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An overview of the mental health system, for the Older Leaders 4 Change programme being run by NDTi. Diagrams from JCPHM, King's Fund, NAO, Mental Health Strategies (for DH).
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people lives communitiespeople lives communities
Older Leaders for Change in Mental Health
Module 2
6 June 2014
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Part 1What is currently in place to support people with mental health problems?
Part 2What are the current issues?
What have people with mental health problems done to influence change?
Part 3What can Older Leaders do to raise the profile of older people’s mental health and influence change?
Overview
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What is currently in place to support people with mental health problems?
Part 1
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What “the system” means to you…
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What “the system” means to me…
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Who is the MH system for?
5% 45%
20% 40%
75% 15%
Multiple complex conditions
Single chronic disease/At risk of a majorprocedure
Healthy, minorHealth issuesIf any
A&E over-utilisation,high care variation
Infections,complications,readmissions
Multiple complex conditions
Patient Segments Cost Breakdown
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Who is the MH system for?
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Who is the MH system for?
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The other 1 in 4…
*92% of people with diabetes receive care
26% of people with a mental health problem receive any care
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Who is the MH system?
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Who is the MH system?
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What is the MH system?
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What is the MH system?
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Medical Services Person• Diagnose• Medicate• Service
• Community Mental Health• Crisis Resolution• Assertive Outreach• Early Intervention in Psychosis• Forensic Services• CAMHS• Acute/inpatient care• Drug and alcohol• Liaison• LD / Challenging Behaviour• Older People• Primary mental health care / GPs
• Stigma• Discrimination• Lack of rights• Removal of rights• Little understanding• Little support
What is the MH system?
How the system currently flows…How the system currently flows…
How the system should flow…How the system should flow…
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What is the MH system?
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What is the MH system?
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What is the MH system?
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What is the MH system?
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What will the MH system be?
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What will the MH system be?
NHS spend 83.3% of all MH budget
DP money spent:NHS + social service providers - £4.7m (15.5%)
Non-statutory providers - £25.8m (84.5%)
80%80%
20%20%
80%80%
20%20%
Without choice…
With choice…
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Break
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What are the current issues?
What have people with mental health problems done to influence change?
Part 2
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What have you done to help things improve?Can be something to do with mental health
Can be something beyond mental health
Why did that work?What is the general lesson / principle of why that worked?
A time things have improved…
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Levers / drivers for change
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Levers / drivers for change
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MH payment system
Individual patient needsAssessment and diagnosis
Individual patient needsAssessment and diagnosis
Mental Health Clustering ToolStandardised summary of individual needsMental Health Clustering Tool
Standardised summary of individual needs
ClusterGlobal description of combination & severity of individual needs
ClusterGlobal description of combination & severity of individual needs
Care PackagesIndividually negotiated care plan informed by NICE Guidance
Care PackagesIndividually negotiated care plan informed by NICE Guidance
Quality and Outcome MetricsTriangulated measurement of process and effect
Quality and Outcome MetricsTriangulated measurement of process and effect
Local/national TariffDerived from joint understanding of accurate costs
Local/national TariffDerived from joint understanding of accurate costs
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Change
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Lunch
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What can Older Leaders do to raise the profile of older people’s mental health and influence change?
Part 3
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What are your reflections today?
Emerging ideas for influencing…
Questions and discussion
Discussion
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Paths to Personalisation
JCPMH
NHS Confederation MH Network
Mental Health Foundation
CQC
NSUN
Sources of information
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Contact
Rich Watts, MH Programme LeadT: 01225 789135
Twitter: @rich_w