New Model of Care The Southwest Secure Network
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- Ginger Boone
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1 New Model of Care The Southwest Secure Network Phase One Pilot Presented by Anne Forbes, Jason Fee and Patrick Neville
2 New Care Models ambition - Patrick Neville The Mental Health Taskforce report set out the rationale for developing new models of care for mental health: Promoting innovation in service commissioning, design and provision that joins up care across in-patient and community pathways (reaching across and beyond the NHS); Making measureable improvements to the outcomes for people of all ages and delivering efficiencies on the basis of good quality data Eliminating costly and avoidable out of area placements and providing high quality treatment and care, in the least restrictive setting, close to home
3 Why New Models? Five Year Forward View - Huge challenge for the NHS needing to fix the 20/30bn funding gap by 2020 Need to provide innovations to develop real solutions to unmet need and local pathways Mental health pathway improvements Commissioning gap the split in funding creating huge travel distances and inequitable access to care 52% of southwest secure patients were not in the southwest Moratorium on new service developments creating real difficulty in creating solutions We couldn t continue as we were we were already planning to develop a network 9 months prior to the New Model Invitation
4 New Care Models - Southwest - Anne Forbes Southwest was a successful Phase One Bidder - Went live April 2017 Bid includes all providers of mental health secure care in the southwest as partners in a clinical network Led by Devon Partnership NHS Trust as the Accountable Care Organisation Key aim is to repatriate patients to the southwest, to offer a southwest provided whole system solution, to define need, offer consistent high quality acre and to provide improved community services
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6 Headlines Circa 450 people in secure care of which 80 Assuring Transformation cohort Circa 52% out of region already reduced to 45% Circa 25% females only 10% treated in region Indicative budget circa 70 million 2 CFT across 7 CCG area s Specialist teams Pathfinder and FIND
7 Where our patients were placed
8 Low Secure Length of Stay
9 Low Secure Bed Occupancy
10 Medium Secure Length of Stay
11 Medium Secure Bed Occupancy
12 South West Regional Secure Services: Programme Governance Structure South Region National PARTNERSHIP BOARD PARTNERSHIP CO-ORDINATING GROUP CLINICAL DESIGN CONTRACTING AND PROCUREMENT BUSINESS MODEL PERFORMANCE AND OUTCOMES COMMUNICATION AND STAKEHOLDER ENGAGEMENT WORKFORCE TASK AND FINISH GROUPS SUPPORT FUNCTIONS FINANCE HUMAN RESOURCES BUSINESS INTELLIGENCE QUALITY GOVERNANCE LEGAL CONTRACTING INFORMATION GOVERNANCE INFORMATION TECHNOLOGY ORGANISATIONAL DEVELOPMENT CLINICAL ENGAGEMENT Note the partnership board, communication and stakeholder group, and clinical design groups all dedicated patient involvement
13 New Care Models Clinical Case Jason Fee Clinical outcomes Care closer to home Least restrictive Outcome based Removing variation
14 New Care Models - Clinical Case Achieved by Remove variation & increased flow in bed management. No unnecessary out of region placements Regional bed management and increase in-region bed stock to c320 Reduce people in secure inpatient care investment CFT. Investment in specialist teams to in-reach into mainstream secure service Regional Clinical Network
15 New Care Models -Clinical Network benefits and challenges Standardised Access criteria developed by Clinicians Standardised outcomes and performance developed by Clinicians Sharing good practice and quality standards driving improvements Clinician validation and peer review of outliers e.g. LOS variance, seclusion Clinical Network has designed the commissioned care pathway
16 New Care Models Provider Partner, Patient benefits and challenges Patrick Neville Care Pathway - Part of the pathway providing care to meet need Consistency of approach improving what is provided locally Developing this as partners Prevention of delay with local engagement through partnership early indicators that this is rapidly developing bumpy start Travel distance as close to home improving access to family and friends about time!! Patients and Families have asked for this repeatedly, every new development and every consultation.
17 New Care Models Provider Partner, Patient benefits and challenges Improved access to local teams see this increasing Change and developing trust independent sector working as part of the NHS in an integrated way Making this work, commitment to the approach bumps and all
18 New Care Models How do we know its works Jason Fee This is a two year project with ambitions stretching over the next 5 years. Its been operational for 2 months Success Everyone (almost everyone) has come home providing comprehensive services in area Those that have pan regional needs may be in a setting meeting their needs even if out of area Everyone is being cared for by a dedicated Forensic Community Team Patients and family satisfaction has improved, travel distance reduced and needs are met Outcome orientated, evidence based whole care pathway embedded as the normal practice. It s a sustainable and affordable system.
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