Greater Manchester Mental Health Crisis Care Concordat Action Plan
Greater Manchester Mental Health Crisis Care Concordat Action Plan
- Commissioning to allow earlier intervention and responsive crisis services
No. / Action / Timescale / Led By / Outcomes / Comments / RAG
Matching local need with a suitable range of services
1.4 / Service User Network Forum / On going / Laura Mercer
OPCC / Service User Network Forum themed events will be run across GM periodically to ensure that the user voice continues to inform the Concordat work. / Themed events will be held so service users from across GM can have the opportunity to share their views which will be gathered and embedded in the GM Crisis Care Concordat Action Plan. Health Watch will be providing an input also.
1.5 / Autism Awareness / On going / Adele Owen / GMP officers will be more Autism aware. / GMP has a signed off 2 hour stand-alone Autism/ Neuro Diverse training package. The National Autistic Society has seen the package and are very complimentary of it. Other Police Forces have requested it. This training package has been delivered to the OPCC Custody Volunteers and 250 Police Specials. It is also due to be delivered to the new recruits over the next few years. Roll out to front line staff is under consideration. GMP are also in talks with the National Autistic Society to be a Pilot Force along with two other Forces to work to specific autism standards. As of January 2017, these plans are still under discussion.
1.6 / Suicide Prevention / January 2017 / Andrea Fallon / GM Suicide Prevention & Bereavement Support Action Plan to be in place.
Local SP Action Plans also in place. / The draft GM Suicide Prevention Executive Action Plan was adapted to take into account the revised National Suicide Prevention guidance published Autumn 2016, ensuring the GM Plan met the National expectations. There was a GM launch event for the National guidance with all GM Boroughs held 4th Nov 2016 to share the recommendations as they produce their local plans. A GM Suicide Prevention Conference is planned for May 2017.
1.6.2 / Suicide Bereavement Support / On-Going / Nicky Lidbetter, Self Help / Suicide Bereavement Support / A Bereavement Course
Postvention Support Group is run by the charity Self Help.
1.7 / CYP Mental Health / Timescale to be confirmed / Sara Barnes / Description of service offer to Mental Health Implementation Executive, to include:
To co-produce and articulate a multi-agency and single system response that maps onto the Thrive model for CAMHS; developing an emotional well-being and mental health service for children, young people and those who care for them that is supported by locality wrap around service and provision that seek to prevent a journey of escalation and/or increasing severity and complexity.
The key principles of the emerging pathway are described below:
- GETTING ADVICE (COPING) - Prevention services across 7 days accessible through a range of mediums and in a range of settings
- GETTING HELP - Early Intervention and improved and timely access to support for a young person in distress. Aimed at reducing risk and enhancing early interventions. This evidence based approach will be underpinned by enhanced training and support for multi-agency teams who may be first responders or who are already engaged with the young person.
- GETTING RISK (INTENSIVE) SUPPORT – A flexible crisis response with access to risk assessment, advice and support 24:7 from a confident and well trained multi agency workforce with access to appropriate hospital and community based places of safety and/or intensive home treatment teams who can support young people in crisis in their own homes.
- GETTING MORE HELP - Follow up and prevention of future crises through effective multi agency care planning, improved access to evidence informed interventions and increased delivery of help in community settings including a young person’s home.
Improving mental health crisis services
1.15 / Local Concordat Delivery Groups / On going / Karen Maneely, Pennine MH / Regular partnership meetings take place however the frequency of these meeting differs from borough to borough and was mutually agreed. Updates from each meeting are feed in to the Bi-Monthly Trust wide Partnership Meeting. Membership of these groups are revised annually. The Concordat action plan is discussed and updated in each meeting. This action links to 1.14b.
1.15a / MMHSCT Local Concordat Delivery Group / On going / Glyn Hulme / Group established at MMHSCT to oversee concordat Delivery
Improved partnership working in X locality
1.16 / Rochdale/Bury triage services / On going / Umer Khan
Chief Inspector
Rochdale / A 24/7 MH Telephone Triage phone line service across two divisions. Working with NWAS (North West Ambulance Service), MH Commissioners and MH trust. PC also based at hospital to create links to the MH unit. / 24/7 Street Triage Scheme
The Mental Health RAID team covers Rochdale and Bury, providing 24/7 advice and support to frontline officers attending incidents involving people with mental health issues.
This scheme is a collaborative initiative funded by the Rochdale CCG - supported by Pennine Care - GM Ambulance Service and the Police
Evaluation parameters have been agreed, providing the success is replicated, the intention is to transform this into core service
Rochdale MH Crisis Care Concordat Group is in place and action plan includes adoption of a 'single door referral pathway'.
1.17 / Safe Sobering Units / Preparatory stages / Karen Maneely, Pennine MH / Initial engagement has taken place in all 3 acute trusts to scope out model and location of safe and sober units. / Units attached to A&E to support better crisis response. This action forms part of the CQUIN schedule for 2015-16. A dedicated project manager, senior nurse, is leading on this project with quarters 1 and 2.
A large scale engagement and scoping exercise has been undertaken as per the CQUIN across the Pennine footprint with a range of partners to gain a detailed insight into the views of a wide range of stakeholders with regards to issues, pressures, gaps in services and to discuss potential solutions specifically relating to pressures placed on urgent services including the police, ambulance and A&E by people who are intoxicated with minimal or no other identified health need.
In each borough stakeholder group/s were convened with key individuals invited from the relevant organisations including; Acute Trusts, GMP, NWAS, street pastors/ angels, PCFT, commissioners, local alcohol service providers and public health colleagues. The aim of gaining an insight into each organisations priorities with regards to alcohol related demand, existing service provision and plans for short term development, needs across the boroughs and pressures/ demand on services. It is acknowledged that further engagement work would be required with service users and patients if commissioners wanted to proceed with developing new service models.
It was evident in all boroughs that the development of a specific clinical Safe and Sober model/ service as outlined in the initial CQUIN schedule would not deliver the required outcomes to meet the presenting issues, nor would it be feasible within the current configuration of the hospital estate nor would it be financially viable for the levels of need and unpredictable demand. Therefore the scoping focussed on what services/ interventions could be developed to meet the local needs and compliment existing service provision/ local strategy. An end of year report was presented to commissioners which recommended considering expanding schemes such as the street angels/ pastors and also consider the approach taken in Tameside and Glossop with regards to licensing etc.
1.18 / Information sharing protocol with GPs / Suggested action / Sandy Bering / To enhance the support in place before crisis, agreed information sharing/confidentiality protocols should be in place with GPs, recommendations from DVHR’s should be linked in and mutual referral processes should be in place for identified individuals in need of support. / Being set aside for scoping and options appraisal.
2. Access to support before crisis point
No. / Action / Timescale / Led By / Outcomes
Improve access to support via primary care
2.0 / Peer Support A&E Volunteer Service / Joanne Harding, Self Help / The Peer Support A&E Volunteer Service
provides volunteer support in A&E
departments to clients awaiting a mental health assessment.
A&E departments often have long
waiting times and the waiting areas can be stressful environments. This service aims
to alleviate any additional distress that
a person may experience.
The service also aims to stop clients from
leaving the emergency department prior to assessment.
Peer support volunteers are able to work
with clients to create a care plan, tailored
to their needs, which decreases the
likelihood of them having to visit A&E in a
future crisis. / Peer Support A&E Volunteer Service is being introduced with consideration of roll out after evaluations are completed.
2.1 / Business case submitted to CCG for city-wide roll-out of successful Shared Point of Access pilot in Salford South, involving all Salford IAPT providers in order to improve waiting times and recovery rates. / March 31st, 2016 / Judd Skelton
Commissioner-led in partnership with GMW (Alison Harris –clinical lead for Salford Primary Care Psychological Therapies Service) and other providers / Roll-out to take place form 1st April, 2016 if recurrent funding is secured. / Access to Primary care NICE-recommended psychological therapies for common mental health disorders already available primarily through GP referrals to Six Degrees CIC or the GMW-provided Salford Primary Care Psychological Therapies Service. (However, this service cannot be seen as a step-down service for patients still at risk of suicide).
2.2 / Guardian Angel Dementia Buddies devices / Ongoing / Peter Harrison
(Wigan borough CCG) / Wigan CCG, GMF&RS and GMP are supporting the Good Deeds Charity with raising awareness of Guardian Angel Dementia Buddy devices. GMF&RS have covered funding costs for each person in the Borough with a dementia diagnosis to be given two devices of their choice, as part of the Dementia Friendly Communities programme. Devices (badges, bracelets, bag tag or key rings) are chipped and readable from most mobile phones when the NFC setting is open, providing a name and an emergency carer contact number once scanned. / The devices will assist Police, NW Ambulance Service, Fire Service and members of the public to contact family members promptly for people with dementia who may be found confused and alone rather than take to an A/E department.
2.3 / Raising awareness in GMP of Guardian Angel Dementia Buddy devices. / Ongoing / Adele Owen (GMP) in support of Mike Aldred of the Good Deeds Trust Charity / Dementia Buddy devices awareness in GMP / A 5 minute video box about the devices has been created and is accessible to all GMP Personnel on the GMP Intranet
2.4 / Raising awareness in GMP of Guardian Angel Dementia Buddy devices. / On-going / Paula Breeze
GMFRS (Fire & Rescue Service) / GMFRS to have access to the 5 minute video box about the devices
Improve access to and experience of mental health services
3. Urgent and emergency access to crisis care
No. / Action / Timescale / Led By / Outcomes
Improve NHS emergency response to mental health crisis
Social services’ contribution to mental health crisis services
3.1 / `` / ```
4. Improved quality of response when people are detained under Section 135 and 136
of the Mental Health Act 1983
4.4 / NWAS ERISS, system adapted for mental health patients and offered to mental health trusts / On-going / NWAS
(Point of contact TBC) / Electronic Referral and Information Sharing System (ERISS) has been adapted for use with patients who are known to mental health services. This system alerts attending Ambulance crews of care plans in place and appropriate contact numbers for patients in crisis, which can reduce Emergency Department attendances.
This system is available to all mental health care providers following a registration process. / The ERRIS system is ready to be implemented with Mental Health Trusts, this allows mental health providers to alert NWAS of care plans regarding MH patients, the attending ambulance crews are alerted to the fact patients have care plans in place and are therefore able to adhere to the care plans and advise police, who may be present, accordingly.
We are able to conduct demonstrations of this system, then we can facilitate the registration process and provide training, the system and all training involved is free of charge.
Now available to access.
Improved training and guidance for police officers
4.8 / Police Crisis Intervention Officers (CIO’s) / On going / Paul Nickeas
Greater Manchester Police / The skilling up of specific police frontline response officers in mental health issues through the development of roles akin to the Nightingale Officer role in GMP. The creation of ‘Crisis Intervention Officers’ whose role it will be to take more of a lead on mental health. / North Manchester Division initially trialled it with a small number of officers. Bolton have recently provided enhanced training (CRADLES) to 160 officers.
A randomised control trial is planned by GMP and evaluation outcomes will determine whether training is rolled out across GM.
Improved services for those with co-existing mental health and substance misuse issues
4.11 / Youth custody liaison and diversion. To ensure that there are clear care pathways for those aged 16- 18 years of age with mental health conditions. / On going / Divisional Youth Offending teams
Peter Robinson,
Criminal Justice Vulnerability Officer,
Greater Manchester Police / Support in custody for young people with mental health conditions. / Early stages of clarification of current landscape.
Integrated Healthcare in Custody will begin in GMP on 1st Feb 2017. Liaison & Diversion will follow.
5. Quality of treatment and care when in crisis
No. / Action / Timescale / Led By / Outcomes
Review police use of places of safety under the Mental Health Act 1983 and results of local monitoring
Service User/Patient safety and safeguarding
5.4 / Missing patient protocols / On going / Adele Owen, Greater Manchester Police / Now in place in a number of areas. Regular meetings held policies created. Showing significant reductions in some areas. / In place on a number of divisions. Regular local partnership meetings are also held. Significant reductions in missing person reports from hospitals in some areas.
January 2017- A GMP review is taking place to address the current numbers of patients reported missing from hospitals. / GMW
PEN
MMH
Other
5.5 / North West Regional Policy for Conveying Mental Health Patients / On going / North West Ambulance Service / A clear defined policy is in place with regards to the conveyance of patients with mental health needs in crisis. / A clear defined policy is in place with regards to the transportation of patients with mental health needs in crisis. It clearly defines the roles of ambulance service, police and mental health teams with regard to ensuring that patients should always be conveyed in a manner which is most likely to preserve their dignity and privacy consistent with managing any risk to their health and safety to other people and to other people. The current policy also includes time frames for a response.
Jan 2017- Regional Police Forces signed up to the Conveyance Policy have agreed its contents for further sign off but there have been delays with NWAS due to staff changes. NWAS now want to amend contents to remove time frames. NW Police have asked for further negotiation before they will agree to changes proposed but continue to work to the last Policy.
Staff safety
5.6 / Joint Working Protocol / On going / John Mytton, NHS Protect / National Guidance and a Joint working agreement between agencies to identify points of contacts and create understanding in terms of crime reporting procedures. / Guidance is soon to be shared nationally but local buy-in will need to be agreed.
Primary care response
6. Recovery and staying well / preventing future crisis
No. / Action / Timescale / Led By / Outcomes
Joint planning for prevention of crises
6.2 / Military Veterans Mental Health Services / On-going / Claire Carson of Pennine has the GM Contract. / Combat Stress presentation to SMHP Board- 31st March 2015.
Board members asked to ensure there is signposting for support for ex-service personnel in their own organisations and for service users.
Update from Jane Arands and Alistair Dawkins
RH sent email request 8.12.15
GMP Police Custody suites are aware of this charity and the Live at Ease charity for signposting and referral purposes.
Pennine Care run a Military Veteran’s Mental Health Service for GM.
6.3 / Pennine Service User/Carer Advice Line / Preparatory Stages / Clair Mcguire / An advice and support line is now available for all patients open to Pennine Care mental health services (over 16). This commenced 1st December 2015. It is important to stress that whilst the phone line is open to all Pennine care mental health patients over 16 there is a target group that it is designed to support as below: