Care Pathways and Packages Development

1. Care Pathways and Packages Development

2. Data items within the Mental Health Clustering Tool 2

3. Mental Health Care Clusters 3

4. Cluster payment periods • 1 Common mental health problems (low severity)-12 weeks • 2 Common mental health problems-15 weeks • 3 Non-psychotic (moderate severity)-6 months • 4 Non-psychotic (severe)-6 months • 5 Non-psychotic (very severe)-6 months • 6 Non-psychotic disorders of overvalued Ideas-6 months • 7 Enduring non-psychotic disorders (high disability)-Annual • 8 Non-psychotic chaotic and challenging disorders-Annual • 9 Blank cluster-Not applicable • 10 First episode in psychosis-Annual • 11 Ongoing recurrent psychosis (low symptoms)-Annual

5. Payment Periods Cont’d • 12 Ongoing or recurrent psychosis (high disability)-Annual • 13 Ongoing or recurrent psychosis (high symptom and disability)-Annual • 14 Psychotic crisis-4 weeks • 15 Severe psychotic depression-4 weeks • 16 Dual diagnosis (substance abuse and mental illness)-6 months • 17 Psychosis and affective disorder difficult to engage-6 months • 18 Cognitive impairment (low need)-6 months • 19 Cognitive impairment or dementia (moderate need)-6 months • 20 Cognitive impairment or dementia (high need-6 months • 21 Cognitive impairment or dementia (high physical or engagement)-6 months

6. Relationship between mandated and proposed forensic, LD & alcohol misuse clusters

7. Main elements of the CPP Model Individual service user needs Anxiety / Accommodation / Hallucinations / Living conditions etc. Mental Health Clustering Tool Standardised summary of individual needs Cluster Global description of combination & severity of individual needs Care Packages Negotiated care plan Quality and Outcome Metrics Triangulated measurement of process and effect Local Tariff Derived from joint understanding of accurate costs

8. Outcomes Outputs Person Support Plan Covering elements of Mental Health Care Programme Social Care Activities/support Health Activities/Support Mental Health PbR CPA Non CPA Social Care FACs Financial Assessment Personal Budget One Big Conversation Physical Health Long terms condition Personal Health Budget Care Coordinator

9. Next Steps • DOH acknowledge project slippage • New Cluster booklet • New 2013-14 Guidance for Commissioners and Providers • Commissioners considering Care Planning CQUIN • Major emphasis on accurate data collection

10. MH PbR Project summary Finance / Costing Forensic Learning Disabilities Algorithm / Transitions Quality and Outcomes Psychological Medicine IAPT CAMHS Alcohol IC supporting requirements for all work streams

14. Key milestones • Readiness review completed • PbR CQUIN agreed • Joint action plan developed for 2013-14 • MOU signed and cluster monitoring with commissioners started • Stronger links between PbR and operations • Pre cluster tariff (P) developed for PCL • Local tariff to be agreed by year end

15. 2013-14 CQUIN • PbR PREM . Tied into national patient survey- Top 4-6 questions • PROM- Short version of the WEMHWS • Family and Friends Test • All of the above on one simple questionnaire • Still keeping a watching brief on clustering

16. Training Programme Quantitative Qualitative RiO/CAST Assessment Formulation HoNOS/Cluster (CAST) Cluster transitions Knowledge Centre Problem List Care Plan Problems (categories) Care Plan Interventions (categories) RiO Text fields Assessment Formulation writing HoNOS/Cluster Cluster transitions Knowledge Centre Problem List Care Plan Problems(text) Care Plan Interventions(text) Clinical Dashboard/Reporting HoNOS/Cluster completion Cluster accuracy (Red Rules) Care Plan completion HoNOS/Care Plan problems (Red R) Problem/Intervention guidelines Caseload profile Outcomes (HoNOS) Resources Supervision HoNOS/Cluster completion Cluster accuracy Care Plan completion HoNOS/Care Plan problems Problem/Intervention guidelines Caseload profile Outcomes (HoNOS) Resources