South Gloucestershire Mental Health Crisis Care Concordat – Action Plan v.3
The Mental Health Crisis Care Concordat
- The Mental Health Crisis Care Concordatis a national agreement between services and agencies involved in the care and support of people in crisis. It sets out how organisations will work together better to make sure that people get the help they need when they are having a mental health crisis.
- Access to support before crisis point – making sure people with mental health problems can get help 24 hours a day and that when they ask for help, they are taken seriously.
- Urgent and emergency access to crisis care – making sure that a mental health crisis is treated with the same urgency as a physical health emergency.
- Quality of treatment and care when in crisis – making sure that people are treated with dignity and respect, in a therapeutic environment.
- Recovery and staying well – preventing future crises by making sure people are referred to appropriate services.
Click here to access the Crisis Care Concordat.
All references and guidance can be found here: Mental Health Crisis Care Concordat
The South Gloucestershire Mental Health Crisis Care Concordat action plan is a multi-agency plan. The plan sets out key actions to improve support to people presenting in mental health crisis in any setting in the community or in health, social care or criminal justice services. It is anticipated that the plan will change and develop over time. If you have any comments or additions please send them to:
Ref / Concordat Theme / Focus / Outcomes / Lead Agencies / TimeframeA / Access to support before crisis
A1.1 / Early Intervention – protecting people whose circumstances make them vulnerable / Communications campaign around mental health and associated services – making every contact count / New mental health web content for South Gloucestershire Council and CCG.
Communications campaign – South Gloucestershire Mental Health Network
GPs and key services will be informed about the service ‘offer’ and will support referrals to early intervention services. This ‘offer’ should also cover children and young people.
Annual communications plan agreed by Mental Health Partnership.
Mental Health Awareness Week Information Campaign across South Glos
Time to Talk e campaign on SGC website
Projects linked to Everybody’s Business Grants / South Gloucestershire Council (SGC)
SGC Department of Public Health (DPH)
Clinical Commissioning Group (CCG)
Communication
SG Mental Health Partnership / July 2015
A1.2 / People in crisis presenting at North Bristol Trust / For Southmead Emergency Department to be aware of South Glos services and provision.
To improve partnership working with the psychiatric liaison team and services in the community.
All services to be aware of drug and alcohol pathway.
To pilot support in the ED when new rotations start.
Information can be checked ensuring that South Glos AWP services are being called out of hours for South Gloucestershire residents. / CCG
Psychiatric Liaison team – NBT
Drug and Alcohol services
Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) / April 2015
August 2015
A1.3 / People presenting with Drug & Alcohol problems, who are admitted or in the ED at NBT.
Proactive cross promotion of services i.e. Mental Health & drug and alcohol / South Glos AWP will work jointly with the South West Clinical Network to includelocal mental information in111.
To ensure patients with drug and alcohol problems receive appropriate community services.
Better relationships between Drug & Alcohol and mental health services
– ‘Getting to know you’ eventNovember 2014
Mental Health attendance at monthly D&A panel
To publicise self-referral as a way to provide details of Service User organisations
2 days a week access to alcohol liaison nurse. / AWP joint bid
SGL Work-force Dev. Group
SG Drug and Alcohol services AWP
Developing Health and Independence
PHE
SGC
AWP / Tbc
June 2015
May2015
A1.4 / Improving Access to Psychological Therapies services (IAPT) / Improving access for BME, older adult groups
Continued development of services for people with Autism and people with a learning difficulty
Work via Healthwatch to consult different communities of interest about their experiences of IAPT.
Analysis of needs of IAPT service users through mental health cluster data and ICD 10 codes / CCG
IAPT providers / April 2015
March 2015
A1.5 / People with a learning difficulty with mental ill health / Audit against green light toolkit
Aim for October LDPB / CCG
AWP
Sirona Care and Health / Learning Difficulties Partnership Board Oct 2015
A1.7 / Appropriate and proportionate responses to individuals in mental health crisis / Implementation of the joint Police and Mental Health supervision group. Open to other agencies.
Continue commissioning of the Primary Care Liaison Service – providing early assessment and support for people in mental distress
Appropriate adult service – can services provide support to appropriate adult volunteers? / AWP
Police / October 2014
ongoing
October 2015
A1.8 / Strategic planning for vulnerable groups. / South Gloucestershire Mental Health Needs Assessment to identify local priority groups experiencing the biggest mental health inequalities.
South Gloucestershire Mental Health Strategy to outline of local approach to supporting priority groups who experience the biggest mental health inequalities. / Public Health – SGC and stakeholders
SGC DPH / March 2015
June 2015
B / Urgent and emergency access to crisis care
B1 / People in crisis are vulnerable and must be kept safe, have their needs met appropriately and be helped to achieve recovery / Support for people in crisis should be based in the community whenever possible.
B1.1 / People presenting with self-harm in the Emergency Department / Audit of ED presentation for the mental health needs assessment. Data available for the psychiatric liaison team 9am-5pm. Analysis of out of hours data to be investigated.
To be part of the mental health needs assessment and to be included in the analysis of the Suicide and self harm prevention steering group. / NBT and Public Health
Suicide and Self harm steering group / March 2015
B1.2 / People in secondary mental health services who suffer relapse. / Increase in the number of people with a crisis and contingency plan. / AWP
CCG / Monthly monitoring
B1.3 / People with a learning difficulty who relapse / Audit of individuals who have a crisis and contingency plan. / Sirona
CCG / Quarterly monitoring
B1.4 / Review of acute and psychiatric intensive care bed capacity / Acute bed capacity planning for short and medium term for South Gloucestershire residents. / CCG
AWP / March 2015
B1.5 / S136 detentions when individuals are intoxicated / Review of current audit of individuals who were intoxicated at time of detention and outcomes for those individuals.
Discussion of the audit findings at theSouth Gloucestershire Mental Health Service User and Carer Forum. / AWP
Avon and Somerset Constabulary
MH Service User and Carer Forum / March 2015
June 2015
B2 / Equal access
B2.1 / People with sensory loss / Awareness raising, recording of physical disabilities including information about support for people with sensory loss in new mental health communications. Accessibility of information and interpretation.
Healthwatch to undertake some targeted consultation with specific communities to find out their level of awareness of MH services including IAPT. / Primary Care
Sirona
AWP
CCG
Healthwatch / June 2015
May 2015
B2.2 / People from BME communities are underrepresented in commissioned IAPT services / Explore with BME representatives the barriers and solutions to registration and participation in IAPT services.
Healthwatch to undertake some targeted consultation with specific communities to find out their level of awareness of MH services including IAPT. / CCG with stakeholders / May 2015
B2.3 / Audit of people from BME communities accessing secondary mental health services / Audit of caseload and inpatient caseload data compared to prevalence in the wider community / AWP
CCG / February 2015
B2.4 / People with cognitive impairment or who lack capacity / Commission appropriate adult service. Funding transfer for appropriate adult service via the Better Care Fund from April 2015. / SGC
Avon and Somerset Constabulary
Brandon Trust / April 2015
B2.5 / Support to vulnerable adults who are sub threshold of statutory services / Co-commissioning project on community provision – Joint commissioning group reporting to Mental Health Partnership / SGC + Joint commissioning
Group / April 2015
B2.6 / English as a second language / Accessibility of information and interpretation. / All services / Ongoing
B2.7 / Gypsy and Traveller Community / The traveller liaison unit at Patchway Library and Police residents meetings. / Multi-agency / Ongoing
B2.8 / Mental health and primary care / Exploring provision from the community hubs in priority neighbourhoods and increase joint working with GPs and primary care team where space available and need / AWP
IAPT
Sirona
Primary Care / March 2015
B3 / Access and new models of working for children and young people
B3.1 / Earlier access to mental health support for children and young people /
- Have earlier access to CAMHS – re-look at criteria
- Have a 247 Service, ie text/email/phone/Facebook
- Access more help from School Nurses
- Give CYP access to Websites, posters, events & school lessons
- Friendlier access to GPs
- More counselling in schools
- More mental health and Drug Alcohol organisations in schools
There is also the new piloted service ‘Off the Record’ which provides a counselling service to South Gloucestershire Young People aged 11-15, based in three locations within South Glos.
Explore working with schools starting with children in Year 1 (5-6 yrs olds). To be looked at with the findings from the school mental wellbeing survey.
Development of one local Mental Health and EWB training offer promoted to all front line workers and volunteers.
Audit of counselling provision across SGC schools (secondary and primary)
Improved CYP mental health content including service access information held by all key partners
Develop a local Mental Health toolkit aimed at school staff, students and parents
Tier 1 support:
- Work on a 24/7 support service for CYP, i.e. websites/text/email/phone/Facebook/posters/events and school lessons.
- ‘Core’ offer for counselling services in schools and better access and support from School Nurses.
- Specific MH training to staff working with YP (a lot of training focus in adults)
Tier 2 support :
‘Off the Record’ is providing a new counselling service to South Gloucestershire young people aged between 11-15 years, based in three locations within South Glos. / SGC DPH
CCG / July 2015
Pilot running
B3.2 / Increasing support for young people in crisis. / Fixed term NHS England funding secured for Bristol and South Glos for a Crisis and Assertive outreach service for young people. This will allow the current CAMHS Provider (Community Children’s Health Partnership) to explore more intensive models of support and extended hours working. The pilot will be evaluated and will inform re-commissioning plans for community children’s health services. / CCHP
CCG
B3.3 / Equal access for young people / Participation work is undertaken by Barnardos who are in partnership with CCHP (NBT). One area of their work is to provide engagement with ALL children and young people for all circumstances and backgrounds.
School Health Survey to provide clear audit of local need broken down by geographical areas, gender, ethnicity and age group. / NBT
CCG / Completed
April 2015
B3.4 / Supporting young people in crisis / Tier 1- Core ‘offer’ for counselling services to be developed for all schools.
Tier 2 - ‘Off the Record’ currently providing a counselling service to South Gloucestershire young people aged between11-15 years, based in three locations within South Glos.
Tier 3 – The Community CAMHS service runs on a referral basis with resulting waiting times. The hospital CAMHS team is based at the Bristol children’s hospital and is available for assessments from 9am to 5pm Monday to Friday.
Tier 3.5 - There is an on call CAMHS consultant for out of hours consultations at the children’s hospital or on the telephone should an emergency situation arise. This can be accessed by GPs, social care and other health professionals where appropriate.
Tier 4 – Inpatient service commissioned by NHS England. / SGC
SG CCG / Completed
Completed
Completed
Perinatal mental health / Perinatal mental health - there is an emerging national focus on perinatal mental health services, it is a key priority, and it features in the ‘Forward View into Action’ planning guidance for 2015/16. The Maternity and Children Strategic Clinical Network is carrying out a piece of work to develop a regional consensus as to the way forward for these services in the South West.
A questionnaire was circulated to gain a better understanding of the current provision of perinatal mental health services across the South West. From this the Network has created a vision for perinatal and infant mental health services in the South West, with suggested actions and the prioritised list of standards from the NSPCC Prevention in Mind document. This will be taken forward by the Network and the CCGs. This will be BNSSG wide for SG.
B4 / All staff should have the right skills and training to respond to mental health crises appropriately
B4.1 / Awareness of Mental Health & Learning Disabilities / To increase the number of multi-agency staff with mental health and learning disability awareness.
Development and roll out of bite size mental health awareness courses
Police are able to recognise different vulnerabilities – ongoing programme via the joint supervision group with AWP.
LD Awareness is providing training to a wide range of groups and organisations. They are also facilitating the support/training for the Autism Innovations. / Multi-agency training group
SGC Workforce Training Team / June 2015
Ongoing
B4.2 / Restraint under the Mental Capacity Act / Multi Agency training to increase the knowledge of the use of restraint under the Mental Capacity Act.
Module MCA training 3rd module deprivation and deportation and restraint – 6 Cs / SGC
Multi-agency training group / Ongoing
B4.3 / Improve confidence of emergency department staff to support people with a learning disability. / Delivery of an action plan agreed between the LD liaison nurses and the ED clinical team / Sirona
NBT / June 2015
B4.4 / BME Community / Knowledge and skills framework working with BME communities. Multi-agency training / SGC workforce training team
B4.5 / Improving skills and competencies of multi-agency staff to work with children and young people in mental health crisis. / Multi-agency training package on Mental health in children and young people. / SGC workforce training / June 2015
B5 / People in crisis should expect an appropriate response and support when they need it.
B5.1 / Commissioning of S136 Place of Safety / CCG to review commissioned capacity for 15/16
To expand to 0.67 space plus staffing requirements. / CCG / February 2015
B5.2 / People who use services and their supporters know who to contact in a crisis / Improve communications about primary care liaison service and mental health crisis service.
Recognition that mental health crisis is not a blue light response
Increase number of individuals with crisis and contingency plans
Information sharing built into assessment / AWP
B5.3 / Mental health inpatient bed capacity review / Findings from acute care pathway review to inform commissioning intentions for adult acute and psychiatric intensive care unit beds for South Gloucestershire. / CCG
AWP / March 2015
B5.4 / Carers / Triangle of Care implementation – in place in AWP potential to roll out Sirona CLDT team
Families will know who to contact in a crisis.
New Carers Strategy
Work with FAN @ DHT on this
Carers Charter – accessible information sharing governance regarding confidentiality
What about identification and support for Young Carers whose parents/carers have a mental health illness? / AWP
Sirona
SGC
CCG
CCG & AWP / Ongoing
April 2016
B6 / People in crisis in the community where police officers are then first point of contact should expect them to provide appropriate help. But the police must be supported by health services, including mental health services, ambulance services and Emergency Departments
B6.1 / Joint mental health & police provision group / Seeking community resolutions for frequent attenders
Shared risk management
Shared Training
Joint review of use of detention S136
Positive relationship building / AWP
Police + other stakeholders / October 2014 – ongoing
B6.2 / Implementation, monitoring and review of the S136 multi-agency protocols for both adults and children. / There is currently a PROTOCOL FOR THE MULTI-AGENCY MANAGEMENT OF PLACES OF SAFETY UNDER s135 and s136 of the MENTAL HEALTH ACT 1983. It is supported by Avon and Wiltshire Partnership NHS Trust, Bristol CCG, North Somerset CCG, South Gloucestershire CCG, Bath and North East Somerset CCG, Swindon CCG, Wiltshire CCG, Bristol Council, North Somerset Council, South Gloucestershire Council, Bath and North East Somerset Council, Swindon Council, Wiltshire County Council, Avon and Somerset Constabulary, Wiltshire Police, South West Ambulance Service. This pathway now also covers young people from ages 14-16 yrs. / Stakeholders as listed / Ongoing
B7 / When people in crisis appear to need urgent assessment, the process should be prompt, efficiently organised, and carried out with respect. / Implementation of the multiagency S136 protocol / Analysis of delays in assessment longer than 9 hours.
Shared ownership of data / AWP
LA
EDT (S136 Group)
Police
AMHP / January 2015
B8 / People in crisis should expect that statutory services share essential ‘need to know’ information about their needs
B8.1 / Multi-agency information sharing / Roll out of the South Gloucestershire Primary Care Green Folder scheme to mental health and learning disability service users. / AWP
Sirona Care and Health / October 2015