1 IntroductionWelcome to our first edition of Walkabout, a planned regular bulletin on the work of t he East Midlands Development Centre (EMDC), a service improvement and development team at NHS East Midlands dedicated to Mental health, Offender healthcare and Children. While this performs the function of a regional update on our programs, we want it to convey something more. As a team we work actively with and on behalf of the delivery system, we are out and about in the region working closely with commissioners and providers most of the time. A critical function for us is to facilitate and act as a catalyst for positive change. Our programs draw on a vast base of experience from users/carers, voluntary sector, offender health services and professionals. While we see the challeng es that staff deal with, we are always s truck by just how hard people strive to deliver the best, the opportunities and innovation that they create to overcome obstacles and the excellence services and care they provide. We want Walkabout to convey the experience of delivering high quality care and positive change. So we hope that those who read this will work with us to share and spread what is happening in the East Midlands. Walkabout aspires to be about the lived experiences of change in the East Midlands and about the endless possibilities for continuous self-sustaining improvement and innovation. As this is an E-bulletin further content can be access via the “Read more” hyperlinks at the end ofeach article. This link will take you to our regional website where further information can be found. www.eastmids.org.uk Who are we? A dedicated improvement and development team that is deployed by NHS East Midlands to support Mental Health, Offender Healthcare and Children & Families. We are funded by the National Health Service (NHS) and Department of Health (DH). To enable the most effective impact, the team works with all aspects of the delivery system, this means in practice that we are out and about across the region, not based in an office. Some refer to this type of role as a ‘f ieldworker’. The role we occupy draws on a consultancy model and the team have a range of skills from improvement methods, organisational development, change management techniques and project management. We also have team members who have specific policy based knowledge and experience of care delivery. This provides a unique combination of skills and knowledge to support improvement. There are five posts that hold locality responsibilities and have been put in place to provide an individual and personal contact point at the sub-regional level and support local projects. The resources we have access to are used to fund our t eam and distributed to programmes and through these processes, the delivery system to enable local and regional projects to be undertaken in line with agreed priorities for change and improvement. We maximise the release of staff to Issue 1 June 09 WalkaboutThe bulletin for the East Midlands Development Centre NHS East Midlands
Transcript
8/14/2019 Walkabout - EMDC Bulletin June 2009 Issue 1
Introduction Welcome to our first edition of Walkabout, a planned regular bulletin on the work of the East MidlandsDevelopment Centre (EMDC), a service improvement and development team at NHS East Midlandsdedicated to Mental health, Offender healthcare and Children.
While this performs the function of a regional update on our programs, we want it to convey
something more. As a team we work actively with and on behalf of the delivery system, we are outand about in the region working closely with commissioners and providers most of the time. A criticalfunction for us is to facilitate and act as a catalyst for positive change. Our programs draw on a vastbase of experience from users/carers, voluntary sector, offender health services and professionals.While we see the challenges that staff deal with, we are always struck by just how hard people striveto deliver the best, the opportunities and innovation that they create to overcome obstacles and theexcellence services and care they provide.
We want Walkabout to convey the experience of delivering high quality care and positive change. Sowe hope that those who read this will work with us to share and spread what is happening in the EastMidlands.
Walkabout aspires to be about the lived experiences of change in the East Midlands and about theendless possibilities for continuous self-sustaining improvement and innovation.
As this is an E-bulletin further content can be access via the “Read more” hyperlinks at the end of each article. This link will take you to our regional website where further information can be found.www.eastmids.org.uk
Who are we?A dedicated improvement and development team that is deployed by NHS East Midlands to support
Mental Health, Offender Healthcare and Children & Families. We are funded by the National HealthService (NHS) and Department of Health (DH).
To enable the most effective impact, the team works with all aspects of the delivery system, thismeans in practice that we are out and about across the region, not based in an office. Some refer tothis type of role as a ‘fieldworker’. The role we occupy draws on a consultancy model and the teamhave a range of skills from improvement methods, organisational development, change managementtechniques and project management. We also have team members who have specific policy basedknowledge and experience of care delivery. This provides a unique combination of skills andknowledge to support improvement.
There are five posts that hold locality responsibilities and have been put in place to provide anindividual and personal contact point at the sub-regional level and support local projects.The resources we have access to are used to fund our team and distributed to programmes andthrough these processes, the delivery system to enable local and regional projects to be undertakenin line with agreed priorities for change and improvement. We maximise the release of staff to
Issue 1 June 09
Walkabout The bulletin for the East Midlands Development Centre NHS East Midlands
8/14/2019 Walkabout - EMDC Bulletin June 2009 Issue 1
undertake projects, build temporary capacity until the system embeds change, and allowstakeholders to take control of the skills they need to deliver the desired improvements.
This combination of a core team and funded projects has provided flexible and adaptive approachwhile maintaining a continuous with a speed of response that is at times required.
The following link shows some case examples: http://www.eastmids.org.uk/about/case-examples/
We also believe as a dedicated improvement resource, embedded in the Strategic Health Authortiy(SHA) we bring a number of advantages over other options for Primary Care Trusts (PCTs) andproviders to seek assistance and expertise on change management approaches;
Intimate understanding of the workings of health, social care and offender healthcare systemsof the East Midlands environment as our team comes from the environment you work in
Access to a broad and informed knowledge base and extensive networks in and outside theregion
Expertise and familiarisation with a range of improvement methods, organisationaldevelopment and user/carer/professional engagement skills
As part of the SHA, commitment to the values of NHS East Midlands and consistent with the
vision and strategy for the NHS, your interests and values are ours too Appreciation of the policies relevant to healthcare and ability to support with implementation
We are focused on 3 critical work streams
Children and maternity, including mental health Offender Healthcare Mental health, with joint funded programs with social care for dementia and personal budgets
Each work stream will have a number of priority programmes, in line with the needs of the NHS. Theyare agreed with key senior stakeholders and continuously reviewed so that we can take account of
the changing needs and new priorities that emerge throughout the year. More information on thework streams can be found below or on our website: www.eastmids.org.uk
To find out more about the team follow this link: http://www.eastmids.org.uk/about/our-team/
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As I write I have completed just over a year of working in the East Midlands. They say time flies whenyou are enjoying yourself. And yes, I have enjoyed many aspects of the past year but also been filledwith some trepidation as we prepared and implemented changes to the improvement model for EastMidlands and established a fresh approach to working with the delivery system. This has includedstrengthening partnerships across the region and at the county level and responding to the localagenda. Releasing resources to support change as well as providing change expertise through our core staff group. Championing the needs of key vulnerable groups through improved strategicrelationships and working inside the system as an integral part of it.
Want to know more about Dean? http://www.eastmids.org.uk/about/our-team/dean-repper/
Within the last year we have seen the Care Services Improvement Partnership (CSIP) and theNational Institute for Mental Health in England (NIMHE), previous improvement organisations workingin the region, wound up both regionally and nationally. They both made a fantastic contribution to our appreciation of change and its intricacies in health and social care and they have left a valuablelegacy of knowledge in the important areas of mental health, learning disability, social care andchildren. There were a number of reasons for that change both at the national level and locally. A keydriver was the devolution of resources from the centre to the regions to support regional and localimprovements and to move key parts of DH(located in regional government offices) into the regionsso it is closer to service delivery.
In the East Midlands we made an early move to make changes to the model we had while conservingwhat worked well. Along the way we had to ask some hard questions of ourselves. In the earlymonths when I went out and about I realised we had a tough job on our hands to meet the challengesthat the emerging health and social care landscape presents. As an improvement team we have tobe able to articulate our value added, we have to be relevant and visible.
I hope you find our first of regular updates interesting and helpful but as ever it will get better withyour feedback.
Jill GuildJob Title: Strategic Relationships & Programme Manager Program Responsibility: Mental Health in Later LifeRegion: NottinghamshireEmail: [email protected]
ChildrenThe Children’s and families programme is comprehensive, responsive to currentstrategy, works with regional partners and assists individual organisations andpartnerships at a locality level.
The priorities for 2009/10 have been identified as follows:
Children with a disability Transition Commissioning Vulnerable groups Maternity Safeguarding Partnerships Leadership and capacity building CAMHS (child & adolescent mental health services)
The programme supports both national policy frameworks and local strategic objectives. All work programmesand approaches are developed jointly with policy leads in the SHA and work programmes are delivered inpartnership. Read more: http://www.eastmids.org.uk/children-families/
Offender HealthThe main focus for our Offender Health programme is on supporting positivechanges in the well-being of people with health and social care needs in all areasof the criminal justice system. The Offender Health and Well-being Partnership builds on the work of theDepartment of Health (DH), the Home Office (HO) and more recently Ministry of Justice (MoJ) to modernise and mainstream prison health care into the wider NHS
and the developments highlighted in the consultation on ’Improving Health, Supporting Justice’. As changes instructures within the MoJ and DH regional presence proceed, we will continue to work in partnership toimprove health, address health inequalities and reduce crime by maximising the opportunities provided bybetter integration of health, social care and criminal justice systems.Read more: http://www.eastmids.org.uk/offender-health/
Mental HealthThe mental health programme responds to joint commissioning and provider agendas across healthand social care. It builds in where appropriate and agreed locally a number of national policyobjectives.
DementiaFebruary 2009 the Department of Health has launched its first National DementiaStrategy called Living Well with Dementia. This is the first of its kind in the UK andwill provide a framework within which local services can deliver qualityimprovements to dementia services and address health equalities relating todementia.
What does that mean for us in this region?The region will be lead by the collaboration of the Department of Health and the Strategic Health Authority.Programs of improvement will be delivered through the East Midlands Joint Improvement Partnership (JIP) thePrevention and Early Intervention programme board. This is chaired by David Pearson from Nottingham
County Council and the board recently set up an East Midlands Dementia Strategy Improvement group whereBrenda Howard Director of Strategy, Nottingham County Teaching Primary Care Trust has agreed to be thesponsor for the Improvement Group.
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On the improvement group are representatives from both Health and Social Care across the East Midlandsregion. Commissioners and providers and people who use the service and their carers are all members. Weare delighted to have the Alzheimer’s Society chairing this group. The group aims to meet quarterly and toover see the support for implementation of the strategy and co-ordinate the development activity. Leadershipfor the support programme for the Dementia Strategy will come from: [email protected] (SHA) [email protected] (DH regional team)
Improving Access to Psychological Therapies(IAPT)We know that in the short-term psychological therapies are as effective asmedication in treating anxiety and depression and can be more effective atpreventing relapse in the long term. Improving access to psychological therapies(IAPT) was identified in the Government’s white paper, Our Health, our care our
say, as one of its key mental health programmes that will contribute to improving the health and wellbeing of the population. To meet this aim the IAPT programme is concerned with increasing the recognition of depression and anxiety and raising the standards of treatment for people suffering from those disorders.
Last year we had two new services set up by PCTs as part of the wave one IAPT roll out. This year we have asignificant growth as all bar one PCT will set up new IAPT services. In addition to services from NottinghamCity(provider arm of PCT) and Lincolnshire NHS Foundation Trust, this year we will have services in; DerbyCity (Trent CBT-independent provider), Derby County (Lincolnshire Foundation Trust/Mental health Matters-voluntary sector & Derby Mental health service/Turning Point-voluntary sector, Nottingham county(Nottinghamshire healthcare Trust/Rethink-voluntary sector), Leicester county& Rutland (Leicester PartnershipTrust/Rethink/Assuria), Leicester City (transition project with Leicester Partnership Trust and City VoluntarySector), Nothamptonshire (Changing Minds- PCT provider arm).
Supported by the SHA Service Improvement Team and the workforce deanery the IAPT providers arebeginning to recruit their trainees in readiness to join the new high and low intensity therapy courses startingthis autumn.
Existing trainees are getting close to finishing their courses, preparing for exams and putting together professional portfolios in readiness to take up permanent posts in IAPT services in Nottingham and
Lincolnshire. Drop out from the courses has been relatively low and trainee feedback has been positiveoverall.
It really is going to be an exciting year as East Midlands progresses an ambitious and visionary programme of access to ‘talking therapies’.
Nationally IAPT has focused on CBT for depression and anxiety. It is important to make this evidence baseavailable and to deal with what is one of the commonest forms of mental health disorder. However, we arekeen to promote all evidenced based ‘Talking therapies’ for a range of problems. We are supporting
Interpersonal therapy for depression and also NICE guidelines for Personality Disorder. We will have moreupdates on that in our next Walkabout. Read more: http://www.eastmids.org.uk/mental-health/iapt/
Delivering Race Equality (DRE)See www.mentalhealththequalities.org.uk for more on this important initiative
The East Midlands benefits from 40 Community Development Workers (CDWs)who are a driving force responding to the DRE agenda. Community developmentworkers take a holistic approach to mental health which focuses on theinterrelationship between health, culture and social economic factors that affect a
service user and their carers. CDWs work in partnership with mental health staff and communitygroups/organisations to support ethnic minorities across a range of issues that affect a person's mentalwellbeing and recovery. CDW'S link these community services with the work of mental health services. Thispromotes greater understanding by professionals and improved access to mental health services for peoplefrom BME communities. This agenda is supported by a multi-agency DRE Leads Forum represented by
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leaders who can provide the scaffolding of support not just for CDWs but for the working systems andprocesses that DRE requires to take it beyond 2010.Read more: http://www.eastmids.org.uk/mental-health/delivering-race-equality/
Personalisation and Mental HealthHow much choice and control do you have over what happens to you? For thosewho access public services, they want a lot more choice and control.
Since 2007, there has been an drive to see that health and social care must beginto put people first through a fundamental transformation of public services. Centralto this is enabling people to exercise choice and control over the way they live
their lives, reassured that the services they receive are of high quality, safe and meet their individual needs for independence, well-being and dignity. The Putting People First Concordat (2007) reflected this message andprompted a commitment to create a personalised Adult Social Care system. “Ensuring older people, peoplewith chronic conditions, disabled people and people with mental health problems have the best possiblequality of life.” This requires system wide transformation, aided by a 3 year programme started in April 2008which is meant to show significant progress by 2011. It is naturally linked to a national performance indicator –NI130 which stipulates that 30% of people accessing mental health or learning disability services in receipt of personal budget must be using a direct payment.
One way this is being reflected regionally is through a joint exercise between the DH Social Care Team andthe EMDC to work with partners in sub localities to promote not only meeting but exceeding the 30% target. Byinjecting additional resources within an existing pool of investment we are matching enthusiasm within thesystem to make person-centred approaches central to how we do business. We will be working with test siteslike Northamptonshire, where leaders and staff within the County Council, Northamptonshire HealthcareFoundation Trust and the PCT are exploring the big questions about resource allocation, eligibility criteria andculture change; sending a strong message of commitment followed by action in order to take the agendaforward across health and social care.Read more:http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081118
Suicide PreventionThis project is a key part of the support we are providing to the Mental HealthNext stage review, which in the east midlands identified suicide prevention apriority.
The national suicide prevention strategy identifies that those who have self harmed are a significant high risk group. Many who self harm will attend an A&E
department following their act. The National Clinical Practice Guideline Number 16 relates to the initialmanagement of self harm and contains guidance on assessment.
In the East Midlands we are reviewing, (based on the nice guidance and ‘Better Services for People WhoSelf-Harm Quality Standards for Healthcare Professionals’ the psychosocial assessment availability anddelivery across the large A&E and the acute hospitals sites to help inform how care is delivered and learn fromthe approaches being taken.
LegislationWhile this programme has now come to an end there are a number of projects thatwe would like to keep you informed about in 2009.
The Amended 1983 Mental Health Act (2007) came into place on November 3rd 2008. We have been supporting local areas with the implementation of the Act. Inso doing we have seen the enormous commitment and enthusiasm by local
services to bring this Act in and to prepare their staff for the various changes. In addition we have beensupporting carer and service user engagement as core to the work being undertaken. Ongoing work remainswith the implementation of the Independent Mental Health Advocacy Services, age appropriate services
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(children and young people) and the new roles that can be undertaken by mental health professionals. So if you want to find out more about this new legislation and the acronyms of AC, RC, AMHP, IMHA, CTO etc wehave a range of literature, booklets and publicity materials that provide easy ways to understand the Act andthe changes that have been made.
In this section we want to encourage you to share what is going on in your area, we hope it will be amix of innovation in care examples, improvement stories, ward winners, personal successes etcClick on the county hyperlink to read more.
This months thought piece, presented by Dean Repper , Director East MidlandsDevelopment centre “The therapist or the therapy”
http://www.eastmids.org.uk/about/thought-piece/
If you would like to submit a thought piece please email [email protected]
Notice Board
Latest news, resources and products you may find useful.
A multi-lingual leaflet on patient’s rights is released for the first time ever Patients’ rights will no longer be lost in translation as an NHS leaflet is released in more than 25 differentlanguages for the first time ever.This multi-lingual leaflet is the idea of the Mental Health Act Administration Team at NorthamptonshireHealthcare NHS Foundation Trust and focuses on a patient’s rights when detained under the MentalHealth Act.The team recognised the difficulties of many patients from different ethnic communities in understandingtheir rights and when to use them. With the support of NHS teams in the East Midlands and nationally,who work on safeguarding patient rights in mental health, money was raised to cover costs. TheNorthamptonshire team began the ambitious task of producing the different documents, which will now belaunched on 8th June at a dedicated event in Northampton. Read more: http://www.eastmids.org.uk/2009/06/05/nhs-leaflet-released-in-more-than-25-different-languages /
New Horizons On 22 May, service users and carers gathered at the Park Inn, Northampton to participate in a regionalListening Event with Louis Appleby, National Director for Mental Health in England. Participants’ views willhelp shape the policy developments for, “New Horizons which is a new strategy that will promote goodmental health and well-being, whilst improving services for people who have mental health problems. Itwill build on the National Service Framework for mental health.”http://nds.coi.gov.uk/content/detail.asp?NewsAreaID=2&ReleaseID=398462
Coaching and Mentoring
Did you know that we have a qualified coach and mentor in the centre? I am registered on the T.I.N. (TheImprovement Network) coach list, where you can read my area of interest and support. I particularly enjoy working with staff working in change and organisational development so if you are
interested in taking up a coaching or mentoring opportunity please call or email me [email protected] or 01623 812941.
IAPT – Leadership and Influence Course
We have successfully filled the first cohort of the IAPT Leadership course which is fantastic news and theteam (Dena Adamson, Dr Les Ashton and Mark Houghton) are now busy preparing the action learningorientated course to start in mid June. In addition we are also looking at how we might create some training opportunities for Primary Care staff inmental wellness and signposting for help and support. So many people who are starting to suffer fromanxiety and depression could be helped from progressing into a more severe condition if they weresupported effectively in the early stages of their problems.
We are presently looking as to how we can support staff to intervene appropriately by providing trainingand information sessions. Watch this space.
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Did you know that 1 in 10 employees in any one year will be affected by Mental Health conditions?
The economic downturn is forecasted to cause a 26% rise in Mental Health problems affecting more than1.5 million people in the UK. Dena Adamson has been working with Marie Chellingworth, Low IntensityCourse Leader from Nottingham University as well as with one of the major clothing retailers in the EastMidlands to look at how HR Managers might deal with and recognise Mental Health issues within their employees and start to act as sign-posters and to help further services. We hope that we might be able to transfer this model to other large employers in our region in the near
