likely to be of benefit to
them.
Community mental health teams, (including all
specialist functional teams) have fully integrated
management, policies and systems.
User run or led services are provided at a level that
the LIT deems to reflect an adequate mix within the
overall provider arrangements.
NO AMBER OPTION
The LIT (or member organisations of the LIT)
are working to establish or increase the
provision of User run or led services within the
LIT area (with agreed funding streams).
There is very little, or no, identification of, or
engagement with, local mental health voluntary
sector services in planning and management
mechanisms.
There is some identification of, and
engagement with, local mental health voluntary
sector services in planning and management
mechanisms, but there are no arrangements in
place to ensure continuity of funding for key
services.
Local mental health voluntary sector services are:
known to statutory MH services (through mapping);
involved in LIT planning and management
mechanisms; and arrangements are in place to
ensure continuity of funding for key services.
There are significant problems with the
recruitment and retention of key staff to provide
services.
There is no agreed workforce strategy and
action plan in place across all agencies.
There are some problems with the recruitment
and retention of key staff to provide services.
There are no significant problems with the
recruitment and retention of key staff to provide
services.
There is an agreed workforce strategy and action
plan in place across all agencies which meets the
minimum standards set out in the notes for guidance.
UNDERPINNING PROGRAMMES
27. Recruitment and Retention
28. Workforce Planning
29. Education and Training
30. Representative Workforce
There are significant problems in providing
education and training for the mental health
workforce.
Local services have no systems and strategies
in place to build a workforce that reflects the
diversity of the local population, or to promote
cultural competence in the workforce.
Please refer to guidance notes for further details
There is an agreed workforce strategy and
action plan in place across all agencies.
However, it does not meet the minimum
standards set out in the notes for guidance.
There are some problems in providing
education and training for the mental health
workforce.
Local services have some systems and
strategies in place to build a workforce that
reflects the diversity of the local population and
to promote cultural competence in the
workforce.
There are no significant problems in providing
education and training for the mental health
workforce.
Local services have comprehensive systems and
strategies in place to build a workforce that reflects
the diversity of the local population and to promote
cultural competence in the workforce.
Final - 7th June 2002
31. Link to LIS
32. Integrated MHER
33. Local Directory
34. Funding
OTHER PRIORITIES
35. “Safety Privacy and Dignity in
mental health units”
Single Sex Accommodation
36. Mental Health Promotion
37. Specialist Services
38. Mental Health Act 1983
Section 135/136/Places of Safety
RED
There is no senior mental health representative
on the local LIS group, and no or minimal
reference to mental health issues within the
current LIS.
A mental health electronic record spanning
health and social care is not in place. Plans to
address this are absent or inadequate. Current
systems are not capable of capturing the
Mental Health Minimum Data Set.
A comprehensive directory of local services is
not in place.
AMBER
There is a senior mental health representative
on the local LIS group, but the current LIS
contains no clear investment statements for
mental health information.
A mental health electronic record spanning
health and social care is not in place. There are
however agreed and funded plans to address
this issue, which will mean the capture of the
Mental Health Minimum Data Set by April 2003.
Funds have not been identified / allocated to
meet the costs of implementing the NSF and
NHS plan over the financial years 2002-3 to
2004-5.
There remain some mixed sex accommodation,
bathing and toilet facilities in inpatient/residential services, (including secure
services).
Funds have been identified / allocated only
partially or provisionally to meet the costs of
implementing the NSF and NHS plan over the
financial years 2002-3 to 2004-5.
As at September 2002, a mental health
promotion strategy is not being implemented.
NO AMBER OPTION
As at September 2002, a mental health
promotion strategy is being implemented.
Local residents have access to only one or
none of the following at a level which is
sufficient for local needs: services for people
with sensory impairment and mental illness,
eating disorder services, mother and baby
services (Please specify).
Local residents have access to two of the
following at a level which is sufficient for local
needs: services for people with sensory
impairment and mental illness, eating disorder
services, mother and baby services, (Please
specify).
Local residents have access to all of the
following at a level which is sufficient for local
needs: services for people with sensory
impairment and mental illness, eating disorder
services, mother and baby services.
There is no written policy which meets the
needs of the MH Act regarding Section 135/136
and/or no routine arrangements within the LIT
catchment area to monitor appropriateness and
frequency of use of Section 136 powers and
distribution of places of safety.
There is a written policy in place which
complies with the needs of the MH Act and with
established arrangements for regular
monitoring at least annually within the LIT
catchment area of appropriateness and
frequency of use of the Section 136 powers and
use of places of safety.
There is a written policy in place which meets the
needs of the MH Act and is demonstrated by
regular monitoring within the LIT catchment area
to be working well in practice. The policy is
sensitive to the needs of patients in terms of:
geographic distribution; minimal reliance on use
of police-based places of safety; and in terms of
powers considered by ethnicity or gender.
Please refer to guidance notes for further details
No AMBER OPTION
NO AMBER OPTION
GREEN
There is a senior mental health representative
on the local LIS group, and the current LIS
contains clear investment statements for mental
health information.
A mental health electronic record spanning
health and social care is in place, which is also
fully capable of capturing the Mental Health
Minimum Data Set.
A comprehensive directory of local services is in
place.
There is a full local agreement to the
identification / allocation of funds to meet the
costs of implementing the NSF and NHS plan
over the financial years 2002-3 to 2004-5.
There are no in-patient/residential services with
mixed-sex accommodation, bathing or toilet
facilities. Women-only day and visiting areas are
available as defined by assessed need.
Final - 7th June 2002
39. Mental Health Act 1983
Board reports and action plans
40. The Mental Health of People with
Learning Disabilities
41. Dual Diagnosis – LIT/DAT
Interface
RED
No report has been presented to Boards locally
based on the self assessment of local
arrangements and remedial action required to
respond to the recommendations in the MHAC
9th Biennial Report.
AMBER
A self assessment report regarding
recommendations in the MHAC 9th Biennial
Report has been received by respective local
Boards but the related action plans are still
under development or not yet agreed and
resourced.
There is no agreement between mental health
and learning disability services about
commissioning and provision roles, frequent
disputes between the two services and no plans
for integrated service development.
There is a degree of agreement between
mental health and learning disability services
about commissioning and provision roles and
responsibilities. Some progress towards
achieving NSF and Valuing People objectives
for people with learning disabilities with mental
health problems, but also some disputes
between services.
The LIT and DAT(s) have jointly identified a
lead commissioner and lead clinician for dual
diagnosis.
No discussions have been initiated between the
LIT and the corresponding DAT(s) on Dual
Diagnosis.
Please refer to guidance notes for further details.
GREEN
A self assessment report regarding
recommendations in the MHAC 9th Biennial
Report has been received by respective local
Boards with realistic and fully resourced action
plans agreed and in place at 30/9/02 and
ongoing self-assessment and annual Board
reporting arrangements established.
There is clarity of agreement between mental
health and learning disability services about
commissioning and provision roles and
responsibilities and people receive the
standards of mental health services described
in the NSF and Valuing People.
A local Dual Diagnosis strategy and plan have
been agreed between the LIT and the DAT(s).
Final - 7th June 2002
NOTES FOR GUIDANCE
The following notes are intended to help in clarifying the brief statements in the
framework itself. Remaining uncertainties can be discussed either with your Strategic
Health Authority mental health leads or with Mental Health Strategies (0161 727 9419)
or james@mentalhealthstrategies.co.uk
1.
Assertive Outreach
The Mental Health Policy Implementation Guide (section 4) provides a detailed
specification for this service. For a green rating, services should be provided in
accordance with this specification. “Local needs” should be judged by reference
to the size of the local target population.
2.
Crisis Resolution
The Mental Health Policy Implementation Guide (section 3) provides a detailed
specification for this service. For a green rating, services should be provided in
accordance with this specification. “Local needs” should be judged by reference
to the size of the local target population.
3.
Early Intervention in Psychosis
The Mental Health Policy Implementation Guide (section 5) provides a detailed
specification for this service. For a green rating, services should be provided in
accordance with this specification. “Local needs” should be judged by reference
to the size of the local target population.
4.
Secure Places
If provision is below 50% of the assessed level of need, the rating should be red;
if from 50% to 99% at amber; only if 100% at green. Services do not need to be
based within the geographical boundary of the LIT to count, provided there is
access.
5.
Women’s Services - Women-only day services
Mental health support services provided for women, in the community, in a
women-only setting(s). The service may not be labelled “mental health services”
by the organisations that provide them, but they will provide services and support
that meet the mental health needs, i.e. these services may be provided by the
statutory or voluntary sectors. Where provided by the voluntary sector,
arrangements should be in place to ensure continuity of funding.
Final - 7th June 2002
6.
Carers’ Services
The NHS Plan says that by 2004, 700 more staff will be recruited to increase the
breaks available for carers, and to strengthen carer support networks. It does not
matter whether services are provided by the statutory or voluntary sector.
7.
Black and Minority Ethnic People’s Services
This indicator is assessing the adequacy or appropriateness of both mainstream
services and services targeted at particular ethnic groups. The extent to which
specialist targeted services are necessary or viable will depend on the local
population and local assessment of its needs. Effective planning and provision
will require the collection of data, its reporting to the appropriate planning
processes, (Boards, Governance Committees etc) and action plans arising that
are monitored appropriately, including by user and carer representatives.
8.
'Gateway' Workers
The NHS Plan says by 2004 500 community mental health staff will be employed
to work with GPs and primary care teams, with NHS Direct, and in A & E to
respond to people who need immediate help, who can call on crisis resolution
teams if necessary. Plans are needed for recruitment, and to integrate existing
staff and systems at the interface between primary and specialised services to
improve access to services.
9.
New Graduate Primary Care Workers
The NHS Plan says by 2004 1000 new trained graduate primary care mental
health workers will be employed to help GPs manage and treat common mental
health problems in all age groups.
10.
Primary-secondary interface
On the scoring sheet, please tick those elements which are in place. The four
elements listed have been identified as the core structural elements of a good
working relationship between primary and secondary care. The reference to
exchange of information relates to the target in the SaFF for 2001/02 which
reads: "By March 2002, every health authority and local authority must have
multi-agency protocols agreed and operational for the sharing of information
relevant to reducing risk of serious harm to self or others." SMI is severe mental
illness.
11.
Acute Inpatient Services - Acute Care Forums
This indicator reflects an early priority/recommendation within the Acute Care
Guidance, launched in May 2002, as part of the Policy Implementation Guide.
12.
Acute Inpatient Services - Ward Organisation
On the scoring sheet, please tick those elements which are in place. This
indicator reflects an early priority/recommendation within the Acute Care
Guidance launched in May 2002, as part of the Policy Implementation Guide.
Final - 7th June 2002
13.
Prison (MH) Services
The indicator definition is self explanatory
14.
Care Programme Approach - Access to Care Plans
Effective and safe care is provided when staff have ready access to the care
plans of clients. Out of hours, or for a re-referral, care plan details should be
accessible by the member of staff who will need to engage with the client at the
point of contact, (within a service setting) or prior to making a visit into the
community.
15.
Care Programme Approach - Information Sharing Protocols
The indicator definition is self explanatory
16.
Care Programme Approach - Comprehensive
The indicator definition is self explanatory and is a slight refinement of the
indicator for LIP 3
17.
Care Programme Approach - Carers' Plans
This was an NSF target for April 2002, hence there is no amber option. Either
services have met this target, (green) or they have yet to meet it, (Red).
18.
NHS Direct
Local services must work with NHS Direct to facilitate access to local specialist
mental health crisis provision, 24 hours a day, 7 days a week. In order to do this
local services will have agreed protocols with NHS Direct on the direct referral of
clinically indicated clients and adequate services are available to meet their
needs within an acceptable time frame.
19.
Transition Protocols
On the scoring sheet, please tick those elements which are in place. The exact
detail of “cut-off ages” and transitional systems does not matter. What does
matter is local agreement as to their effectiveness, and implementation.
20.
Planning Process
On the scoring sheet, please tick those elements which are in place. This
indicator should reflect the updated position as at September 2002. Agreements
should have been reviewed within the last year.
Final - 7th June 2002
21.
Commissioning - Planning
A thorough comprehensive LIP should be built around the agreed negotiated
priorities and assessed service development programme of all the LIT
constituent member organisations. Independent commissioning of services
outside the joint agreements within the LIT should therefore be unnecessary.
This indicator reflects the degree to which member organisations have
committed themselves to the joint planning process recommended within the MH
NSF.
22.
Commissioning - Health Act Flexibilities
Fully integrated service provision and choice for clients without over-burdensome
inter service referral/assessment processes are likely to be achieved better
where pooled budgets exist. This measure will identify the degree to which local
organisations have utilised the Health Act Flexibilities to improve client access to
a full range of services.
23.
Local Strategic Partnerships
Comprehensive guidance on this topic is given in “A new commitment to
neighbourhood renewal - national strategy action plan”.
Local Strategic Partnerships represent a major opportunity for mental health
services to become better integrated into their local communities. They offer the
potential to engage the wider community in support of recovery-based service
models, and to influence the public’s response to mental health issues. Local
Strategic Partnerships also emphasise citizenship - and mental health services
need to stimulate work to address the specific disadvantage faced by citizens
with the most severe mental health problems.
For a green rating, there should be substantial evidence of benefits deriving from
practical partnerships between mental health services and local non-specialist
community, voluntary or private organisations (to promote, for example, social
support, leisure or employment opportunities.)
24.
Provision - CMHTs
Interpretation of “fully integrated” will inevitably vary to some degree. Indicators
of full integration include: joint bases; joint management; joint training; joint
budgets; joint casenotes; joint information systems; joint operational policies;
joint rosters. Most or all of these should be in place for a green rating. A green
rating does not however require there to be a single employer. “Community
mental health team” includes specialist functionalised and generic teams.
Final - 7th June 2002
25.
User Led Services
Consideration needs to be given to the range and nature of services provided in
the area and whether there is a sufficient mix of services either provided
exclusively by users or user organisations OR sufficient user led services hosted
by other providers, e.g. the NHS or PSS. This indicator recognises that some
service users require choice in provision and may wish to include services run by
their peers amongst the mix of services they access. An adequate mix will be
one that the LIT assesses to meet the most significant demands of local users.
Adequacy of provision also requires that where such services need funds to
operate, the providers have enough confidence in funding streams to plan over
longer than a one year horizon.
26.
Voluntary Sector
This is a similar indicator to that of User Led services above. The Voluntary
sector offer a useful range of services to complement those provided by statutory
services and hence increase the choice available to clients in meeting their
assessed needs. Engagement in service planning processes is likely to ensure a
complementary arrangement of services rather than ad hoc provision.
27.
Recruitment and Retention
The significance of problems should be judged in terms of the impact on service
provision. If services have dealt with staffing issues in creative ways, ensuring
minimal service impact, they could be rated amber or even green.
28.
Workforce Planning
The determination of what is locally key must be for local decision. As a guide, a
comprehensive plan should include: a detailed analysis of the structure of the
current workforce; analysis of trends in recruitment and retention and plans to
address any shortfalls; the future numbers, types and skill mix of staff required to
deliver the NSF standards and NHS plan targets; training issues including skills,
knowledge and leadership.
29.
Education and Training
Education and training should ensure that the skills, knowledge and values of the
mental health workforce are appropriate to the delivery of the service models in
the NSF and NHS plan. The significance of problems should be judged in terms
of the extent to which training and education address:



issues arising from all NSF and NHS plan standards and commitments
needs of all staff groups (including staff without a professional
qualification)
knowledge, skills and values.
Final - 7th June 2002
30.
Representative Workforce
The extent to which targeted approaches are necessary or viable will depend on
the local population and local assessment of its needs.
At minimum,
arrangements must exist for accessing specialist support when required.
31.
Link to LIS
For a green rating mental health must have at least equal status and attention
within the LIS (Local Information Strategy) in terms both of detailed planning and
of resources, and there must be a clear commitment within the LIS to the
resources required to deliver the mental health information strategy.
32.
Integrated MHER
The Mental Health Information Strategy provides guidance on these issues. For
a green rating, the local system must deliver the requirements of this strategy,
and must be capable of capturing the Mental Health Minimum Data Set.
33.
Local Directory
The Mental Health Information Strategy provides guidance on the requirements
for this directory. For a green rating, the local directory must be widely
accessible to staff, service users and the general public, and deliver the
requirements of this strategy.
34.
Funding
The costing template which LITs are completing this autumn will provide hard
data on this issue. This indicator is seeking a more subjective perspective on
the adequacy of funding and the confidence of the LIT that commissioners will
make available the necessary funds to meet the NSF and NHS Plan priorities
within the target time-scales. (targets requiring achievement by 2005).
35.
“Safety, Privacy and Dignity” - Single Sex Accommodation
This indicator does not require application of these standards to all small
community based rehabilitation units or small longer term accommodation in the
community (although the principle of maintaining the privacy and dignity of all
residents remains of course important).
36.
Mental Health Promotion
“Making it Happen” offers comprehensive guidance on the development and
implementation of local strategies for mental health promotion. For a green
rating, local strategies should satisfy the following criteria:


be based on an assessment of local needs to identify key settings and
target groups
demonstrate a clear rationale for selected interventions which are based
on the evidence or which, through their implementation, can add to the
evidence base
Final - 7th June 2002


include action to reduce discrimination against people with mental health
problems
show evidence of links to mainstream community development initiatives
to promote social inclusion, such as neighbourhood renewal, education
action zones etc.
and there should be demonstrable progress on these issues.
37.
Specialist Services
On the scoring sheet, please tick those elements which are in place. This
indicator measures adequacy of access to specialist services, irrespective of
location. Services do not have to be located within the geographical boundaries
of the LIT to make a green rating possible. If services are very geographically
remote, this may however affect local views as to the “sufficiency” of access.
38.
Section 135/136 - Places of Safety
The Code of Practice to the Mental Health Act offers guidance on this issue.
Although the LIT has no statutory accountability for this issue, its constituent
agencies will need to be cooperating closely to ensure good practice. This
indicator asks that the LIT be assured that member organisations are carrying
out their necessary monitoring arrangements. There is no suggestion that LIT
itself is responsible for monitoring these arrangements.
39.
Mental Health Act 1983 - Board Reports
This indicator is establishing to what extent there has been follow-up to the
recommendations of the Mental Health Act Commission’s 9th Biennial report.
Again the LIT is asked to identify if it is assured that those member organisations
with specific responsibilities are carrying these out effectively. There is no
suggestion that the LIT itself is responsible for these issues.
40.
The Mental Health of People with Learning Disabilities
“Valuing people” offers important guidance in this field.
41.
Dual Diagnosis
‘The Good Practice in Dual Diagnosis’ guidance published as part of the Policy
Implementation Guide in April 2002 offers background to this indicator.