the dudley and walsall pathway

The Dudley and Walsall PathwaySustainability & Transformation Network 17.4.18

Dr Rose Jones – Consultant Psychiatrist

Susanne Tracey – Specialist Nurse

Jonathon Davis – Specialist Nurse

Background

• In 2009 Consultant Dr Renju Joseph felt there was a gap in service provision for patients with Autism and ADHD. He was supported by Jacky O’Sullivan (Clinical Development Director) and together they wrote several business cases that were taken to the Trust and their host CCGs. Eventually the Trust supported the establishment of the service ‘at risk’.

• Challenges included convincing colleagues, managers and commissioners about the importance of this service and getting support from GP’s around prescribing.

Progress

• We currently have over 20 commissioners involved all accessing care on a spot purchase basis

• The service has so far won 2 awards: – Best Mental Health Support Services Centre – West

Midlands in the 2017 – Social Care Awards DWMHT staff awards – Front line

team of the year 2017

• The service is a wonderful example of clinicians and mangers working together to achieve something great

Who we are

• Consultants

– 1 x Full Time (+ 1 x 1 session per week)

• Specialist Nurses

– 1 x Prescriber, 1 x soon to be prescriber

• Full time secretary

• 2 x very helpful receptionists

• Numerous students and specialist interest trainees

Who we see

• Those who require a diagnosis of ASD

• Those who require a diagnosis of ADHD and want treatment

• Those who already have a diagnosis of ADHD and require medication optimising or monitoring

• ADHD CAMHS transitions

What we offer

• ASD

– One assessment with Consultant (1-2 hours as needed)

– One DISCO assessment (informant history) with Specialist Nurse, where possible

What we offer

• ADHD

– Initial Assessment with Specialist Nurse/Consultant (1 hour)

– DIVA Assessment with Specialist Nurse (1 hour)

– Up to 5 follow-up sessions to stabilise medication regime

– Yearly review

What we don’t do

• ASD

– Management

• ADHD

– Crisis Response / Urgent appointments

12 Week Audit - ADHD

• METHOD: Data was accessed via Clinician’s diaries and OASIS (electronic patient information system) to look for outcomes.

• RESULTS:

• Total 129 appointments

• New diagnosis of ADHD: 11

• Previous Diagnosis of ADHD 21

• Follow- up: 97

Current Case Load

• 207

• Growing by around 5-10 per week

Next Steps

• More admin

• Occupational Therapist

• Groups

Difficulties

• How do we quantify the impact of our treatment?

• What is the exit plan?

• How do we resist becoming a ‘Community Mental Health Team for those with ADHD’?

• Crisis Management

*

*Mainstream Schools

*Poor Concentration

*Disruptive behaviour

*Poor academic

performance

*Truancy

*Suspension

*Exclusion

*Wrong crowd

*Alcohol misuse

*Drug use

*Petty crime

*Risk taking

Unemployment

Crime

Substance Addiction

Mental Health Problems

Lack of family

support

Homelessness

Sexual exploitation

2 years Custodial

Sentence

Addiction ServicesMental Health

Services

Physical Health Probation

Housing/ BenefitsEducation

Adult Neurodevelopmental

Service

Thank you