Mental Health and Dementia Strategic Clinical Network Event 23 September 2013.

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

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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 involvement

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Mental Health & Dementia Strategic Clinical Networks (London Region)

Strategic Clinical Network

23 September 2013

Key Progress (First 6 months) Achievements (Next 3 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

• 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 Opportunities

• 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

• Integration/pressure on A&E• Working across other clinical

networks (e.g. CVD) • Mental Health Informatics• Prevention/Resilience

• Leadership in clinical commissioning (Mental Health CCG Network)

Mental Health SCN

Challenges Risks

• Mental and Physical health “parity of esteem”

• Mental health in Primary Care• Mental health in a context of wider

challenges in NHS

• Fragmented NHS systems• Variable capacity within CCGs• Resource pressures

London Mental Health SCN Priorities 2013/14Strategic work plans & desired outcomes

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Primary care commissioning. Working with AHSN (UCLP) to

support London CCG MH Network

Mental health in Primary

Care (depression,

anxiety)

Psychosis & urgent care pathways

Integration of mental health into physical health care pathways. Support those with long term conditions who

also have mental health conditions

Prevention of mental illness in the early years.

Building resilience in

young people

Support Health in the Criminal Justice System

Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelinesBenchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards

Key Progress (First 6 months) Achievements (Next 3 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

• 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 anti-psychotic audit

• GPwSI – communicating to commissioners

Dementia SCN

Successes Opportunities

• Dementia Commissioners Network

• Launch of London DAA – London region signed up to three stretching commitments

• 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

Dementia SCN

Challenges Risks

• Leadership in clinical commissioning

• Developing the post diagnosis ‘offer’

• Fragmented NHS systems• Variable capacity within CCGs• Resource pressures

London Dementia SCN Priorities 2013/14Strategic work plans & desired outcomes

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Living well with dementia, including in care homes

Improved end of life care

Improved quality of care within the NHS

Strategic commitment to improve care and integrating innovation

Good quality early

diagnosis & intervention

Optimising medicines use

Evidenced based best practice │ Needs assessment │ Care pathway profiling │ Referral & access protocols │ Patient assessment guidelinesBenchmarking │ Measurement │ Informatics & Analytics │ Training │ Redesign modelling │ Service model recommendations │ Standards

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

9. 2013/2014 Commissioning Guidance sent out

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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

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Challenges and risks

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• 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

• 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

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

Domain 2: Enhancing quality of life for people with long-term conditions. Lead - SCN Manager

Theme: Supporting people to self-manage their long term conditions.Lead - QILTheme: 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

Clinical Director CVD SCN

Clinical Director CANCER SCN

Clinical Director MCYP SCN

Clinical Directors MH,D & N SCN

Crosscutting themes: Oversight and Planning Group, SCN AD, SCN Managers and Senior QILs

SCN and Senate Work plan lead: AD Lucy Sutton

Quality Improvement Leads and admin team

Overarching strategy: SCN Manager

Project support to SCN steering groups and subgroups

Administrative support to SCN

steering groups and subgroups

Wessex Strategic Clinical NetworkClinical Leads: Dr Christopher Kipps and Dr Denise CopeContact: England. [email protected]

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

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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

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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

parity of esteem for mental and physical health 20

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 neuro-developmental 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 2013Yorkshire & 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

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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.)

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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

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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

Yorkshire & the Humber Mental Health, Dementia, Acute & Chronic Neurological Conditions

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Dementia Acute & Chronic Neurological Conditions

Clinical Leads Dr Wendy Burn & Dr Oliver Corrado - DementiaDr Helen Ford & Mr David Broomhead - Neurological ConditionsDr Wendy Burn (Interim) – Mental health

YORKSHIRE & HUMBER CONTACTSIan Golton, Associate Director – [email protected]

Alison Bagnall, SCN Manager - [email protected]

Sheriden McKiniry, QIM (A&CNCs) - [email protected]

Penny Kirk, QIM (QIM- dementia) - [email protected]

James Barnes (QIM (MH) – email details to be confirmed

Dr Wendy Burn – [email protected] (Dementia and MH (interim))

Dr Oliver Corrado – [email protected] (Dementia)

Dr Helen Ford – [email protected] (A&CNCs)

Mr David Broomhead- [email protected] (A&CNCs)

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