Community Wellbeing Hub (Norwich & Central Norfolk) Euan Williamson (Commissioning Programme Manager, Norwich, North & South Norfolk CCGs) 16 May 2018
Background In the Five Year Forward View for Mental Health (2016) there s a significant focus on increasing resources for community based, easily accessible and preventative models. The local Sustainable Transformation Partnership (STP) in Norfolk & Waveney has made the development of wellbeing hubs a key priority. The hub concept is based on local ideas that have been developed over the last three years. The hub model is based on models in Aldershot (Safehaven), Lambeth and Bradford.
Current Situation Use of mental health acute beds grew by 7% between 2014-2017 and there was a 3% rise in the number of referrals to specialist mental health services over the same period. Impacting on system partners, such as an increase in Ambulance call outs, attendances at A&E and calls to the Police from people reportedly with a mental health problem. Number of out of area placements (mental health acute bed placements not in the local provider Norfolk and Suffolk NHS Foundation Trust (NSFT)) has been rising for several years.
Case for Change Traditional mental health services have been developed to treat mental illness and not mental distress. It means services are often focused on medical solutions to mental ill-health. The concept of mental distress is recognised as an important factor in poor mental wellbeing, for example, stress is what many of us cope with on a day to day basis but sometimes it becomes too difficult to manage and becomes distress. If it is left for too long unsupported it often becomes a mental illness. There is a need to adapt services to better support the psychological and social aspects of an individual, in addition to their physical symptoms. The hub approach is designed to offer a non-medicalised, easy to access, nonstigmatising safe place for people to access information, advice and support. If an individual is experiencing a crisis episode then the hub can also act as an alternative to formal services.
Existing Crisis Response System
Key Model Features Daytime hub offering support, advice and information, and an open-access public café. It will include peer support workers and volunteers, and could integrate other agencies to offer specific advice, such as housing, benefits, physical health etc. Likely to be open from 12pm to 5pm, 7 days a week. Evening hub offering direct support and emotional support for people experiencing clear mental distress. The will likely integrate with existing support line provision and statutory mental health crisis resources provided by NSFT. Likely to be open from 7pm to 12am, 7 days a week. Post-crisis Support Package daytime support. Access to 1:1 sessions, group sessions and activities for 6-8 weeks following crisis. Triage line a key learning point from other services was the need to incorporate a triage line, offering advice and triage for professionals and agencies supporting people who could benefit from the hub. It will play a role in risk identification and to ensure the hub model isn t used inappropriately.
Churchman House (Bethel Street, Norwich) Churchman House is an 18 th Century Grade I listed building in the centre of Norwich. It is large (923 sqm) and has played a prominent role in the Norwich community for many years. Until recently it was used as the Norwich Registry Office, and is equipped for office use. It has parking for 30 cars and is widely accessible to public transport, and local residents. The building is owned by Norwich City Council.
Churchman House Ground Floor Overview Floorplan Main Entrance Reference library Access to online directory Quiet seated area Reception area Large meeting room Recovery college Educational sessions Support sessions Kitchen and toilets Community Café Garden and Kitchen Garden, and Car Park (30 Spaces) Crisis support area Emotional support Place of quiet Consultation rooms Communal area Discreet Rear Entrance from car park
Churchman House First Floor Overview Floorplan Office space Office meeting room Main staircase and proposed lift Office space and consultation rooms Triage and support line Crisis resolution team presence Social care presence Staff space
Expected Quality Outcomes Improved outcomes for people experiencing mental distress and crisis, due to a more integrated approach to care and better continuity between urgent care and community services. Improved mental health urgent care response for people in Norwich, with the hub offering, where suitable, a focal point for emergency services. Improved communication between partners by integrating services and providing a focus for mental health urgent care activity. Efficient utilisation of crisis resolution services and mental health workforce resources, and emergency health system partners. Improved the efficiency of the Section 136 suite and the acute wards by reducing demand and thereby increasing workforce capacity. Contribute to suicide prevention in Norfolk.
Expected Resource Outcomes Reduce the number of presentations at NNUH A&E, by people experiencing a mental health crisis. Provide an alternative referral route for Primary Care and reduce the number of people requiring consultation that includes a mental health element. Reduce the number of emergency ambulance conveyances from patients homes to A&E, of people experiencing a mental health crisis. Reduce the number of avoidable admissions to mental health inpatient beds. Decrease the number of avoidable referrals to the Crisis Resolution Home Treatment Team (CRHT). Reduce the number of inappropriate referrals to mental health services.
Next Steps CCGs will be conducting an engagement process over the next 2-3 months to understand people s views and what they want from the hub. Formal consultation will take place later in the summer. Procurement process to identify a preferred service provider will take place during the autumn. The refurbishment of Churchman House, in partnership with Norwich City Council, is going to last around ten months. The anticipated opening of the hub is April 2019.
Questions?