PROGRAMME INITIATION DOCUMENT MENTAL HEALTH PROGRAMME

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1 PROGRAMME INITIATION DOCUMENT MENTAL HEALTH PROGRAMME 1. BACKGROUND: 1.1 Primary Care 90% of mental health care is provided within primary care services, with the most common mental health problems identified as anxiety and depression. There is anecdotal evidence that there is variation in screening, referral and access to mental health support in primary care. Furthermore, it is estimated that approximately 26,100 adults in Warrington will experience a common mental disorder (ONS), yet GP recording systems suggest there are only 18,500 adults within Warrington with a current diagnosis of mental illness which suggests unmet need/ under diagnosis. 8% of individuals with mental health problems require the specialist intervention and support of Secondary Mental Health Services. There is some (limited) evidence available locally to highlight the co-morbidity with physical ill-health, (an existence of a physical health problem i.e. cardiovascular disease). There is some evidence to suggest that people with SMI physical health needs are not addressed, and that people with long term conditions may experience depression & that this is not recognised or managed. 1.2 Dementia Warrington has an aging population, higher than the national average. Warrington projections suggest a 60% increase in people aged over 65 by It is further predicted that the increase in incidence of Dementia almost doubles over this period (POPPI 2010), suggesting that 1 in 6 people will be affected by Dementia. The number of people currently diagnosed with Dementia is 996, modelled estimates suggest actual prevalence may be almost 2,100 & dementia is forecast to rise to between 3,400 and 3,900 by The impact of an ageing population and increased prevalence of Dementia will impact on the whole system. 1.3 Substance Misuse There is evidence to suggest the link between mental health problems and substance misuse, yet we fail to provide seamless services for this cohort of people. The rate of hospital admissions for alcohol related harm has increased year on year & Warrington admissions are twice that of the national average. The impact of substance misuse impacts on the whole system & the rate of admission is significantly linked to deprivation. The welfare reform is likely to affect mental health and wellbeing & may increase the incidence of mental illness. The impact of which will further challenge the system unless we work in an integrated way to avoid duplication and provide effective & evidence based solutions. 1

2 2. PROGRAMME DEFINITION: The aim of the programme is to promote mental health & wellbeing and prevent mental ill health. The programme aims to promote earlier recognition and improve access to mental health & social care support in primary care. The programme further aims to ensure that people with mental health problems achieve and maintain optimal mental health and physical wellbeing and independence from an integrated system. 3. PROGRAMME OBJECTIVES: The programme will: Promote mental health wellbeing & prevention in the primary care system Raise awareness of mental health issues and services available in primary care. Reduce inequity and improve access to support for people with mental health problems within the primary care system Reduce variation in management of people with mental health problems in primary care Ensure seamless integrated service provision for people with mental health problems across the system. Ensure that people with mental health problems have their physical health needs addressed. Implement the system wide recommendations of the National Dementia Strategy providing integrated services to support people with dementia in holistic way. Improve the identification of Dementia & earlier access to support services Improve whole system recognition and management of Dementia (closing the gap between prevalence c2,000 and identified c1,000 people with Dementia) and ensure system is able to meet and provide high quality services for the predicted increasing demand. Improve care provision for people with Dementia in acute secondary care Improve care for people with Dementia in care/ residential homes Develop substance misuse services to ensure a seamless integrated service provision across the health and social care system. 2

3 4. PROGRAMME SCOPE: The Mental Health Programme does not address children s mental health issues which will be managed through the children's programme. Transition of young people into adult services is not within the scope of the programme. Dementia will be managed by the Mental Health Delivery Group, but recognises the link to the Frail Elderly Programme The programme will include co-morbidity e.g. the mental health of people with a long term condition, people who have a mental health problem and a long term condition etc. 5. PROGRAMME DELIVERABLES: Improved access in primary care Seamless step up & down pathways across mental health providers Training & awareness programme for professionals in primary care. Training & awareness programme for the public on mental wellbeing & service availability Refreshed & agreed local Dementia Strategy Standardised Dementia screening & referral tools Dementia training & awareness programme for primary care professionals Dementia training & awareness programme for care homes Dementia training & awareness programme for staff in acute care (may include rotation to specialist Dementia services) Improved environments for people with Dementia in acute secondary care Improved environments for people with Dementia in care homes Agreed DAAT Strategy. 6. RELATIONSHIP WITH OR DEPENDENCY ON OTHER PROGRAMMES: The Mental Health Programme has a relationship with the following programmes, Urgent Care Programme Long Term Conditions Programme Frail Elderly Programme The dementia workstream has a key link to the frail elderly programme The Mental Health Programme has a key dependency with the Information Programme, and will brief the programme on its information requirements. The Programme Office and Transformational Board will identify interdependencies between programmes and workstreams and will ensure delivery is coordinated and duplication is avoided. 3

4 7. ASSUMPTIONS: The programme is part of the Integrated Quality Innovation Productivity & Prevention (QIPP) programme. There is an assumption that this programme will integrate service delivery in order to make better use of limited resources, address rising demand and ensure equitable and high quality service provision across the system. Any service improvements will be evidence based and address Quality, Innovation Productivity and/ or Prevention. Quality improvements and cost savings are fundamental to the programme & service improvements will need to demonstrate how they deliver these. The programme areas have been identified due to the following activity assumptions, Unmet mental health need in primary care which may require higher level of intervention & services from the system if not managed earlier. An ageing population, with increasing prevalence of dementia An increase year on year of alcohol related hospital admissions. The primary care and Dementia workstreams will need to undertake audits/ health economics modelling to determine the level of need/ prevalence as a baseline measure of current and projected need. The metrics will provide a baseline measure and will inform how we do things better across the system. 8. PROGRAMME APPROACH: The key deliverables will be achieved by working in collaboration through the Mental Health Delivery Group. There are three core workstreams within this programme which will be taken forward by sub-groups who will report back to the Mental Health Delivery Group to ensure coordination and collaboration. The three workstreams are, Primary Care Workstream Dementia Workstream Substance Misuse Workstream Where possible, strategies will be developed at workshop events, involving senior managers & clinicians. This approach will support a collaborative approach and will support innovative service redesign by promoting creative thinking. 9. KEY PERFORMANCE INDICATORS & BENEFITS Key Performance Indicators (KPIs) The key performance indicators (KPIs) will provide the most important performance information that enables us to understand whether the programme is on track. The programme will determine KPIs that will demonstrate what success looks like and these will be SMART (Specific, Measurable, Achievable, Realistic and Timely). In order to monitor each workstream, they will have as a minimum one KPI. 4

5 Benefits Benefits Management aims to make sure that the desired changes have been clearly defined, are measurable, and provide a compelling case for the change and ultimately to ensure that the outcomes are actually achieved. The programme will define its intended benefits/ dis-benefits of the change & remain focused on delivering these to ensure the programme delivers value and remain aligned with the overall objectives of the programme. The development of the benefits criteria will be undertaken with our users and carers. They will be engaged in determining what the success criteria for the programme is, building on the benefits articulated by partners engaged in the Stakeholder Planning Workshops. Benefits that have been identified to date include: Benefit Primary Care Staff have improved experience and are better supported when managing people with mental health problems Measure Staff survey Programme Plan: See attached Programme Plan Risk Log: The Risk Register contains some early risks that the delivery group identified. These will be analysed and the register developed as a key deliverable of an initial delivery group meeting. Project Organisation Structure: See attached Programme Organisation Structure Communication Plan: The Communication plan will follow, however attached is the first draft of a stakeholder impact assessment from the delivery group. Approved by: (Executive) Date approved: Document No.: Mental Health Programme PID / /V1.0 5