Minutes of a meeting of Talk Wandsworthheld on 8th June 2017 11amat the Talk Wandsworth Hub.
Present:
Malik GulDarren Fernandes
Gareth Jones
Heindrik Hinrichsen
Grant Kennedy
Mohamed Ali
Ruth McKinney
Martin Haddon
Dr. Momotaj Islam
Lystra Charles
Naseem Aboobaker
Joan Robinson
Dorrett Boswell
Freddie Brown
Catherine Mutala
Dr. Carlis Douglas / (Chair) Wandsworth Community Empowerment Network
SWLSTG Coproduction Lead
TW Business Manager
TW Clinical Lead
Putney Wellbeing Friends
Elays Network
WCEN
Healthwatch
WCEN
Hope Atrium
Mushkill Aasaan
Balham Seventh Day Adventist Church
BME Mental Health Forum
New Testament Assembly
Mind
Hope Atrium
Apologies:
Darren BladesDr. Zakia Akhtar / ThamesReach
Muslim Network
1. Welcome & Introduction:
The group introduces themselves.
Malik Gul (MG) reflects on the previous meeting and the discussion around the pilot IAPT projects at Mushkil Aasaan, New Testament Assembly, Elays and St. John the Evangelist RC Church. He outlines the purpose of this meeting to get a sense of where the project is at, what is the baseline data, where do we want to get to?
Heindrik Hinrichsen (HH) adds that he wants to talk about wellbeing as a new arm to the service that helps increase access and early intervention and raise awareness. Carlis Douglas (CD) wants to hear more about what therapies are on offer and staff training programmes.
3. Talk Wandsworth Update and Programme
HH talks through the targets for the TW programme – the ‘givens’ that have to be met and those that the service develops that address local issues and ‘wants’. Gareth Jones (GJ) gives a full update:
Building: The TW hub has the refurbishment complete and just waiting for the IT connections to come into place and should open next week (week beginning 12.06.17). The service has continued out of Springfield Hospital and GP Practices so there has been no delay or gap in service delivery.
IAPT – worked out of Springfield and 26 GP Practices. TW will have more of a hub and spoke approach and work out of the hub and also the exiting 26 GP’s (the GP’s have been very positive about the IAPT service and conversations are beginning around them accommodating counselling services through the wellness centre).
The Hub has already held a service user forum and Saturday workshops which have been very well received.
Process: There are many ways to access the TW service: GP referrals or Self referrals through:
- Phone 0203 513 6264
- Website
- Walk in to the Hub – First Floor Office Premises, 56 Tooting High Street, SW17 0RN
Initial contact (with all routes of entry) will include a conversation with a member of the admin team to collect basic information, discuss the service and book into a triage session. Aim for the timeframe between referral to triage of 1 week (can be longer if need to send a letter to GP/no picking up on call backs etc). There is then the local target of treatment beginning within 6 weeks.
Dr. Momotaj Islam (MI) asked about those who would come in a state of crisis and whether they can be seen straight away and HH responded that they have protocols in place for this and Hestia Crisis Café is 5 minutes away so connections are being established here.
CD raises the concern that, especially with African-Caribbean communities, getting a ‘window’ where the person decides to seek help can be short lived if there are long waits involved where a person can then get ‘cold feet’. HH agrees and responds that there are many people who access their serves who are on that verge of ‘do I/don’t I?’ and IAPT is a big step – an admission you cannot do it by yourself. Sometimes it can be better that someone only accesses once they are ready otherwise they tend to dropout and this links well with the wellbeing level – shorter, informal, ‘go along and check it out’ interventions. Grant Kennedy (GK) agrees that this softer entry point could be a big idea and can become a major part of IAPT.
Mohamed Ali (MA) raises the concern about language and how the service can deal with the diverse populations. Is there an age limit to the IAPT service? Freddie Brown (FB) agrees that the staff should reflect the community. MG responds that part of the coproduction work with this project is that the service works with these communities and we develop ‘partners’ in the community who are informed, advise, refer and ‘front’ the service. HH agrees that we should get the community to come to the hub (to visit of to make use of the group apace/rooms) and the hub to go into and meet communities. This needs to be secured with proper management and granular details.
GJ continues to talk about the targets they have been set – from NHS England have the Prevalence estimate set – 44,000 people in the Borough appropriate to access TW. Last year they had the target of 12.6% of this 44,000 = 5,500 people to engage with. This year the target is 16.8% (7,500 people) to be identified and supported by Talk Wandsworth. This will rise each year to 11,000 people to be been in 2020. This is a huge number of people to identify, engage and support. Additional funding will match these increased targets. Recovery level will be defined by initial and completion assessments. 50% need to meet the ‘recovery’ level.
GK asked whether the numbers for the wellbeing process would be included in these figures and HH responds that in other places they have been included as they ‘received support’ and this is something that needs to be looked at when this develops.
HH talks through what the service offers – 1-2-1 sessions and group therapies and different options within these to help the patient receive the best option for them to learn the skills. Group sessions range from shorter (4-6 week) courses or longer ‘seminars (8 to 10 weeks) and 1-2-1 of up to 12 sessions with a trained clinician. There are new internet based apps – Ieso and Silver Cloud – that are proving very effective for some people who want more of a message based/online way to learn skills to help manage their conditions. These are followed up with a session with a Therapist every 2 weeks to monitor progress. Group sessions were proving increasingly popular over 1-2-1 sessions as it brings together many stories and people help each other.
Action Point: Next step is to establish a project management plan and a detailed workstream of coproduction with communities.
4. Culturally Adaptive TW
MG comments that social circumstances have a huge impact on a person’s mental health and wellbeing – such as poverty and inequalities. HH agrees and says that some of these services are focused more around building skills to cope with a condition as best they can within the circumstances they are in. It is difficult to affect the wider circumstances but they can help people to deal with them and cope.
Dorrett Boswell (DB) talks about the Service going out to communities as opposed to people just going to TW. She talks about people who are in contact with health services but their wellbeing is still low – what can be done to help these people? Communities and people are already doing some 1-2-1 work but can often be disengaged as they don’t know how to support them. How can this fit into the service? Education for better conversations etc. GK responds that this can be done as community led wellbeing seminars for the Trust – ‘how to access people in Tooting’ etc. A transfer of skill and MH spoke about 2-way learning/conversations between TW and communities on how to access and support each other and the different circumstances/settings involved.
MG agrees that there is scope for a ‘new level’ of work below TW from within the community – needs to be squared with TW outcomes and targets.
CD comments that TW could be useful for those coming out of services but there is a lack of knowledge out there about what help is available.
HH comments about the value of teaching and how some teachers/therapists can be very good at listening etc. – a teacher’s effectiveness helps the person to learn and this is an art. The 2 way learning between the Trust and Communities will increase the value of the teacher. This ‘teacher/enabler’ could be someone in the community rather than within the service. MG gives the example of the Mushkil Aasaan (MA) IAPT pilot where Anna came to ‘teach’ and Dr. Zakia Akhtar brought Islamic teaching into the session and this represented great 2-way learning for the community and Trust and meant that people were engaged with the programme. This can be culturally adapted for other groups. HH agrees and comments that this would involve an openness from both sides and a governing framework in place to mitigate risk. Naseem Aboobaker (NA) confirmed that the Mushkil Aasaan IAPT course was coproduction in a real sense – the syllabus was given to them through Anna and enhanced by MA. GK adds that it is a great idea to have TW expertise on one side coming together with the cultural sensitivity on the other. This is effective and is not changing the measurements/course material but adapting how it is delivered.
HH comments that working in communities through group sessions is backed up by the evidence that this is the most effective way for learning and a move away from the ‘luxury’ idea of 1-2-1 therapy. CD responds that there can be a challenge to those who do not want group therapy/to open up and talk to many people. NA responds that often groups help people to open up and there are 1-2-1 options available at TW too. MA responds that this could be a space where the wellbeing work could help – people come along to an informal session, get information from people they have already spoken to – less daunting.
Action Point: Identify community facilitators able to culturally adapt as part of the coproduction workstream
5. Well Being
HH tells the group about the wellbeing work that is being done in Sutton. Sutton IAPT have a fully established wellbeing service sitting in front of IAPT – growing rapidly and very popular. The staff satisfaction is huge and they are now treating 1/3 of all patients to the service.
They initially went to the community and learned from the community what they wanted wellbeing seminars on and these proved different to those they had initially thought.
Referrals are made in the same way as the TW service and offered a wellbeing assessment – 20 minutes on their strengths, interests, hobbies, goals etc. There are then a variety of workshops that are offered from short 1-2 hours with top-tips and no commitment, to some that may be 1-2 weeks. They are very flexible in terms of time/venues. Overtime in Sutton these have become very community based and also have workshops in GP’s. People can attend as many as they want – more casual and can help resistant people get into the service or can help people in and of its own self. They build on people’s interests and hobbies and aim at improving wellbeing.
This idea got a good reception from the group – it helps destigmatise, reduces the use of hostile language, is a softer route into the service, can help those on a level below TW, more relatable.
Action Point: Obtain list of wellbeing topics currently available and circulate.
Action Point: Invite wellbeing service in Sutton to meet with the group.
Action Point: Obtain TW data on who they are seeing – ethnic specific and underrepresentation.
Action Point: Develop governance frameworks for this work
Action Point: Look at recruitment process and how to be creative with the advertising to get a reflective workforce.
6. Date of next meeting
10th August 2017 12.30pm
5th October
7th December
Venue TBC