Evolving Care Services Approach for Enhanced Patient-Centered Care

1. Resetting our Care Services Joanna Forster Adams : Chief Operating Officer Andy Weir : Deputy Chief Operating Officer Alison Kenyon : Deputy Director of Service Development Mark Dodd : Head of Operations – Regional Services integrity | simplicity | caring

2. Care Services: This is the next phase – it is not a standing start Our operating models have evolved over the course of the last 15 months. At times we have been more (significantly)constrained with how we can support people We have learnt and adapted along the way (and will need to continue to do so) integrity | simplicity | caring

3. What we aiming to achieve Care Services “Putting health inequalities, inclusion, wellbeing and sustainability at the heart of what we do, we will deliver clinically effective, patient centred care in the context of Covid19 safety, IPC standards and ongoing uncertainty and change”. Describe how we will deliver care and support in each of our services. Support and enable our service level leadership teams to work with people to: • Build on what’s been learnt over the last year • Continue to keep our service users and staff safe • Use this opportunity to stabilise, understand and reset • Draw out gaps and concerns about unmet (and forecast) demand • Understand (and respond) where people have been excluded integrity | simplicity | caring

4. What we aiming to achieve integrity | simplicity | caring

5. We are at different points in different services but are focussing on: o Using data and intelligence o Connecting with communities and people o Locking in innovation (where it works for people) o Understanding experiences and impact o Keeping people safe o Moving to access models that don’t exclude integrity | simplicity | caring

6. Our approach • Knowing and understand the gaps/harms that the last years disruption has resulted in for people who use or would access each service. Focusing on how to reach these people and support them proactively. • Understand and respond to the health inequalities of the people who use our service. Focus on Access, Experience and improving the physical health of our service users. • Understand service user experience and put create a proactively flexible responsive service delivery model. • Create flexibility for people based on access challenges and experience of people using our services. • Address gaps, delays, issues with access, new demand. • Ensure safety for staff, service users and the public. • Learning, capturing and locking in innovation • Identifying what innovation in practice should be continued and what resources this would take. • Be inclusive and engaged with the people we serve and our workforce • Build in ongoing resilience (business continuity and flexibility). • What we need in terms of estates and our facilities • Stay connected to and support the front line (those closest to the people we serve) integrity | simplicity | caring

7. But we need to keep it as straightforward and simple as possible so….. integrity | simplicity | caring

8. But we need to keep it as straightforward and simple as possible so….. integrity | simplicity | caring

9. The Key Issues by Service Line Acute Services Stabilisation plan agreed with continued focus on flow, quality improvement and activities. ACE work manifesting in improvements in gatekeeping and out of hospital offer. Older Adults Continuing the success of strengthening the IHTT team and their offer support more people at home. MAS significant backlog and unmet need – recovery plan in place. Community and Wellbeing Services Particular focus on PCN alignment and responding to local need/demand. Health inequalities agenda to improve access for specific communities and groups of people. Significant backlog of people needing access to psychological therapies. Learning Disabilities Continued focus on physical health and wellbeing. Restarting group work and supporting partners to restart invaluable services. The gaps in pathways have created real issues for people and families. integrity | simplicity | caring

10. Liaison Services Increased waiting times and backlog so primary focus is on catch up. Joint models of care for long Covid. ALPS Continuing the improvements made despite constraints of separation from ED. NICPM Reopened to admission but remaining waiting list due to demand for service. (Not new issue) Perinatal Continued focus on inclusion and building on success in access. The innovation in this area is starting to benefit marginalised and previously excluded communities and people. The future estate and facilities plans are a key priority. CYP Deaf Camhs focus on safe return to face to face activity (estates issue across the region). Focus on CYP complex assessments and digital poverty (excluding some families that need support). Forensic Focus on restoring discharge activities and pathways to enable transition. Recovery of imbalance on Forensics and PICU. Transition to Provider collaborative model. integrity | simplicity | caring

11. The Key Issues by Service Line Addictions A key area where we see significant increases in demand (particularly in alcohol misuse). Focus on working much more in partnership with Primary Care and with CMHT’s to make sure we can meet the demand collectively. Developing plans for integrated model for dual diagnosis. LADS/ADHD Significant backlog and unmet need (some new). Planning to merge and improve access pathways. Veterans Embedding and building on the early success. Locking in the benefits of innovative working and group work. Rehab and Recovery Build on innovation of recovery College, implement new models for complex rehab, focus on partnerships for future models. integrity | simplicity | caring

12. Emerging Themes Blended approach to delivery of support, care and interventions Older Adults community based services Memory Assessment service LD Community Services Community Adult Services Perinatal community service Deaf Camhs Gender Rehab and in particular the Recovery College Personality Disorder Services Gambling LADS ADHD Veterans A focussed reinvigoration of the physical health agenda Community and Wellbeing services All inpatient services Forensic services Rehab and Recovery (AOT in particular) Addictions integrity | simplicity | caring

13. Emerging Themes Services where we are building on innovation Gender Community and wellbeing Liaison and ALPS Perinatal Older Adult IHTT service LD Community Services Recovery service Veterans Gambling integrity | simplicity | caring

14. Emerging Themes Services where we are building on partnerships Community and Wellbeing Personality Disorder Services Addictions Acute services Forensic Liaison Rehab and Recovery Perinatal Learning Disability and Supported Housing The Willows and our dementia services Services where resources (workforce and ? funding are key) All (of course) – core services in particular Out of hospital care and treatment (short and long term) Memory assessment (short term) All adult services where demand expected to increase by 12%) CYP ADHD and LADS Gender integrity | simplicity | caring

15. Next Steps and Discussion • Reviewing alongside our leadership teams • Setting out the gaps to be built on (understanding harms, gaps and emerging demand) • Drawing in our support and expertise from across the Trust (and from Partners) • Identifying themes and action that should be consistent across services (and managing this) • Key focus on strengthening service user and carer engagement, involvement and inclusion at service level as a priority • Focus on outcomes and impact (measures) in our day to day planning work • Further development of work (alongside other strategic planning themes) to set out our vision and strategy for future of our care services. integrity | simplicity | caring