MERIT Excellence, Resilience Innovation & Training Jointly developing Mental Health Service in the West Midlands Shakeel Sabir Head of MERIT Vanguard
Background - New care models Multispecialty community providers moving specialist care out of hospitals into the community Enhanced health in care homes offering older people better, joined up health, care and rehabilitation services Integrated primary and acute care systems joining up GP, hospital, community and mental health services Urgent and emergency care new approaches to improve the coordination of services and reduce pressure on A&E departments Acute care collaboration local acute care providers working together to enhance clinical and financial viability
Who is involved in MERIT? Birmingham and Solihull Mental Health NHS Foundation Trust Black Country Partnership NHS Foundation Trust Coventry and Warwickshire Partnership NHS Trust Dudley and Walsall Mental Health Partnership NHS Trust Total population 3.4 million
The way forward Sovereign organisations with local focus Urban model of care Reach potential through scale of developments Replicability Need for new commissioning structures Accountable care? Personal health budgets?
Overall aims Clinical services areas where working together can make a difference: Crisis care Recovery culture Consistency of service provision whilst retaining localism Support function working in partnership Sharing of best practice Critical mass and resilience Shared care records
Our 2017/18 Clinical Workstreams Recovery Culture Crisis Care Across our Alliance we have all of the recognised components of an urgent care system but these are not operating consistently. We will develop a crisis care blueprint for a replicable clinical model that delivers the Crisis Care Concordat and a single bed management function with streamlined, clear and efficient processes to maximise and increase flexibility of our bed utilisation. We will deliver: Shared bed management across the West Midlands Electronic Health Shared Record - Viewer Seamless crisis care pathway and improved after crisis care. Crisis Care Website Improve quality of crisis assessment o Agreed standards, skill mix and competencies
Clinical workstream (continued) Recovery Culture Our Alliance will explore different models of recovery and share best practice and service user feedback with the aims of preventing relapse/readmission back to secondary care, being more responsive to our local communities and actively working to facilitate recovery and improved quality of life. We will deliver: Community Engagement - co-production and collaboration model MH First Aid Developing proactive recovery practices within our mental health services ReQuol Toolkit Support service users back into employment IPS (Induvial Placement Support)
Our Enabling Workstreams Workforce We will carry out joint workforce planning to allow us to respond quicker and more effectively to national and local staffing issues, including recruitment, retention and new roles. We will develop and deliver joint training programmes. We will develop a shared flexible staffing function to give us critical mass and reduction of agency usage. Information Technology A shared patient record system will bring clinical benefits and support our standardised crisis and acute care systems. Coordinating infrastructure, technical support and training will bring economies of scale, purchasing power and knowledge sharing.
Challenges Different organisations with different service models Different size organisations with different constraints Consistent Crisis Care provision Challenging conversations Cultural change new ways of working Time constraints and available resources from Trusts IT infrastructure variation across the Trusts
Achieved so far Programme set up and governance structure in place Relationship building across the four Trusts Development of Bed Management specification Bed Management Memorandum of Understanding & SOPs Shared Patient Record specification Procurement of Shared Patient Record system IT development of Bed Management & Shared Patient Record ReQuol Toolkit development with Sheffield University Mental Health First Aid Train the Trainer Individual Placement and Support (IPS) workshop Service users & Carer workshop Co-production approach
Next steps Information Sharing Agreement August 17 Website for service users and clinicians providing details of what services are available across Vanguard postcode search August 17 Training Passport August 17 Shared Patient Record Go-live into existing Clinical Systems November 17 Bed Management System Go-live- November 17 Mapping of Mental Health services across Vanguard e.g. Liaison Service, Street Triage & Places of Safety Community Engagement and Recover Practices models October 17 Flexible staffing arrangements across the MERIT Vanguard - November 17
MERIT Mental Health, Excellence, Resilience Innovation & Training Building Equality, Diversity and Inclusion into New Models of Care
EDI MERIT Workstreams Recovery - Clinical Info Tech- Enabler Crisis Care- Clinical EDI Enabler Pool Resources to coordinate Work Plans and Equality Impact Assessments, leading to greater engagement with Mental Health Services across communities 7 Day Working- Clinical Research & Innovation - Enabler Workforce - Enabler Quality Governance - Enabler
Improved patient and carer experience Improved Staff experience Reduced levels of bullying and harassment investigations and disciplinary cases Reduced health inequalities in the region Improve e-quality and effectiveness in service provision and access to Mental Health Services Culturally Responsive Services
EDI Logic Map (Action Plan) Year 1 Years 2-3 4+ years Develop a standardised Equality Analysis Framework Provide support / guidance and scrutiny of EQIA s Conduct a baseline assessment and gap analysis on Equality in each Trust Co-production and Collaboration with all Workstreams to embed EDHR Shared Strategic Objectives and Action Plans to address health inequalities and access issues Align the workstream work programme with EDS2 and WRES Stakeholder engagement events across the region Continue to address gaps identified in year 1 and set key priorities Develop EDHR training packages for all Trusts to deliver Develop a set of consistent Equality, Diversity & Inclusion Standards EDHR integral to all workstreams Showcase best practice case studies Improved service delivery
Achievements to date Created a Single EqIA Tool and Guidance consistent approach EqIA Workshops held with Workstream Leads EDI Workstream membership extended to External groups representing protected characteristic including LGBT Network, EBE representation Developed a Community Engagement Sub-Group in partnership with the Recovery Workstream (Community Connections) Delivering a Training programme ( Forward Thinking Leadership ) in partnership with HEE/ Leadership Academy West Midlands focusing on Inclusion and elements of WRES (Workforce Workstream) Inclusion masterclass for Chief Executives, Executive Directors and Board members
What difference has the EDI workstream made? Joint partnership accountability Increased awareness of EDI principles amongst staff Continuous embedding of EDI in core and enabling workstreams A standardised process for carrying out Equality Analysis improving quality of EqIA s Improved staff and service user engagement Increased community engagement e.g. Faith groups, LGBT and Gypsies & Travellers
An example of Recovery and EDI Embedding Human Rights Approach in Recovery Standards: - Prevention - Wellbeing - Recovery - Independence Stigma-reduction: Supporting the roll out of Mental Health First Aid training (Focus on BME, LGBT and Faith Communities) Reqol Recovery Model improved connectedness (Community Connection Sub Workstream)
An example of crisis care and EDI LGBT issues FREDA Principles Cultural competencies Bed Management Dignity & Respect Standards Geographical demographics Age / Race / Religion / Gender issues & Implications
A mental health trust alliance to transform acute care in the West Midlands Thank you