Programme Report January 2016 Version 1.8

Transcription

1 South Region Early Intervention in Psychosis Programme Programme Report January 2016 Version 1.8

2 Contents 1. Introduction Purpose of Document Summary EIP Audit Specification Findings EIP Investment Status of Service Development and Improvement Planning EIP Structures Percentage of Caseload Allocated an EIP Care Coordinator within 14 Days of Referral NICE Concordance Workforce Performance and Outcomes Individual Provider Reports Discussion Recommendations Appendix 1 EIP Preparedness Programme Board Appendix 2 EIP Preparedness Programme Clinical Group... 22

3 Document Ownership and Status Document Owner Document Status Sarah Amani Draft Document Name and Version Control Versi on Date Authors Changes Included Sarah Amani First draft Sarah Amani & Sarah Roberts Frank Burbach & Stuart Clark Belinda Lennox,, Will Pank, Sarah Roberts, Sarah Amani Frank Burbach & Stuart Clark Updated summary and discussion Revised additions from EIP Commissioning Guide and related research evidence Revised to include EIP Service Development & Improvement Plan status Document Review Distribution List Forum Preparedness Clinical Group Preparedness Programme Board South Region Mental Health Priority Board (NHS England) Chair Prof. Belinda Lennox Fiona Edwards Julia Davison Document Approval [Persons designated with final approval and sign off of this document] Name Fiona Edwards Prof Belinda Lennox Title, Organization CEO, Surrey and Borders Partnership NHS Foundation Trust & Chair of EIP Preparedness Board South Region EIP Preparedness Senior Responsible Officer

4 1. Introduction Waiting times and access standards can be used to measure and improve services as well as identifying an expected standard of care. In physical health, the NHS Constitution guarantees patients right not to wait more than 18 weeks for consultant-led treatment, but mental health treatment has historically been excluded. For the first time, in April 2015 NHS England committed to waiting time standards for mental healthcare, supported by 80 million of investment targeting first episode psychosis in 2015/16. The new access and waiting time standards require health systems to ensure >50% of people with suspected first episode psychosis receive a NICE recommended package of care within 14 days of referral and will commence in April Early Intervention in Psychosis (EIP) Teams were originally set up as part of the National Service Framework for mental health in the late 90 s but despite mounting evidence of their effectiveness, have seen a significant decline in resources over the years. The new EIP access and waiting time standards mandate a reinstatement of EIP teams, with a statute to deliver the range of evidence based NICE recommended interventions Clinical Background The independent Schizophrenia Commission, established by the mental health charity Rethink Mental Illness, reported many deficiencies in the services for people with psychosis resulting in: Death years earlier than the general population. Only 1 in 10 who might benefit from cognitive behavioural therapy has access to it. Lack of employment opportunities; only 8% in employment. Inadequate support and recognition of the role of carers. Problems in the services for those with African-Caribbean or African backgrounds. A need to extend Early Intervention for Psychosis services. A need for improved prescribing. 2. Purpose of Document Developed in partnership with members of the South region EIP Preparedness Clinical group, the purpose of this paper is to provide the Board with a single report that establishes local levels of demand, current levels of performance against the new standard and the gap in terms of staffing, skill mix and training needs. The report intends to identify key areas of focus and also good practice, to help ensure equitable EIP services across the South Region.

5 3. Summary The findings in this report are based on data submitted by EIP teams in the South Region between August and September Whilst some of the results are encouraging and reflect the commitment and compassion of front line staff and managers, there are significant areas that cause concern and require urgent action. The data brings into stark focus the major investment needed to build the workforce capacity and skillset to deliver the full range of NICE recommended interventions within EIP teams. Of particular concern is the low provision of CBT for Psychosis, Family Interventions, and Individual Placement Support (IPS). Only 21% of the region s caseload has access to individual psychotherapy such as CBT for Psychosis. This is lower than the national findings of the National Audit for Schizophrenia (NAS2, 2014) which found a total of 29% of those accessing mental health services had access to CBT for psychosis. 1 Of the total 4,205 people accessing EIP services in the south region, only 17% have been able to access Family Interventions and 41% have received support to attain or retain their employment or educational activities. The above findings are unsurprising given the wide variation in the funding and staffing of EIP teams across the region. Differing commissioning priorities, provider history and practices appear to have culminated in a variety in structures and capacity of EIP services across the South Region and ultimately a vast difference in performance outcomes. 1 Report of the second round of the National Audit of Schizophrenia (NAS2) 2014

6 4. EIP Audit Following nominations to a region wide board, an inaugural meeting with representatives from commissioners and providers from the South of England was held on 15 th May 2015 (Appendix 1). One of the first decisions made by the board related to benchmarking the south of England EIP workforce, current demand and provision of services. It was decided that in the absence of any other EIP specific benchmarking tool that reflected the new standards, the programme would develop its own and encourage transparency in order to gather accurate data and share best practice. An online audit (the EIP Matrix: ) was developed in partnership with the Preparedness Clinical Group. 4.1 Specification The content of the EIP Matrix was generated by the nominated members of the EIP Preparedness Clinical Group (Appendix 2) who provided their expertise to develop the specification. The first section of the audit asked providers to list their EIP services, indicating the current caseload, age ranges and annual budget. The audit was further divided into three subsections covering: 1. NICE Concordance 2. Performance and Outcomes 3. Staffing and Workforce Training The EIP Matrix calculates percentages, using denominators and agreed thresholds to produce colour coded bar charts which indicate levels of achievement against NICE standards. Following its seventh and final iteration, the EIP Matrix ( ) was tested by the Oxford AHSN informatics team to verify accuracy and reliability. Instructions to register to use the Matrix were sent to the clinical group with guidance following final board approval. Access to the EIP matrix was controlled via unique identifiers and passwords assigned to EIP Clinical Leads as part of the registration process. Data submissions were received between 3 rd August and 1 st September Findings The findings in this section are from data submitted from the 16 providers of 32 EIP teams between 3 rd August and 1 st September The level of completeness of the audit by providers was generally high; however as with all self-reporting audits there were some issues with accuracy. Where there were discrepancies, the programme team verified the data with the submitting clinical leads. Some areas where the data was questionable included smoking cessation and carers support, this was identified as an issue in a number of organisations and was a result of smokers and carers not being identified and recorded accurately. There was one organisation unable to provide the data due to technical difficulties with their electronic health record and the fact that EIP services are currently provided within a generic Community Mental Health Team (CMHT), making information difficult to extract. In light of the differing commissioning priorities, resulting levels of investment, service development decisions, provider history and practice, there is a wide variation in the investment and structures of EIP teams across the South of England. This provides challenges in ensuring all EIP services in the South Region are able to meet the access and waiting time standards and highlights the need for focused activities specific to provider organisations.

7 5.1 EIP Investment The range of responses in the level of investment in EIP per 100,000 of the population (from highest to lowest investment) is as follows: Health Economy Served By Reported Annual EIP Budget Population (100,000) EIP Cost Per 100,000 Cornwall Partnership NHS Foundation Trust 1,246, , Berkshire Healthcare NHS Foundation 1,650, , Trust Sussex Partnership NHS Foundation 3,098,357 1, Trust 2Gether NHS Foundation Trust 1,179, The Zone (Plymouth) 379, , Isle of Wight NHS Trust 287, , Central and North West London Mental Health Foundation Trust (Milton Keynes) Surrey and Borders Partnership NHS Foundation Trust 359, , ,762,991 1,432 1, Oxford Health NHS Foundation Trust 1,364, , Kent and Medway NHS and Social Care Partnership Trust 2,323,208 1,969 1, Avon and Wiltshire Mental Health Partnership NHS Trust 2,123,926 1,900 1, Southern Health NHS Foundation Trust 1,643,339 1,458 1, Dorset Healthcare University NHS Foundation Trust 650, Somerset Partnership NHS Trust 406, Devon Partnership NHS Trust 651,012 1, Solent NHS Trust In addition to the data provided it is worth highlighting the challenges of providers working in rural areas. Cornwall Partnership NHS Foundation Trust and Kent and Medway NHS and Social Care Partnership Trust both cover a large geography with some highly rural areas bringing particular challenges of increased travel of clinicians, isolation of teams and also isolation of patients from central services. An increase in resource for the size of the population is likely needed in these areas. Health Economy Served By Reported Annual EIP Budget Total caseload EIP Cost Per predicted case 2Gether NHS Foundation Trust 1,179, ,306.02

8 Berkshire Healthcare NHS Foundation Trust 1,650, , Cornwall Partnership NHS Foundation Trust 1,246, , Sussex Partnership NHS Foundation Trust 3,098, Surrey and Borders Partnership NHS Foundation Trust 1,762, , Oxford Health NHS Foundation Trust 1,364, , The Zone (Plymouth) 379, , Isle of Wight NHS Trust 287, , Central and North West London Mental Health Foundation Trust (Milton Keynes) Kent and Medway NHS and Social Care Partnership Trust 359, , ,323, , Avon and Wiltshire Mental Health Partnership NHS Trust 2,123, , Southern Health NHS Foundation Trust 1,643, , Dorset Healthcare University NHS Foundation Trust 650, , Somerset Partnership NHS Trust 406, , Devon Partnership NHS Trust 651, , Solent NHS Trust The table above details the EIP cost per case across the 16 providers in the South Region. This ranges from 2, to 8, (Solent does not currently have a budget for EIP as it is a very small service with 2 staff based within a CMHT). The estimated annual cost for treatment in a fully compliant early intervention team is 8, By these calculations only 2gether Trust meets this level of investment. The NHS Benchmarking Network report Mental Health Benchmarking, Early Intervention in Psychosis Analysis. finds the mean spend across the country for 2014/14 as 6,926 and the median as 6, /16 National Tariff Engagement Document (2015) Accessed at:

9 5.2 Status of Service Development and Improvement Planning A summary of progress of commissioners and providers in committing resources (including time and funding) to develop SDIPs that specifically address the new EIP standards is as follows: RAG Rating Green Amber Red Organization Criteria Description* On track. Successful delivery of the EIP Service Improvement and Development Plan (SDIP) highly likely. There are no major outstanding issues that appear to threaten delivery significantly at this stage Significant concerns. Successful delivery is possible, however constant attention is required. Commissioner/s and provider/s need to address risks as highlighted below. Critical concerns. Achievement of the standards unlikely. There is an overall lack of clarity on who is leading on EIP standards at executive level and allocation of the budget required. Lead MH Commissioner has confirmed EIP uplift? Provider has ring fenced increased EIP budget EIP Service Development & Improvement Plan in place Comments RAG** Gether NHS Foundation Trust Avon and Wiltshire Mental Health Partnership NHS Trust Berkshire Healthcare NHS Foundation Trust Y U U EIP SDIP status unknown. Provider reports EIP funding has been increased. Commissioner has yet to attend EIP programme board. Y N N EIP funding released to provider. Provider unsure of where money located. SDIP not evidenced, Y N N EIP uplift of 1m confirmed by CCGs but not ring fenced by provider. Provider does not have a standalone EIP service. SDIP not evidenced. Service was previously dismantled. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 9 of 23

10 4. Central and Northwest London Mental Health Trust (Milton Keynes) Y Y Y Funding allocated & ring-fenced for EIP. SDIP developed. Staff recruited Cornwall Partnership NHS Foundation Trust Dorset Healthcare University NHS Foundation Trust Devon Partnership NHS Trust Y Y Y CCG engaged. EIP SDIP in development. New funding of 100K has been allocated. Team is currently recruiting staff. Y U U 80K EIP funding appears to have been agreed for 15/16. SDIP not complete. N N U No EIP funding uplift for 2015/16. SDIP not complete. EIP service reconfiguration in discussion. 8. Isle of Wight NHS Trust N N Y No EIP funding uplift. SDIP in place Kent and Medway NHS and Social Care Partnership Trust Oxford Healthcare NHS Foundation Trust Solent NHS Trust Somerset Partnership NHS Trust Southern Health NHS Foundation Trust N N U East Kent CCGs have released EIP uplift of 168K. West Kent CCGs have not released EIP uplift to provider. Provider has not ringfenced increased EIP funding. Y Y U Funding allocated, funding ring fenced. Staff recruited. SDIP not evidenced. N N N No EIP budget and no evidence of SDIP. N N U No EIP Uplift. Provider and commissioners in discussions. No evidence of SDIP. N N U No funding uplift for EIP. No evidence of SDIP. Variation in EIP service delivery. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 10 of 23

11 Surrey and Borders Partnership NHS Foundation Trust Sussex Partnership NHS Foundation Trust Y Y Y Commissioners have confirmed EIP budget uplift. SDIP in place. Staff recruitment underway. Y Y Y Commissioner has confirmed EIP uplift. SDIP in place. Variable contribution from 6 CCGs. Staff recruitment delayed due to uncertainty over finances. 16. The Zone (Plymouth) KEY: Y: Yes; N: No; U:Unknown *Based on Self Reports & Soft Intelligence **Please note that the above status will change as and when new updates are received by the programme N N N No EIP uplift. Current service design unable to deliver new standards. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 11 of 23

12 5.3. EIP Structures The South Region EIP Preparedness Programme has established different structures of EIP services. A NICE Concordant EIP service requires a standalone EIP team to deliver treatments. Although this is the case in the majority of provider organisations, it is not the case in all. The rationale for mandating stand-alone EIP teams is the clear evidence that they are more clinically and cost effective 3 and better enable the implementation of NICE-concordant interventions 4 There are concerns with adaptations of the model 5, especially integration into CMHTs, in that they result in: isolation of EIP workers limitations in clinical supervision lack of availability of competent therapists abrupt or gradual increase in caseload numbers Deviation from the evidenced based model in rural and urban settings as a way of reducing short term costs has shown to have a negative impact on the experience and outcomes of people using services and carers; and produces higher longer-term costs. 3 Fowler D, Hodgekins J. Howells L, Millward M, Ivins A, Taylor G, Hackmann C, Hill K, Bishop N and Macmillan I. (2009). Can targeted early intervention improve functional recovery in psychosis? A historical control evaluation of the effectiveness of different models of early intervention service provision in Norfolk Early Intervention in Psychiatry 3: V. Bird, P. Premkumar, T. Kendall, C. Whittington, J. Mitchell and E. Kuipers Early intervention services, cognitive behavioural therapy and family intervention in early psychosis: systematic review. The British Journal of Psychiatry 197: Singh and Fisher (2007) One-year outcome of an early intervention in psychosis service: a naturalistic evaluation. Early Intervention in Psychiatry 1: South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 12 of 23

13 5.4 Percentage of Caseload Allocated an EIP Care Coordinator within 14 Days of Referral The Zone (Plymouth) Sussex Partnership NHS Foundation Trust Surrey and Borders Partnership NHS Foundation Trust Southern Health NHS Foundation Trust Somerset Partnership NHS Trust Solent NHS Trust Oxford Health NHS Foundation Trust Kent and Medway NHS and Social Care Partnership Trust Isle of Wight NHS Trust Dorset Healthcare University NHS Foundation Trust Devon Partnership NHS Trust Cornwall Partnership NHS Foundation Trust Central and North North West London Mental Health Foundation Trust (Milton Keynes) Berkshire Healthcare NHS Foundation Trust Avon and Wiltshire Mental Health Partnership NHS Trust 2Gether NHS Foundation Trust Although 8 of the 15 Trusts appear to be able to allocate a care coordinator within 14 days of referral in over half of cases, the wide variation in performance on this key indicator is of concern. This metric likely reflects a number of possible problems in the delivery of a specialist EIP service, including insufficient staffing levels. Delays in the clinical pathway (usually between initial assessment at single point of entry/ ward admission/ initial outpatient appointment to first appointment with the EIP team) are likely to account for the sub-optimal performance in many trusts. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 13 of 23

14 5.5. NICE Concordance A NICE concordant EIP service is able to offer and deliver the following NICE recommended treatments to >50% of people within 14 days of referral: CBT for Psychosis (CBTp) Individual Placement Support (IPS) for education and employment Family Interventions Medicines management Comprehensive physical assessments Support with diet, physical activities and smoking cessation Carer-focused education and support programmes These results indicate that performance is not yet adequate on most of the indicators of NICE concordance. Some of these require staff with specialist skills such as family interventions or CBTp which are not generally available but others reflect current practice (relatively few people are asked if they smoke and if they would like a smoking cessation intervention). South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 14 of 23

15 5.6. Workforce The largest clinical group working in EIP are Care Coordinators who make up 55% of the total workforce. This is to be expected as successful treatment of individuals with first episode psychosis often requires a high degree of concerted effort to get engagement, and coordinated care which is effectively delivered using a case management model. Only 5% of the EIP workforce is qualified psychiatrists. Pharmacotherapy should be initiated by a qualified psychiatric doctor with Consultant level oversight to manage high risk cases. Without the necessary medical input, many people with psychosis are currently going without the necessary medical treatment to aid recovery and manage cardio-metabolic risk factors such as smoking, weight gain, hypertension, dyslipidaemia, and pre-diabetes. The numbers of staff in each workforce category fall far short of the staffing levels calculated to be required to deliver the new access and waiting time standards. For example, there are currently 228 care coordinators but approximately 252 are required; medical staff when approximately 50.4 are required, and 18.4 CBT trained clinicians when approximately are required. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 15 of 23

16 5.7. Performance and Outcomes Engagement in employment or education is a key functional outcome for EIP services and the best services have embedded staff that are trained to provide IPS (Individual Placement Support). Some trusts, e.g. Cornwall, are highly successful due to their specialist employment project. The majority of trusts achieve over 30% employment or education, however, which indicates that with a bit more focus on this area, the >50% target is achievable. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 16 of 23

17 5.8 Individual Provider Reports Provider EIP Matrix Report Sept Gether NHS Foundation Trust Avon and Wiltshire Mental Health Partnership NHS Trust 2Gether Matrix Summary- DRAFT.xlsx Berkshire Healthcare NHS Foundation Trust AWP Matrix Summary- DRAFT.xlsx Central and North West London Mental Health Foundation Trust (Milton Keynes) Cornwall Partnership NHS Foundation Trust Berkshire Matrix Summary- DRAFT.xlsx Milton Keynes (C&NW London) Matri Devon Partnership NHS Trust Cornwall, Matrix Summary- DRAFT.xlsx Dorset Healthcare University NHS Foundation Trust Devon, Matrix Summary- DRAFT.xlsx Isle of Wight NHS Trust Dorset, Matrix Summary- DRAFT.xlsx Kent and Medway NHS and Social Care Partnership Trust Isle of Wight Matrix Summary- DRAFT.xlsx Oxford Health NHS Foundation Trust Kent and Medway Matrix Summary- DRA Southern Health NHS Foundation Trust Oxford Matrix Summary- DRAFT.xlsx Solent NHS Trust Southern Health Matrix Summary- DRA Somerset Partnership NHS Trust Solent Matrix Summary- DRAFT.xlsx Somerset Matrix Summary- DRAFT.xlsx South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 17 of 23

18 Surrey and Borders Partnership NHS Foundation Trust Sussex Partnership NHS Foundation Trust Surrey and Borders Matrix Summary- DRA The Zone (Plymouth) Sussex Matrix Summary- DRAFT.xlsx The Zone Matrix Summary- DRAFT.xls 6. Discussion The key themes emerging on analysis of the data are Investment, Competing Demands, Technology and Medical Leadership. These areas are issues across the South Region to differing levels. Vastly differing levels of investment will inevitably lead to a disparity in the service that can be provided. Only 3 trusts in the South region have invested in EIP to above the national mean spend. NHS England has calculated that the provision of a NICE compliant service costs 8,250 for each patient which means that trusts such as Devon, Dorset and Somerset might need a 2/3 increase in funding to meet the access and waiting time standards for psychosis. Whilst these statistics might at least partially reflect a range of efficiencies and innovations in the delivery of EIP services, it is unrealistic to expect such poorly funded services to be able to achieve the expected outcomes. Services which are currently poorly resourced will be unable to meet even the relatively simple NICE standards such as a focus on smoking cessation. However, only a minority of services, whatever their current levels of funding, are providing specialist Family Interventions and CBT for psychosis and this is the area in which the greatest new investment is required. For better funded services some of the existing staff could be trained to provide these specialist interventions but for services with low staffing levels the existing staff will need to spend all their existing time on care coordination and therefore employing new staff will be the only way of delivering the new standards. Although some services have employed assistant practitioners, many services would benefit from expanding the non-professionally qualified workforce. We would recommend employing both peer support workers (people with lived experience of psychosis) and workers who can be trained to provide specialist employment support. These employment support workers should be integrated within the EIP teams to provide an evidence-based IPS service. Some of the other identified shortcomings- such as the relatively low level of medical time available in many services may reflect local service structures. Many services rely on accessing geographically deployed psychiatrists and the solution may simply involve the redeployment of existing staff rather than new investment. Another common issue is the unavailability of appropriately configured information gathering systems that can report on achievement of the standards and the NICE interventions delivered. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 18 of 23

19 7. Recommendations 1. Providers and Commissioners should take cognisance of the need to increase staffing levels, particularly staff able to deliver specialist family Interventions and CBT for psychosis. 2. Providers and Commissioners should work closely together on ongoing basis to identify the main local service deficiencies and agree a service development and improvement plan with appropriate investment. 3. The existing workforce and newly appointed staff need to be provided with an ongoing programme of training. HEE investment in EIP training in the current financial year is very much welcomed. Ongoing funding for training will be required if the improvement in services intended by the introduction of the access and waiting time standards is to be realised. 4. Accurate data gathering and reporting capabilities from Electronic Health Records need to be developed as some of the data in this report may have been overestimated and the deficiencies may actually be greater. 5. The exercise to gather information using the EIP Matrix, develop by the South Region EIP Preparedness Team, should be repeated post April This will give up to date information on workforce, NICE concordance and outcomes, as well as quantifying progress made towards preparedness. South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 19 of 23

20 8. Appendix 1 EIP Preparedness Programme Board Fiona Edwards Chief Executive Surrey & Borders Partnership NHS Foundation Trust Andrew Keefe Programme Director/Associate Director Mental Health South, Central & West Commissioning Support Unit Prof. Belinda Lennox Senior Responsible Officer South Region EIP Preparedness Programme Sarah Amani Senior Programme Manager South Region EIP Preparedness Programme Tim Francis Mental Health Commissioning Manager NEW Devon CCG Linda McQuaid Director of Children & Young People s Services Surrey & Borders Partnership NHS Foundation Trust Aly Fielden Mental Health & Learning Disability Commissioning Manager Bristol CCG Ian Mundy West Berkshire Locality Director Berkshire Healthcare NHS Foundation Trust Jeremy Rowlands Consultant Psychiatrist Southern Health NHS Foundation Trust Justine Faulkner Senior Programme Manager NHS England South Andrew Dayani Medical Director Somerset Partnership NHS Foundation Trust Sam Wilson Contracts Lead Kernow CCG Sandra Miles Team Manager Kernow CCG Matthew Hall Operations Director Solent NHS Trust Nadia Barakat Head of Mental Health Commissioning East Berkshire CCG Andy Oldfield Head of East Kent Mental Health Commissioning NHS South Kent Coast Clinical Commissioning Group Angus Gartshore Director - Community Recovery Service Line Kent & Medway NHS Partnership Trust Cathy Phippard Director for Mental Health Central & North West London Mental Health Foundation Trust Rob Bale Clinical Director Oxford Health NHS Foundation Trust Lisa Gimingham Deputy Locality Manager Citywide Services Plymouth Community Healthcare Ellen Wilkinson Medical Director Cornwall Partnership NHS Foundation Trust Katy Bartolomeo Senior Commissioner (Mental Health & Substance Misuse) Southampton Integrated Commissioning Unit Jacquie Mowbray-Gould Deputy Director of Operations Devon Partnership NHS Trust Jan Furniaux Service Director 2gether NHS Foundation Trust Mike Kelly Head of Mental Health Dorset Healthcare University NHS Foundation Trust Mike Jarman Chief Executive The Zone (Plymouth) Alexis Bower Medical Director Isle of Wight NHS Trust Emma Wilton Education and Workforce Development Manager Health Education England Thames Valley South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 20 of 23

21 Diane Woods Head of Mental Health & Learning Disability Commissioning NHS North East Hampshire & Farnham CCG Tim Archer Associate Director Joint Commissioning Somerset CCG South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 21 of 23

22 8.1 Appendix 2 EIP Preparedness Programme Clinical Group Dawn Hyde Carer Participation Lead South Region EIP Preparedness Programme Rojina Dorodvand Youth Participation Lead South Region EIP Preparedness Programme Rick Fraser Consultant Psychiatrist Sussex Partnership NHS Foundation Trust Jo Lynch General Manager Surrey & Borders Partnership NHS Foundation Trust Kate Sigov Team Manager Surrey & Borders Partnership NHS Foundation Trust Rachel Esposito Service Manager Avon and Wiltshire Mental Health NHS Foundation Trust Alexandra Luke Service Manager/ Consultant Psychiatrist Berkshire Healthcare NHS Foundation Trust Jeremy Rowlands Consultant Psychiatrist Southern Health NHS Foundation Trust Steve Bell Service Manager Oxford Health NHS Foundation Trust Frank Burbach Clinical Lead Somerset Partnership NHS Foundation Trust Anthony Lacny Consultant Nurse Avon and Wiltshire Mental Health NHS Foundation Trust Collette Chamberlain Care Coordinator Kent and Medway NHS and Social Care Partnership Trust Wayland Lousley Mental Health Transformation Manager Milton Keynes Clinical Commissioning Group Sasha King Senior Occupational Therapist and Quality Champion Central & North West London Mental Health Foundation Trust Helena Laughton Chartered Counselling Psychologist/Deputy Team Manager Oxford Health NHS Foundation Trust Louise Johns Consultant Academic Clinical Psychologist Oxford Health NHS Foundation Trust Angela Hawke Clinical Team Manager Cornwall Partnership NHS Foundation Trust Chris Woodfine Service Improvement Project manager Southern Health NHS Foundation Trust Brenda McCauley Service Manager Devon Partnership NHS Trust Gabby Cooper Team Manager 2gether NHS Foundation Trust Rosemary Croft Commissioning Manager Reading Clinical Commissioning Group Su Tomkins Team Manager Isle of Wight NHS Trust Jo Tedbury Clinical Psychologist Solent NHS Trust Tracy Read Team Manager Dorset Healthcare University NHS Foundation Trust Gary Sargent Team Manager The Zone (Plymouth) Helen Courtney Psychologist Solent NHS Trust South Region Early Intervention in Psychosis Preparedness Programme Report December 2015 Page 22 of 23

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