Introduction to NAPICU & the Commissioning of Female PICU Beds in England Chris Dzikiti International Liaison, National Association of Psychiatric Intensive Care And Low Secure Units (NAPICU) Strategic Programme Manager NHS England London Region
AIMS TO IMPROVE PATIENT EXPERIENCE AND OUTCOMES TO PROMOTE STAFF SUPPORT AND DEVELOPMENT TO IMPROVE THE DELIVERY OF PSYCHIATRIC INTENSIVE CARE TO AUDIT THE EFFECTIVENESS OF CARE TO PROMOTE RESEARCH, EDUCATION AND PRACTICE DEVELOPMENT TO PROVIDE BEST PRACTICE GUIDANCE IN ASSOCIATION WITH NATIONAL BODIES
NAPICU:1996-2016 Multidisciplinary Executive Committee Expanding Membership 20 National Conferences Over 75 Quarterly Meetings NAPICU Website / Journal / Textbook National Surveys of PICU & Low Secure Service Reviews by NAPICU (Practice Devp. & Clinical Gov. Networks) National Minimum Standards (GA & CAMHS PICU) AIMS-PICU (Royal College of Psychiatrists and NAPICU) Guidance for PICU Commissioners (NHSCC and NAPICU) Expert Input into National Committees/Networks (DH, NICE, CoP) International Liaison
NATIONAL SURVEY & RESEARCH JOINT WORKSTREAM WITH DIMH LEADERSHIP & MANAGEMENT TRAINING PIC TEXTBOOK 3 RD EDITION 2016 2017 & BEYOND INTERNATIONAL LIAISON JOURNAL DEVELOPMENT POSTGRADUATE LEARNING IN PICU
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NAPICU ANNUAL CONFERENCES
Latest Guidelines 2016
Latest Guidelines 2014
Commissioning - Background Mental Health Policy Implementation Guide 2001 The single most important issue for women service users is a sense of proper arrangements being in place Single sex areas offer more safety and comfort to women who may by distressed on a disturbed acute psychiatric ward. Services for women should also be sensitive to their cultural and ethnic backgrounds.
How many female PICUs in England 20 30 female PICUs (unverified) London - 5 Midlands & East - 6 North - 7 South - 4
Women s experience Women are more likely to have been sexually abused in childhood than men. Women in contact with mental health services have experienced higher rates of childhood sexual abuse than other women and men. Women who have experienced sexual abuse in childhood face re victimisation the mental health system.
Commissioning Cycle
Review current service provision Service reviews are undertaken to demonstrate a thorough understanding of current services provided in relation to the identified health needs. In essence, it is to ensure that services commissioned for the population are effective and of high quality. Key tasks to be considered as part of a service review include:- Understanding the operational delivery, workforce issues and clinical factors for the service Developing knowledge of clinical effectiveness and evidence base Benchmarking service against national or other indicators to access efficiency Reviewing applicable performance indicators or monitoring clinical outcomes Reviewing user experience and satisfaction with the service Establish best practice clinical/public health guidelines for the service
Five Year Forward View Striving for: Enhanced quality of life for people with mental illness and/or with dementia Improved experience of healthcare for people with mental illness Seamless integrated services for people with mental health problems and substance misuse across all healthcare settings People with mental health problems identified and their physical health needs addressed. Reduced premature death in people with Serious Mental Illness
Challenges of Delivering the 5 Year Fwd View The 5YFV sets out a future for the NHS where current day-to-day pressures such as long stays in hospital, staffing levels, and financial challenges are greatly alleviated, and care is given closer to home through joint working across a range of healthcare organisations. Its goal is to achieve a sustainable NHS that continues to be tax-funded, free at the point of use and that is fully equipped to meet the evolving needs of its patients. This future, it says, is achievable, but only if government, the public and the NHS itself take action.
3 Gaps identified by the 5YFV The health and wellbeing gap - preventing illness and managing demand for NHS services. The care and quality gap - changing the way care is delivered to better meet patients' needs, standards / guidance for female PICUs. The funding and efficiency gap - delivering care more cost effectively within the NHS budget
The Government s mandate to NHS England 2016-17 Objective 1:Through better commissioning, improve local and national health outcomes, particularly by addressing poor outcomes and inequalities. Objective 2: To help create the safest, highest quality health and care service. Objective 3: To balance the NHS budget and improve efficiency and productivity.
Aims for Female PICU Improved patient pathway Reduction in readmission rates Reduction in delayed discharges Reduction in use of out-of-area Female PICU beds Reduction in number of people out-of-area Increase in shared care arrangements Improved access to PICU services Reduction in the inappropriate use of Section 136
Take Home Message We have a once-in-a-lifetime opportunity to shift the focus to commissioning for population health Commissioning for value is all about culture change It requires a sustained focus on outcomes and investing in areas of proven cost-effectiveness It requires us to operate collectively as a system with the right incentives in place We need high-quality and timely intelligence that is also joined-up across systems
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