Mental Health and Dementia
Strategic Clinical Network
Event
23 September 2013
Cheshire and Merseyside Strategic Clinical
Networks and Senate
Update on progress for meeting
on 23rd September 2013
Report
• Key progress – first 6 months
• Achievements – next 3 months
• Challenges and risks
• Success/ opportunities
3
Report
• Progress – clinical leads appointed/ service
mapping completed/ development workshops
held/ priorities identified and shared with systems/
initial work programmes developed/ setting up
network architecture
• Next 3 months – enlarged engagement/ SCN
structures operating/ progress with work
programmes on target
• Risks – internal resource/ old ways of thinking/
engagement challenges
• Opportunities – working with non - NHS partners/
financial challenges/ expand clinical leadership
4 involvement
Mental Health & Dementia
Strategic Clinical Networks (London
Region)
Strategic Clinical Network
23 September 2013
5
Mental Health SCN
Key Progress (First 6 months)
• London Clinical Director
appointed
• SCLG established
• Mental health priority areas
identified
• Engagement Event held (July
2013)
• Working in partnership with AHSN
(UCLP)
• Working relationships with
charities & third sector developing PPI plan
• Liaised with Health in the Justice
System
• Work streams started
Achievements (Next 3 months)
• Host SCLG meetings to decide
specific objectives under priority
areas
• Commence work streams in each
priority area
• Support the Mental Health CCG
Network
• Support Mental Health in Criminal
Justice System
• Work with primary care
commissioning, transformation &
informatics teams within NHE
England
Mental Health SCN
Successes
•
•
•
Clinical Director presentation on
MH to Senior Management Team
NHS England (London)
Engaging with key partners e.g
Social Care, AHSNs, PHE,
Voluntary Sector
Building on previous work e.g
Perinatal Network, NW Urgent
Assessment Pathway, CCG
Leadership programme
•
Opportunities
•
•
•
•
Leadership in clinical commissioning (Mental Health CCG Network)
Challenges
•
•
•
Integration/pressure on A&E
Working across other clinical
networks (e.g. CVD)
Mental Health Informatics
Prevention/Resilience
Mental and Physical health “parity
of esteem”
Mental health in Primary Care
Mental health in a context of wider
challenges in NHS
Risks
•
•
•
Fragmented NHS systems
Variable capacity within CCGs
Resource pressures
London Mental Health SCN Priorities 2013/14
Strategic work plans & desired outcomes
Prevention of
mental illness in
the early years.
Building
resilience in
young people
Psychosis &
urgent care
pathways
Mental health
in Primary
Care
(depression,
anxiety)
Integration of mental health into physical health care
pathways. Support those with long term conditions who
also have mental health conditions
Primary care commissioning.
Working with AHSN (UCLP) to
support London CCG MH Network
Support Health
in the Criminal
Justice
System
Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelines
Benchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards
8
Dementia SCN
Key Progress (First 6 months)
• London Clinical Director
appointed
• SCLG established
• Six priority areas identified
• Working in partnership with all
AHSNs and NHS IQ
• Working relationships with
charities & third sector
• Mapping CCG strategies
• Launch of Dementia Action
Alliance for London
• GP leaders meeting
Achievements (Next 3 months)
• SCLG meetings to decide specific
objectives under priority areas
• Training event with network of
100+ staff – 23 October
• Dementia Action Alliance
commitments under way
• Providing advice to medicines
management leads following antipsychotic audit
• GPwSI – communicating to
commissioners
Dementia SCN
Successes
• Dementia Commissioners
Network
• Launch of London DAA – London
region signed up to three
stretching commitments
Challenges
• Leadership in clinical
commissioning
• Developing the post diagnosis
‘offer’
Opportunities
• Integration/pressure on A&E
• Working across other clinical
networks (e.g. end of life care)
• Working will all three AHSNs &
NHS IQ
• Close working with social care
• Health Education England –
taking forward training
Risks
• Fragmented NHS systems
• Variable capacity within CCGs
• Resource pressures
London Dementia SCN Priorities 2013/14
Strategic work plans & desired outcomes
Good quality
early
diagnosis &
intervention
Improved
quality of care
within the NHS
Improved end
of life care
Strategic commitment to improve care and
integrating innovation
Living well with dementia,
including in care homes
Optimising
medicines use
Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelines
Benchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards
11
South East Coast
First 6 months – key progress
1. SCN core team recruited inc. Clinical Director
2. Work programme developed
3. Stakeholder/Launch event & wider engagement
4. PPI/PPE strategy developed
5. Work plans developed (MH, CAMHS, Neuro &
Dementia)
6. SCN structure developed (Steering Group and
Clinical Advisory Group)
7. Commissioning Forum proposed
8. Baseline reviews completed and shared
13
9. 2013/2014 Commissioning Guidance sent out
Achievements in next 3 months
• Clinical Leads appointed
• Clinical Advisory groups initial meetings
• Task and finish/project groups convened
• Five year strategy developed (CtA)
• AT clinical strategy
• Specialised Commissioning derogation action
plans
• Continue engagement work/stakeholder buy
in/development of wider network
14
Challenges and risks
• Structure untested
• Inability to secure buy in for strategic plans
• Limits on recruitment (Clinical Leads!)
• Shared Themes
• Emphasis on diseases not outcome domains
• Complexity of new NHS landscape
• Commissioners and clinicians overwhelmed with
information
• Meaningful patient and public engagement on a
large geographical scale
•15 Capacity/capability of team
Successes and opportunities
• Positive initial feedback from stakeholders
•
•
•
•
Good relationship with AT(s) colleagues
Strong links with Senate
Baseline reviews have proved useful to wider system
Joint work with AHSN/HEE
• Programme budget
Wessex Strategic Clinical Network
Clinical Leads: Dr Christopher Kipps and Dr Denise Cope
Contact: England. Wessex@nhs.net
SCN and Senate Work plan lead: AD Lucy Sutton
Domain 1: Preventing people
from dying prematurely.
Lead - SCN Manager
Theme: Early
diagnosis/Health Checks .
Lead - QIL
Theme: Diagnostic pathways,
capacity & decision making.
Lead - QIL
Administrative
support to SCN
steering groups and
subgroups
Clinical Director CVD
SCN
Domain 2: Enhancing quality of
life for people with long-term
conditions. Lead - SCN Manager
Theme: Supporting people to selfmanage their long term conditions.
Lead - QIL
Theme: Integration of care
around the needs of the patient.
Lead - QIL
Domain 3: Helping people to
recover from ill-health or following
injury. Lead - SCN Manager
Theme: Rehabilitation, recovery,
ESD, Survivorship. Lead - QIL
Theme: Safe and sustainable
maternity, paediatric and new
born services. Lead - QIL
Overarching strategy:
SCN Manager
Clinical Director
CANCER SCN
Project support to
SCN steering
groups and
subgroups
Clinical Director MCYP
SCN
Crosscutting themes:
Oversight and Planning Group, SCN AD, SCN Managers and Senior QILs
Quality Improvement Leads and admin team
Clinical Directors MH,D
& N SCN
First 6 months – Key Progress
• Reviewed commissioning plans, JSNAs & JHWS across Wessex
• Identified gaps and links between and across plans
• MHDN Stakeholder Event on 11th June, more than 100 delegates –
informed priorities
• Initial work plans agreed by local Commissioning Assembly
• Initial work plan for SCN approved by Oversight and Planning Group
in July
• 8 Project briefs drafted, based on challenges identified so far, for
consideration by SCN
• Decision to appoint 2 people as CDs to manage the breadth of work
18
Next 3 months
• Initial meeting of MHDN SCN Steering Group 1st Oct. Prioritise
actions and projects / teams
• Local champions identified to lead specific projects
• Oversight and Planning Group authorise ‘refined’ plans late Oct
• Involve patients and public, influence local PPI Strategy, due Nov
• Better use of limited resources to effect change
• Refine our understanding of network tools and drivers
• Go out and meet people
19
Challenges, Successes, Risks and Opportunities
• Challenge – to ensure support network is appropriately
adapted to the needs of the developing network
• Success in:
– engagement across Wessex to date
– dual leadership
– Integrating with support team
• Risk losing confidence of key stakeholders if we don’t
establish ourselves quickly and demonstrate effectiveness
• Opportunities to deliver significant improvements and improve
20
parity of esteem for mental and physical health
WEST MIDLANDS SCN
Mental Health, Dementia and
Neurological Conditions
Ben Parfitt - Network
Manager
Dr Karim Saad and
Dr Sharon Binyon Clinical Directors
Work to Date
• New Network in West Midlands
• Stakeholder engagement
• Linking with existing West Midlands Groups and
previous work done, e.g.
• Provider forum for PbR and their Quality and
outcomes subgroup
• West Midlands SHA Dementia work stream
• West Midlands IAPT pilotsLaunch event July
• Launch event July
Mental Health Priorities
• Developing and supporting outcomes-based
commissioning
• Improving physical healthcare for people with a
mental health problem
• Improving primary care mental health services
(including IAPT)
• Developing psychological therapy services for
children closer to home
• Developing care pathways for people with neurodevelopmental disorders
Dementia Priorities
• Supporting increased prevention and timely
diagnosis for people with dementia and ensuring
appropriate support before and after diagnosis
• Promoting 'Dementia Friendly Communities'
• Improving the experience of care for people
diagnosed with dementia
• Improving the experience of end of life care for
people with dementia and their carers
Yorkshire & the Humber Strategic Clinical Networks
Mental Health, Dementia, Acute & Chronic
Neurological Conditions
Mental Health &
Dementia
National Meeting
23rd September 2013
APRIL TO SEPTEMBER 2013
Yorkshire & The Humber
3rd Largest Senate Area, 24 CCGs, 14 Acute Hospitals, 7 MH/Community
Hospitals, 14 Local Authorities, 3 Area Teams covering 5.6m population over a
huge and varied urban and rural demography
• Intelligence Gathering, Scoping and Making our ‘offer’ to stakeholders : (CCGs,
Prescribed Commissioners, LAs, Voluntary, Charities, Area Teams , AHSN etc.)
• PPE Stocktake and Strategy Development
• Appointment and induction of Clinical Leadership
• Draft Work Programme Development/Consultation– Sept 2013 to April 2015
• Identify Cross Cutting themes with 7 sister networks
• S136 and Neuro-rehabilitation projects – early wins
• Formal SCN Launch 17th September 2013
26
NEXT 3 MONTHS
• Firm up Work Programmes and agree Comms Strategy for the SCN
• Establish formal governance to underpin structures/ways of working
• Commence project work using MSP/PRINCE type methodology
• Quarterly reports to CCGs/Area Team/Stakeholders and presentations
to collaborative commissioning groups/NHS England commissioners
• Confirm PHE relationships to support this SCN
• Firm up PPE arrangements
• Agree cross cutting project management arrangements (e.g. IAPT, CYP
Transition in MH, Parity of Esteem, CAMHS etc.)
27
CHALLENGES/RISKS
• CCG Engagement with SCNs generally and with specific areas such as
acute neurology where this may not be seen as a priority
• Access to data to provide Dashboard information that adds value to
commissioners
• Accessing groups that have existed for many years (change
management behaviour)
• Local Authority engagement – “clinical networks” are perceived as being
health only – some aversion to nomenclature
• Small resource in the SCN team in a financially challenged host Area
Team
• Duplication of work with AHSNs, ATs, HWBs, NHSIQ – CCG confusion of
roles/responsibilities
28
SUCCESSES/OPPORTUNITIES
• Formal Launch of the SCN !
• Excellent clinical leadership and engagement in Y+H
• Do once and share and up the pace of the work
• Influence commissioning plans for 2014/15
• Joining up MH and physical health
• National and Regional sharing of best practice
• For 12 national SCNs to really make a difference and place
MHDN on the same platform that cancer, cardiac and stroke
have enjoyed over the last 5-10+ years
• Well respected and very credible NCDs !
29
Yorkshire & the Humber Mental Health, Dementia,
Acute & Chronic Neurological Conditions
Alison Bagnall
SCN Manager
Mental Health
Dementia
Acute & Chronic
Neurological Conditions
James Barnes
Quality Improvement
Manager
Penny Kirk
Quality Improvement
Manager
Sheriden McKiniry
Quality Improvement
Manager
Vacant
Quality Improvement Lead (MH and Dementia)
Clinical Leads
30
Vacant
Quality Improvement
Lead (A&C Neuro)
Dr Wendy Burn & Dr Oliver Corrado - Dementia
Dr Helen Ford & Mr David Broomhead - Neurological Conditions
Dr Wendy Burn (Interim) – Mental health
YORKSHIRE & HUMBER CONTACTS
Ian Golton, Associate Director – Ian.Golton@nhs.net
Alison Bagnall, SCN Manager - Alison.bagnall@nhs.net
Sheriden McKiniry, QIM (A&CNCs) - Sheriden.McKiniry@nhs.net
Penny Kirk, QIM (QIM- dementia) - Penny.kirk@nhs.net
James Barnes (QIM (MH) – email details to be confirmed
Dr Wendy Burn – Wendy.burn@nhs.net (Dementia and MH (interim))
Dr Oliver Corrado – Oliver.corrado@leedsth.nhs.uk (Dementia)
Dr Helen Ford – Helen.ford@leedsth.nhs.uk (A&CNCs)
Mr David Broomhead- D.broomhead@nhs.net (A&CNCs)
31