Meeting Name: Mental Health Network Meeting Venue: Indigo Building, Ashworth Hospital Site, Liverpool Date: 14 April 2014 In Attendance: Dr David Fearnley Chair/ Mental Health Clinical Lead Mersey Care / SCN William Greenwood Network Manager, C & M SCN Elaine Owen Quality Improvement Lead C & M SCN Tracie Keats Quality Improvement Lead C & M SCN Jackie Sanders Network Assistant C & M SCN Mark Parker Mental Health Lead NWAS Nieves Mercadillo Assistant Medical Director 5 Boroughs Partnership Margi Butler Head of Commissioning MH and LD Warrington CCG Julia Burgess Delivery Manager Vale Royal and S Cheshire CCG Alison Van Dessel Programme Manager Knowsley CCG Norma Currie Commissioning Manager/Lead Wirral CCG For Mental Health and LD Jenny Shaw Commissioning Support Manager Wirral CCG Trevor Hubbard A&E Clinical Business Manager Aintree UHT Ian Fenton Charge Nurse / A&E Dept WUTH Pat Nicholl Health Improvement Principal Champs/Sefton Jackie Rooney Patient Experience Manager CWW Area Team Andy Sweeting Project Manager AHSN Helen Garry Service Redesign Manager Wirral CCG Agenda Item Notes/Action points 1 Welcome, Introductions and Apologies 2 Purpose and expectations of the Network Group and Draft Terms of Reference David Fearnley gave a short presentation (circulated with notes) detailing the structure of the Cheshire & Merseyside Strategic Clinical Networks and various groups working across the patch. He also showed the NHS Outcomes Framework, the Network Mental Health Work plan supports the criteria contained within the framework. The MHDN has held two events, 2 nd July 2013 and 28 January 2014, in order to engage with all stakeholders and from discussions and group work at these meetings, the three areas of priority that the group were asked to action were agreed. The optimum outcomes from this meeting include: Discussion around ways to develop the new network
Agree the Terms of Reference for the Group Focus will action the work around the priority areas. The group reviewed the previously circulated draft terms of reference for the group. A chair is required and expressions of interest were requested. This role may be taken on by the new Mental Health Clinical Lead, who is to be appointed at the end of May.- The cochair could be a service user or carer. It was suggested the membership should include carers and a mental health lead from an acute trust, public health representative, community mental health representative. The terms of reference were agreed with the slight amendments and will be signed off at the next meeting. Action: Terms of reference agreed with additions/amendments 3 Patient and Public Approach Elaine Owen referred to the previously circulated SCN Patient and Public Strategy which mirrors the work going on nationally. Elaine is the Network PPI Champion for the Mental Health, Dementia and Neurological Conditions network. A Peoples Voice database has been developed by the SCN by contacting a large number of organisations and inviting representation from the public in a number of ways. They may be involved in one or a number of the networks, and can be involved in meetings or on an advisory basis. There is a system of managing the group and a buddying system is in place. Patient and Public Involvement is also important for the task and finish groups. The group was asked to let Elaine know of any people who may be interested. 4 Final draft workplan for 2014-16 David Fearnley referred the group to the previously circulated SCN draft workplan for 2014-16 (Mental Health, Dementia and Neurological Conditions pages 32-37). This document has been signed off by the Regional Medical Team on the 8th April. William Greenwood commented there will be a series of success measures which will be added by the network by the end of May, if no national indicators are published by then. One typographical error was highlighted within the measures of success for Mental Health 95% of service users should be admitted, transferred or discharged within 48 hours of arrival to A & E This should be within 4 hours The three aims for the Mental Health Network include: Domain 1: Prevent Premature Death To manage acute crisis mental health episodes in a timely responsive manner that meets the needs of the service users and their carers and families.
Domain 2 Quality of life for patients with long term conditions To build an integrated depression pathway Domain 4 Ensure positive experience of care To work with people with learning disabilities to enable them to access mental health services and have their needs met at the right time, in the right place and the right care. David Fearnley congratulated the network team on the production of the comprehensive work plan. 6 Agreeing Task and Finish Groups Manage acute crisis mental health episodes in a timely responsive manner through building an integrated 24/7 emergency mental health pathway Mark Parker (NWAS) commented it is often difficult for ambulance crews to access alternatives to A&E for patients suffering a mental health problem or crisis. However, the NWAS ERISS system is a way of flagging vulnerable patients, for mental health patients details of diagnosis, medication, and carer or best person to contact in a crisis or emergency, are entered upon ERISS system. This was developed originally for end of life care patients and has subsequently been rolled out for other conditions. Mark tabled ERISS leaflets with more information, and is willing to attend a future meeting to explain the system in more detail. It was pointed out more crisis houses are required to stop unnecessary attendance at A & E. At Aintree University Hospital there are problems with drugs and alcohol and the homeless. There are also problems with timely assessment of Section 136 patients and delays occur. The street triage pilot in Warrington has had a big impact, this has reduced the number of section 136 by 70% since December 2013. The street triage currently includes a police officer and mental health nurse. The Sanctuary Project in Manchester takes self referrals and is also used by the police and ambulance, this is similar to a crisis house. Assessment of patients suffering mental health problems often involves waits of up to 9 hours which is inappropriate for the patient and ambulance and police services. The group were asked for expressions of interest in the Acute Crisis Task and Finish Group which will be formed to address the above issues. Jenny Shaw, Wirral CCG indicated she would be keen to lead this group. Action: Jenny Shaw to lead Acute Crisis Task and Finish Group.
To build an integrated depression pathway David Fearnley emphasised the importance of a clear structured depressions pathway. Pat Nicholl took the opportunity to inform the group of the Suicide Reduction Network which is based with Champs. The Operational Group has had their first meeting, with a broad range of representation, they are currently looking at audits and baselines. The programme board will meet in June and will raise awareness of suicide prevention. The network is also looking at a community liaison service for the family and carers post suicide, and at patterns of suicide. The group would welcome any interested parties from the Mental Health Network. Pat has also met with the network team to look at social prescribing, how this can be used more widely by GPs and where there are barriers. Pat is working with Tracie Keats and Jackie Sanders to take this work forward. GPs in Halton have done some work on social prescribing, Pat will let the network have contact details. There are also some issues with IAPT provision across the network. Expressions of interest in the lead role for this task & finish group were requested. The group were asked to let Elaine Owen have details of any interested parties. It was suggested this could be an IAPT provider or GP Lead. Action: Any interest in the lead role for the Depression Pathway task and Finish Group to Elaine.Owen1@nhs.net. Elaine will also actively seek a lead for this group. To ensure people with learning disabilities are able to access mental health services in a timely manner. Jackie Rooney reported Cheshire Warrington and Wirral Learning Disability Network are collaborating with CWP and Five Boroughs, Jackie is leading on a project on access to primary care. There is another Learning Disability Network in Merseyside. David Fearnley also suggested another work stream could be with Forensic and Secure Care for Learning Disability, and support for offenders with learning disability. Janice Wycherley and Elaine Owen was suggested as a good person to chair this group, Jackie Rooney will approach Janice in this regard. Norma Currie and Helen Garry expressed an interest in being involved in this group The Task and Finish groups will come together as soon as possible, with the support of the network team.
9 AOB NWAS can arrange demonstrations of ERISS to organisations. Jim Symington from the Mental Health Crisis Care Concordat is keen to talk to networks on their work and will attend the next meeting. Andy Sweeting from AHSNs offered any support for any relevant projects. Future meetings will run on a three monthly basis. Action Lead Timescale Expressions of interest for role of Chair /Co Chair of the Mental Health Network Group to be forwarded to Elaine.owen1@nhs.net The Network Group Terms of Reference agreed with additions/amendments All End May 14 EO/JS April 14 All to let the Elaine.owen1@nhs.net know of any service users or carers interested in becoming involved with the network groups Anyone interested in joining the Suicide Reduction Network to contact Pat Nicholl (Pat.Nicholl@sefton.gov.uk) All All Ongoing Ongoing Jenny Shaw to lead the Managing Acute Crisis task and finish group with the support of the network Elaine Owen to seek interest in the lead role for the Depression Pathway task and finish group via commissioners. JS/Network June 2014 EO June 2014 Janice Wycherley to be approached to lead the Learning Disabilities Task and Finish Group with the support of the network. Norma Currie and Helen Garry to be on the group JR/EO to contact her April 2014 NWAS can arrange demonstrations of ERISS to organisations MP/EO May 2014 Jim Symington from the Mental Health Crisis Care Concordat to present at next meeting DF/EO July 2014