Options for Support Brokerage in MH
For: Oxfordshire and Buckinghamshire SDS Project Board
Date:16th August 2010
Author: Marion Taylor, Project Manager
Purpose of this paper:
To outline progress to date in relation to the Customer Journey in each county and to identify key issues for further work and development
Background
Each County Council now has an agreed “Customer Journey” for Self Directed Support, and within Mental Health, the systems and processes needed to implement SDS have been reviewed, and the pathway for Mental Health service users within secondary care has been agreed and implemented. These are attached as Appendix 1 and 2 to this document.
Issues for development:
Scope:The current customer journeys do not include those clients with relatively stable Mental Health needs who are not currently in receipt of secondary services, or are not on CPA (who may be receiving regular support in Primary Care, or may self refer). The two counties take somewhat different approaches to this currently – in Buckinghamshire people are held on CMHT caseloads and reviewed every 6 months by a “Reviewing Officer” – in Oxfordshire there is universal access to some day opportunities and so people access from Primary Care/Self referral routes. Consideration needs to be given to this group – and who is responsible for assessing, supporting and reviewing.
Eligibility:The issue of identification of those clients that are eligible is more complex in Mental Health than for other client groups. Currently in both counties the initial CPA assessment does not cover a full social care needs assessment, but does give a basic screen for eligibility, this screen triggers the more full social care assessment. The question here is about whether to include a more complete screening tool within CPA that will identify social care needs and then identify whether these needs are eligible under the FACS guidance, or whether staff are adequately trained in initial screening..
Reablement Activity: The Customer Journey in both counties has an implicit assumption regarding reablement, which occurs either in primary care, or following initial assessment, and prior to the instigation of SDS in secondary services. Both counties need to develop and make explicit this element of the Customer Journey.
Integration with CPA: In both counties the current process sits within CPA, but is not fully integrated into CPA (ie, Social Care Assessment happens following CPA Assessment, support plans are developed in conjunction with CPA Plans, and review is conducted at the same time). Both counties are currently seeking to review the operational delivery of SDS within CPA.
Complexity of Task: The current processes involve quite a lot of steps for Service Users, their carers and Staff – and involve a wide range of people. This can be confusing for clients, and time consuming. Both counties will apply lean thinking to the systems during review of the customer journey, and consider this in relation to criteria for referral to different types of brokerage etc.
Next Steps
Both counties are currently seeking to review the existing Customer Journeys (Appendices 1 and 2).