Mental Health Supported Housing Context and Analysis. 30 th March 2015

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1 Mental Health Supported Housing Context and Analysis 30 th March 2015

2 Overview Background and context Supported Housing provision Acute mental health demand Community mental health services demand Costs of mental health services Mental Health service coverage CPA Housing status Employment status How does this relate to making a CASSH bid?

3 Supported Housing provision Analysis available from CORE / Tenant Services Authority Historic supported housing data available from 2009/10 Housing Association 30,500 supported housing lettings 3,876 Local Authority supported housing lettings

4 Supported Housing provision Extent of support for people with mental health problems or learning disability People with mental health problems account for around 10% of total supported housing units People with a learning disability account for 14% of supported housing units

5 Mental Health inpatient beds Estimate of beds provided for Mental Health & LD in England Data is based on a census that took place in August 2014 Estimated completeness = 90% Includes NHS and independent sector provision Specialty Beds Percentage Adult Acute 7, % Older Adult 4, % PICU total % Eating Disorders % Mother and Baby % Low Secure 2, % Medium Secure 2, % High Secure % High Dependency Rehabilitation 1, % Longer Term Complex / Continuing Care 1, % Other Mental Health beds 1, % CAMHS 1, % Learning Disability 2, % Totals 27, %

6 Mental Health community team support Estimate of CMHT caseloads (Mental Health) in England Data is based on a census that took place in March 2014 Estimated completeness = 90% Community Mental Health Team England Total Generic CMHT caseload as at ,370 CRHT caseload as at ,991 Assertive Outreach caseload as at ,509 Early Intervention (incl Early Onset Psychosis) caseload as at ,353 Assessment & Brief Intervention (incl PMHT) caseload as at ,211 Rehabilitation and Recovery caseload as at ,548 Forensic caseload as at ,328 Eating Disorders caseload as at ,840 Mother and Baby caseload as at ,981 Older People caseload as at ,786 Memory Services caseload as at ,418 Other Adult CMHTs caseload as at ,873 Totals 725,208

7 Example benchmarking comparisons Adult acute beds per 100,000 registered population (16-64) (5% reduction in national & SHA means, 11% median reduction) Average bed provision of 21 adult acute beds per 100,000 registered population (16-64) Variation is evident across the NHS

8 Example benchmarking comparisons Bed reductions - Adult acute beds per 100,000 weighted population (16-64)

9 Example benchmarking comparisons Admissions to adult acute beds per 100,000 registered population (16-64), (minimal change) 2013/14 median admissions are 232 per 100,000 population YHNE peer group shown (199) 20% of admissions not known to MH services 10% via s136 2% of no fixed abode

10 Example benchmarking comparisons Mean length of stay in adult acute beds excluding leave (national increase) 2013/14 mean average length of stay is 32 days National increase from 30.2 days in 2012/13

11 Example benchmarking comparisons Unplanned re-admissions to adult acute beds per 100,000 registered population (16-64) (marginal reduction) 2013/14 mean readmissions = 8.8% 2012/13 rate = 9%

12 Example benchmarking comparisons Adult acute bed occupancy 2013/14 excluding leave (national increase) 2013/14 median bed occupancy increases to 93% from 89% in 2012/13 3 rd consecutive year of occupancy increase

13 Example benchmarking comparisons Adult acute delayed transfers of care 2013/14 delayed transfers of care account for 4% of all working age adult mental health bed days & 7% of all older adult bed days

14 Example benchmarking comparisons Community Mental Health Teams - Contact levels per 100,000 population 2013/ /14 46,500 contacts per 100,000 population for all CMHTs 76% are face to face contacts YHNE peer group = 54,000 CMHT Referral acceptance rates average 78%

15 Benchmarking Specialist Beds Profiling inpatient costs Bed Type Average cost per admission Adult Acute 10,900 Older Adult 28,000 PICU 42,000 Low Secure 361,000 Medium Secure 338,000 Eating Disorders 59,100 Mother and Baby 37,700 High dependency rehabilitation 449,000 Longer term complex / continuing care 560,000

16 Benchmarking Community Services costs Profiling CMHT costs CMHT Type Average annual cost per service user on caseload Average cost per contact Generic CMHT 2, Crisis Resolution & Home Treatment 184 Assertive Outreach 9, Early Intervention 6, Assessment & Brief Intervention 248 Eating Disorders 5, Mother and Baby 2, Older People 3, Memory Services 1,

17 MHMDS Population in contact with MH services Circa 2,000 patients registered with secondary mental health providers per 100,000 population Five fold range evident.

18 MHMDS Population on CPA CPA levels average 500 patients per 100,000 population

19 MHMDS CPA coverage of patients Approximately 24% of people in contact with secondary mental health services are on CPA

20 MHMDS People on CPA in settled accommodation per 100,000 registered population Approximately 240 people (per 100,000 population) aged are in settled accommodation

21 MHMDS % people on CPA in settled accommodation Approximately 65% (median) of service users aged on CPA are recorded as being in settled accommodation

22 People with mental illness or disability in settled accommodation On-line resources Interactive charts and benchmarks available in Commissioning for Value flash/atlas.html

23 MHMDS % people on CPA in employment Approximately 7% (mean) of service users aged on CPA are recorded as being in employment

24 How to use the data in developing your bid Identify your position on available national metrics MHMDS Commissioning for Value NHS Benchmarking Network Formulate your case Identify the case for change Benefits for service users Business case and financial value to be gained Partnership proposals to deliver your supported housing units Timescales

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