Central London Mental Health Transformation stakeholder engagement event

1. Central London Mental Health Transformation stakeholder engagement event Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

2. Welcome Mike Waddington – Communications Director, CNWL Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

3. Agenda for the day 12:00 – 12:30 – presentation covering: current services; areas for development; clinical model development; co-production; next steps 12:30 – 12:50 – small group activity 12:50 – 13:10 – small group activity (switch tables) 13:10 – 13:30 – group feedback 13:30 – 14:00 - open discussion and panel Q&A Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

4. Acronyms and Jargon • We might use the following acronyms today: CNWL – Central and North West London NHS Foundation Trust CLCCG – Central London Clinical Commissioning Group CMHT- Community Mental Health Team MH – Mental Health CRHTT- Crisis resolution and Home Treatment Team PCP- Primary care plus SPA – single point of access • Please let us know if we are using Acronyms without explaining them in full, or any jargon! Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

5. Developing the clinical model Dr Jo Emmanuel – Divisional Medical Director, CNWL Dr Neville Purssell – Chair, CLCCG Alison Evans – Social Care Lead Mental Health Westminster, City of Westminster Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

6. Primary Care Networks in Westminster – Central London CCG Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

7. What are our current services?

8. What do people tell us about our current services? We want less assessments and more treatment Good, accessible, communication about my care is important to me I want to understand where and how to access mental health support I want to be seen as a whole person e.g. professionals understand the impact of my housing We need a shared system (between primary and secondary care) that people can believe in We want people with lived experience of mental health problems involved in our care

9. Why should services change? Feedback from National Collaborating Centre for Mental Health and NHS England work on introducing the framework for community mental health support, care and treatment. • Community mental health services are often not responsive and referrals take a long time to get to the right place • Outcomes and services for people are variable and demonstrate inequalities • We need wider support for people with MH problems, as support provided by community mental health services form only a small part of a person’s life and care

10. Why should services change? Feedback from CNWL staff community services event • “CMHT is all things to all people“ so is unclear on its role • Lot of resource focused on care coordination and multiple assessments rather than treatment • Provision of care is segmented leading to multiple inter-team referrals and potential for rejections • Untapped community resource - new innovative roles, 3rd sector provision under-utilised • Lack of communication between primary and secondary care • ‘Step down’ from secondary to primary care is not smooth resulting in many patients remaining in CMHTs for longer than needed, impairing recovery focus • Focus on process measures rather than patient outcomes • Using NHS resources as effectively as possible Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

11. Making A Difference Alliance Strategic Priorities Options for better individual outcomes: • Recovery focused services • Remove barrier between primary & secondary care • Not focus on moving from one care setting to another • Community safe havens, community spaces • Social prescribing Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

12. National Direction of Travel This community offer includes access to psychological therapies, improved physical health care, employment support, personalised and trauma-informed care, medicines management and support for self-harm and coexisting substance use. Local areas will be supported to redesign and reorganise core community mental health teams to move towards this new way of working. NHS Long Term Plan, January 2019 Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

13. What do we want to change? • We want people with mental health problems to be at the heart of every decision that is made, with effective communication to both patient and GP so that they have timely access to good quality, evidence-based mental health care in the least restrictive settings. • We have set up a collaborative clinically led transformation programme to develop a more streamlined system which allows us to make best use of available resources, reduce silo working and deliver quality clinical care on a needs basis. Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

14. Clinical model development to date • We have set up a partnership clinical group to develop our model • We want to remove the boundary between primary and secondary care, develop a community mental health offer which is centred around the four local primary care networks, and ultimately around the needs and aspirations of the patient. • Through engagement with wider stakeholders, a more detailed model will be developed. Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

15. What are we proposing? Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

16. GP GP SPECIALIST COMMUNITY SERVICES Patient GP GP GP GP GP URGENT ASSESSMENT HUB GP GP Patient GP GP CLINICAL COORDINATING CENTRE SPA for urgent referrals and distinct advice line GP GP GP Borough Wide Services GP GP GP Patient ACUTE TREATMENT GP GP SPECIALIST INPATIENT SERVICES GP Patient GP GP GP GP

17. To be able to work in this way we need: Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group Services working together, no working in silos Focus on interventions rather than repeated assessment No cliff edges between services where support drops off, seamless care instead Flexibility around discharge and top-up support Improved patient experience Support and Education for GPs

18. Impact on patients • Supports recovery focussed working across the system • Flexible support available around needs • Allows more focus on individual outcomes and less on movement between services • Less focus on referral and discharge • Improved information sharing processes so everybody involved in your care knows your plan • Potential to develop mental health hub services around local population need Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

19. Opportunities for co-production • We want to develop this model together • We need your help to work out how to do this Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

20. Proposed plan for change • Development of the model • Systems preparation • Staff training • Implementation and Review • Mobilisation Ongoing engagement and coproduction with stakeholders Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

21. Small group session There are 6 tables around the room, each table will have one of the following 3 questions on it: • How would you like to be involved in developing the new model? • What does good communication look like, with you and between services? • Feedback on the new model Please select one table that you would like to join, after 20 minutes we will ask you to move to a table with a different topic, the facilitators will stay on their tables Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

22. Group feedback Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

23. Panel Q & A Dr Jo Emmanuel – Divisional Medical Director, CNWL Dr Neville Purssell – Chair, CLCCG Alison Evans – Social Care Lead Mental Health Westminster, City of Westminster Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group

24. Next steps • We will gather all of your feedback and share with the clinical group, please complete a form before you leave • If you would like to stay up to date with the programme and future workshops please provide your details on the feedback form provided • Potential for further discussion with existing groups or follow up events • You can stay up to date with the programme through CNWL website or by emailing communications.cnwl@nhs.net Central and North West London NHS Foundation Trust Central London Clinical Commissioning Group