Mental Health Integration Project

Project Initiation

Document

Version: Updated

Date: August 2009

Status:

Author: Jane Meredith Joi Demery

Index

1.Introduction

1.1Background

1.2Strategic objectives

2.Business Case

3.Project definition

3.1Project Scope

3.2Objectives

3.3Constraints

3.4Assumptions

3.5Dependencies

3.6Acceptance Criteria

3.7Tolerances & Exception Criteria

4.Project Organisation

5.Reporting Arrangements

5.1Phase 1 – Project Initiation

5.2Phase 2 – Service Model Development

5.3Phase 3 – Consultation

5.4Phase 4 – Service Delivery Planning

5.5Phase 5 – Implementation

6.Reports

6.1Progress Report

6.2Exception Reports

6.3Risk Log

6.4Issues Log

1INTRODUCTION

1.1Background

Mental Health Services are required to meet the needs of local people against national standards of care. Services should be organised in ways which promote the highest level of mental health and well being within the community as a whole.

The Mental Health Team for Adults of Working age currently provides a mental health service to all service users and their carers within South Gloucestershire, who have severe and enduring mental illness. The service users meet the FACS criteria for critical or substantial need. The team assesses their identified needs and develop a care plan to meet those needs which is reviewed and reassessed as required.

As part of the National Service Framework for Mental Health and the ‘Modernising Mental Health’ White paper, the Building Bridges (1996) and still Building Bridges (1999) the expectation is to have joint systems for planning care which would most effectively be provided by joint community mental health teams.

One of the recommendations made by the MN inquiry report 2006, which were accepted by the South Gloucestershire Council, and Avon and Wiltshire Partnership (AWP), concerned the operational integration of Adult Mental Health Services. The inquiry recommended that: ‘The Trust and South Gloucestershire Council should ensure that significant progress continues to be achieved in the operational integration of mental health and social care adult care mental health teams no later than 31 March 2007. Since this date significant progress has been madearound joint training, Care Pathways and the single point of entry. Work has been undertaken to agree systems that need to be in place for IT, Finance and Management structures.

There have been a number of changes in the wider organisational context which includes the Personalisation and Transformation Agenda. Within AWP there is the implementation of a new IT systems RIO which should provide an IT solution and there has been a review of the Community Teams. Work has been completed across the 6 LA’s to agree consensus on key elements of a service specification.

Due to the changing context in which we are working as outlined above the project board have agreed that the formal agreed date for integration will now be 1stApril 2010.

The aim of this project is to work in a more integrated way and this could be achieved via either of the following options:

Option 1

Co-alignment of staff management, policies and procedures, with Local Authority

staff remaining in the employment of the Local Authority, and responsibility for all Social Care will remain with the Local Authority.

Option 2

Local Authority staff are seconded to AWP under Section 75 agreement to provide fully integrated service. A robust secondment arrangement will be put in place to support staff, details of which will be agreed if this option is pursued.

Staff Terms & Conditions will remain with the Local Authority while the day to day management will be with AWP.

Option 3

TUPE (the Transfer of Undertakings (Protection of Employment) Regulations 2006). The transfer of South Gloucestershire Council employees currently working in the Mental Health Team for adults of working age to AWP to provide a fully integrated service.

All staff would be managed by AWP and AWP would undertake all social care responsibilities on behalf of the Local Authority

1.2Strategic Objectives

In the Community Care departmental plan for 2004 – 2008 The Council has a strategic plan to develop an integrated management model of service in partnership with AWP Trust and the PCT for Mental Health Services for Adults of working age. This is a shared vision by AWP, South Gloucestershire PCT and the Local Authority.

2 BUSINESS CASE

  • For the past 10 years there has been evidence from National Service Framework for Mental Health and the Modernising Mental Health White Paper, the Building Bridges and Still Building Bridges, that a single point of entry into services for people with mental health needs gives service users and their carers a more accessiblepathway into the care and resources that are needed. This is the model of care which South Gloucestershire PCT is committed to commissioning, in line with national mental health policy, the Personalisation and Transformation Agenda and the Dharzi Review.
  • The integration of health and social care within the mental health service will deliver more accessible services to service users and carers; they will receive a standard response regarding the Joint Eligibility Criteria.
  • There will be a single point of entry into the services and a single pathway that is accepted and used by all staff through services and resources. This will lead to an improved service for the service users and their carers.
  • There will be financial implications to changes in IT systems, reconstructing joint teams and joint management. However once these systems are in place the use of single systems for management, IT systems, administration, and resources will mean that there will be efficiency gains in both time management, finances and resources.

3PROJECT DEFINITION

3.1 Project Scope

In Scope:

  1. Consultations with staff, unions, service users and carers.
  2. Communication with all relevant parties.
  3. Assessment of sustainability implications and racial and cultural impact.
  4. Efficiency gains in time and resources (e.g. single point of entry).
  5. Efficiency gains in use of single IT system.
  6. Investigate the delivery and management of the Approved Social Work Service/Approved Mental Health Practitioners.
  7. Interface points between CAMHS and Adults of Working Age.
  8. Definition of the elements of the service that are transferring.
  9. Cost of IT systems, training and team building.

Outside Scope:-

  1. Services from the Local Authority unrelated to Mental Health for Adults of Working Age,
  2. Services for Older People’s Mental Health team are not included in the integration plans.
  3. Transfer of community care budgets.

3.2 Objectives

Project Outcome Objectives are:

  • Formally integrated services between Avon and Wiltshire Partnership and the Council for the mental health services for adults of working age by 1stApril 2010.
  • Mental health services for adults of working age provided in the most efficient and effective way to a consistently high standard and in line with the Personalisation and Transformation Agenda.
  • Services accessed through a single point of entry.
  • Approved Mental Health Professional Service will be managed through the integrated system.
  • Service users are enabled to access services and resources that offer independence and choice.
  • Services have a focus on improving social inclusion.
  • High levels of service user and carer satisfaction.
  • Coordinated services – linking with other agencies.
  • To ensure that staff and resources from both AWP and the Council are being utilised in the most efficient, effective and appropriate manner.
  • To ensure robust Performance Management recording is in place to monitor performance.
  • To ensure robust Financial Management systems in place to make certain that budgets are not exceeded.
  • Interim arrangements for the IT systems will be in place pending the implementation of RIO within AWP.

3.3Constraints

  • The project has a completion date of 31stMarch 2010
  • The budgets are fixed for the Mental Health Team for Adults of Working age.
  • Work by the Project Team members will be done alongside existing responsibilities.
  • Resources will be needed for operational training team building as well as finances to pay for IT systems and any Human Resources issues.
  • There is agreement between AWP and South Gloucestershire Council regarding the transfer of staff.
  • There is a changing national agenda which may impact on this process.
  • Agreement between the 6 LA’s to have a similar approach to the Service Level Agreement.

3.4Assumptions

The following assumptions have been made which could impact the project if they prove to be false.

  • The future budget will be assumed to be equivalent to the current budget but with an increase for inflation. No account will be made by this project of costs that increase beyond the level of inflation.
  • The amount of service users and carers requesting a service will increase in line with the population growth within South Gloucestershire.
  • No more than normal attrition rate for staffing will take place
  • On going political support for integration.
  • The preferred provider will be AWP on the basis that South Gloucestershire Council already has a working relationship.

3.5Dependencies

  • The development of an integrated service will be dependant on Avon and Wiltshire Partnership and the Council coming to an agreement over terms and conditions for staff and resources that will become part of AWP.

3.6Acceptance Criteria

These are the criteria on which the project will be accepted as complete.

  • A service model is defined and is proven viable through investigation and assessment, with engagement of services users and carers through the Mental Health Local Implementation Team (LIT) and other forums as required.
  • Contractual arrangement has been agreed.
  • An implementation plan is developed to deliver the integration for approval by the Cabinet.
  • The integration of health and social care within the mental health service delivers easily accessible services to service users and their carer.
  • They will receive a standard response regarding the Joint Eligibility Criteria.
  • There will be a single point of entry into the services and a single pathway that is accepted and used by all staff through services and resources.
  • There will be a single management structure, which will enable the processes and procedures to be followed in a structured and consistent manner.
  • Financial matters will be managed in a transparent manner.
  • Statutory reporting of performance will be undertaken.

3.7Tolerances and Exception Criteria

An overall tolerance of plus/minus 2 weeks will be allowed within each stage of each phase of the project. If this tolerance is breached (i.e. if any stage of the project is forecast to run 2 weeks under or over schedule) this will be restructured and agreement from the boards will be sought.

4.PROJECT ORGANISATION

Project Board
Role / Name
Sponsor / Dave Crook/Lindsey Scott
Project Assurance / Mike Hennessey LA - Lynne Booth AWP
External Assurance / Roger Pedley PCT
Project Team
Role / Name
Project Manager / Jane Meredith LA – Joi Demery AWP
Team Members– Technical Support / Morag McMahon
Alison Howard-Evans
Team Members– Human Resources / Tanveer ChoudhryLA – Gwyneth Knight AWP
Team Members – Finance / Andrew Birch LA - Sam Robinson AWP
Team Members – Performance / Alan Sharp LA –Neil Manson AWP
Team Members – Operations / Joanne Denyer LA - Rowena Hastings AWP
Team Member – Contracts & SLA / Steve Peacock LA - Amanda Willis AWP
Team Members – Service User & Carers / Nicky Ridehalgh – Rethink
Mark Earl – Rethink
Debi Amor - Rethink
Team Members – Communications / Jane Meredith LA – Joi Demery AWP
Work Group – Service Integration / Jane Meredith
Joi Demery
Joanne Denyer
Rowena Hastings
Neil Manson
Jean Grant – Joint Commissioning Manager LA/PCT

5REPORTING ARRANGMENTS

The project will be delivered in 5 phases:

5.1Phase 1 – Project Initiation

It is summarised in this document – the Project Initiation Document (PID) – for approval by the Project Board. The PID documents the Project Structure, Roles and Responsibilities, the Objectives, the Scope, and the Reporting, Quality Assurance and Change Management processes. The PID will be reviewed towards the end of each Phase to ensure it is still fit for purpose; any changes will be subject to the approval of the Project Board. A copy of all draft and approved versions of the PID will be maintained in the Project’s Configuration Management system.

5.2Phase 2 – Service Model Development

The development phase is likely to be broken down intostages

  1. Investigation of how integration could be provided and any implications Completed
  2. High level planning for integrationOngoing
  3. Assessment of efficiency/cost saving initiatives Ongoing
  4. Initial consultation has taken place with Service Users, Carers and staff, following which it was identified that further work is needs to be undertaken at a strategic level. A further options paper is being prepared for the 26thJune 2009Executive meeting, and for the June AWP Board Completed
  5. Currently in a Consultation phase regarding the 3 Options for an Integrated mental Health Service, this is due to finish at the end of October 09 and a final report to be written by the 6th November 09.

5.3 Phase 3 – Consultation

The purpose of this phase is to widely consult with staff, unions, service users and carers. Further consultations will take place once the options paper has been agreed and signed off.

5.4 Phase 4 - Service Delivery Planning

The purpose of this phase is to develop the implementation plans for the proposed changes in detail. The plans are required to be approved by Cabinet.

5.5 Phase 5 – Implementation

It is anticipated that the Project will progress to implementation following approval of the implementation plans by Cabinet and AWP Board. This phase will therefore deliver the service changes.

6Reports

6.1 Progress Report

The Project Manager will produce Progress Reports for the Project Board outlining the current status of the Project. The report will include a summary of progress against Plan, a milestone status report and a summary of current significant risks and issues – particularly those that need resolution by the Board. The report will be submitted to Board members prior to each Board meeting.

6.2Exception Reports

The Project Manager will produce an Exception Report at any point during the Project where it is felt that the Project is unable to deliver within agreed tolerances. An Exception Plan will normally accompany an exception Report.

6.3 Risk Log

The Project Manager will circulate the log to all members of the project team risks can be added at the beginning of the project and updated at each project meeting.

6.4Issues Log

Issues Log to be circulated to all members of the project team issues can be added at the beginning of the project and updated at each project meeting.

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