Luton s mental health and wellbeing (with a bit about Bedfordshire & Milton Keynes)
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1 Luton s mental health and wellbeing (with a bit about Bedfordshire & Milton Keynes) Loraine Rossati Assistant Director, Personalisation & Mental Health Luton Clinical Commissioning Group
2 Primary Care Mental Health & Well Being Mental wellbeing is everyone s business! In Luton, one third of the population of a [GP practice] Cluster will at some point experience mental ill health. No of People Per Cluster Mental Wellbeing in Primary Care in Luton 10,560 People with a Common Mental Health Problem 240 Est no: of People with Psychosis 5,280 Est no: of people with a Personality Disorder Est no: of people with a Long Term Condition with a Comorbid Mental Illness 3,750 Est no: of people with MUS (Medically Unexplained 3,000 Symptoms) 22,830 Total
3 Gatekeeping function Onyx 22 Crystal 18 Coral 28 Jade PICU 9 Place of Safety Sec 136 Street Triage Assessment for admission Psych Liaison 1-hr referral L&D Hospital Early Intervention in Psychosis (1 team covers Luton & Beds) Routine 28 days CMHT 1 Urgent 72 hours Early Intervention in Psychosis (1 team covers Luton & Beds) Routine 28 days CMHT 2 Urgent 72 hours Earlier discharge Early Intervention in Psychosis (1 team covers Luton & Beds) Routine 28 days CMHT 3 Urgent 72 hours Early Intervention in Psychosis (1 team covers Luton & Beds) Routine 28 days CMHT 4 Urgent 72 hours CRISIS HOME TREATMENT (CRHT) / DUTY SENIOR NURSE Luton s current mental health provision with ELFT IAPT WELLBEING SECONDARY CARE PRIMARY CARE Primary Care Link Wrkr Primary Care Link Wrkr Primary Care Link Wrkr Primary Care Link Wrkr GP Cluster 1 Larkside GP Cluster 2 Kingsway GP Cluster 3 Medics United GP Cluster 4 South East Luton
4 Luton Improving Access to Psychological Therapies service (IAPT): ethnic profile of clients
5 Transforming health in Luton MDT Social Care
6 The STP what s it all about? Sustainability & Transformation Plans are an NHS England initiative and give local NHS organisations and local councils the opportunity to work together to improve the way health and social care are designed and delivered so local people receive the best possible service. Luton is part of the Bedfordshire, Luton & Milton Keynes STP area. 12 NHS organisations and 4 councils have been working together to meet the Five Year Forward View triple aim of: (1) delivering improved health and wellbeing (2) transforming quality of care delivery and (3) making NHS finances sustainable. STP sets out the vision for future health and social care in BLMK: Make sure patients and their needs are at the heart of the care we plan and provide Improve our services by working with patients more effectively Plan for the different ways patients want to access our services Help people take greater control of their own health and wellbeing (and we must do this within the money available to us). No decisions will be made without further discussions with: Service users, public, staff, local elected representatives, third sector organisations Formal consultation on any major service change, or decision that impacts staff.
7 Health and social care in BLMK Almost one million people live in the BLMK area 160,000 in Bedford Borough, 274,000 in Central Bedfordshire, 240,000 in Luton and 225,000 in Milton Keynes. Population The BLMK health economy is facing a number of challenges. We have a growing population which is also getting older. More people are living with long term health challenges, such as diabetes and arthritis, that cannot be cured but can be effectively managed. The quality of healthcare that people receive and also their general health and wellbeing vary across BLMK. We are also facing workforce shortages and significant financial pressures.
8 How the BLMK plan is addressing local health and social care challenges The BLMK plan has brought together 16 partners to look collectively at how we can: break down the boundaries between our local health and social care systems address problems that threaten our clinical and financial sustainability, and develop ideas and priorities to transform local services. 8
9 Some facts & figures about BLMK Care and quality across BLMK GP practices in BLMK have more registered patients per GP than the national average, which can mean some patients have difficulty getting an appointment. Our workforce is ageing and we face challenges recruiting health professionals in primary, community and social care. Patients are not always clear how to access urgent care services, with a number of different organisations operating NHS 111 and GP out-ofhours services across BLMK. Hospitals are struggling to meet demand while maintaining national standards. Ambulance performance, in particular their ability to meet national standards for attending emergencies, is under severe pressure. 9
10 The financial challenge in BLMK Funding and finance across BLMK The current combined annual budget for health and social care is 1.33bn. The good news is that we expect to see this funding rise to 1.67bn by 2020/21, an increase of 26%. The not so good news is that, if we don t change anything, this increase will be absorbed by rising demand for services. More than half (60%) of the current budget goes on hospital services and specialist care. The remaining 40% funds care in community settings and in the home, with mental health (9%), primary care (9%) and prescribed medicines (9%) accounting for the lion s share. Around 31% of our budget supports the 2% most complex people. Approx. 74% of the budget is spent on 20% of the population. Financial challenge: If we don t make changes, by 2020/21 our spending will exceed our income by 311m a year. 10
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