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Delivering for Mental Health

Delivering for Mental Health. Geoff Huggins and Alex McMahon 28 March 2007. Timeline. 1997 – Framework for Mental Health Services in Scotland 2000-2003 – MH and Well Being Support Group visits 2004 – Sandra Grant report (in context of implementation of MH Act)

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Delivering for Mental Health

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  1. Delivering for Mental Health Geoff Huggins and Alex McMahon 28 March 2007

  2. Timeline 1997 – Framework for Mental Health Services in Scotland 2000-2003 – MH and Well Being Support Group visits 2004 – Sandra Grant report (in context of implementation of MH Act) 2005 – review of mental health as a clinical priority – Delivering for Health published 2006 – Delivering for Mental Health published

  3. Mental Health Policy • 4 Populations – 5 million; 1-2 million; 50-100,000; 500 • 4 Approaches – legislation; population health; service development; support for change

  4. Clinical Priority Review • mental health act implementation success • good work around stigma and on population health But • improving and developing treatment services?

  5. Issues • Underdeveloped care pathways • Need to develop better integrated care • ‘First contact’ interventions often weak • Acute inpatient increasingly challenging • Service and quality standards not always in place • Gaps in particular service areas • Policy approach not driving improvement • Outcome measures for mental health not in place

  6. Strengths • Workforce committed to offering a high quality service • Act implementation process effective – showed that focus on objectives works • Doing Well experience positive • Data sources developing and improving • Good momentum on stigma and discrimination • Better evidence and knowledge base

  7. DfH Mental Health Commitments • ICPs for main diagnoses (ahead of schedule) • deciding how to roll out Doing Well programme (done) • crisis standards (done) • national/regional specialist services (done) • milestones for CAMHs Framework (done) • forensic services (on course, but NOS?) • Mental Health Delivery Plan (delivered)

  8. National Delivery Plan • small number of valuable, measurable and deliverable commitments • some national deliverables, some local • 2010 time horizon • performance management • support for change

  9. Process • national group drawn from range of interests (feeding back into other groups)… • three national stakeholder events…everything on the web… • meeting anyone, anywhere, anytime, nothing excluded BUT!!! • commitments must be measurable, valuable and deliverable

  10. Outcomes • Behaviours and culture still the big issue for patients and carers • Drivers/Expectations: • Equality, non-discrimination, diversity • Social Inclusion, ‘section 26’ • Recovery • Rights and Liberties – ‘Millan Principles’ • Trust and respect fundamental (and also for staff…)

  11. Objectives • Better patient and carer experience of services • Better response to depression, anxiety, stress • Improved capacity in identifying those at risk of suicide • Improved physical health of those with mental illness • Better management of long-term conditions • Reduce inappropriate admissions and readmissions • More comprehensive specialist services • Health/substance abuse co-morbidity better addressed

  12. 14 commitments… but also national NHS targets…to force the pace of change • reduce acute inpatient readmissions • stop year on year growth in anti-depressant prescribing

  13. Support for Change • creation of Mental Health Delivery and Services Unit – January 2007 • Benchmarking framework about to be issued – May 2007 • leadership programme – 24 April 2007 – 6 board areas involved • delivery collaborative in place from Septemberl 2007 – NHS GG&C

  14. Performance Management • building on act implementation processbutalso using new NHS targets • Implementation Board in place • Talking to Chief Executives in May • Implementation visits Spring and Autumn • Accountability Reviews in Summer • Reporting into Delivering for Health process

  15. Challenges and risks? • Maintaining engagement and trust with partners • Retaining focus on the commitments and targets • CAMHS agenda is very challenging • Making sure the benefits are delivered in the real world

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