appendix 2 - lambeth black health and wellbeing commission ... updat… · • the lambeth health...

of 43

Appendix 2 - Lambeth Black Health and Wellbeing Commission: action plan

A response to recommendations within the Black Health and Wellbeing Commission report was presented at the Health and Wellbeing Board in April 2015 where input was received from partners with responsibility for commissioning, providers of services and policy makers to improve mental health and wellbeing. A development status was given to each of the recommendation; new action required, progress being made but further development required and significant development already in place therefore no further action required beyond evidencing outreach to black communities. Following on from the Commission’s recommendations a task and finish group, led by the Health and Wellbeing Board Chair, was established in September 2015 to take review progress and actions. The content of this group’s discussions have been fed into the table below. In summary whilst much progress has been made, more is clearly required. The expectation going forward is that the relevant programme or partnership board will continue to progress action in relation to recommendations in collaboration with users and carers and the wider community. Once the proposed Black Well Being partnership is established this will take a key role in helping to drive and support progress against the recommendations. Version control:

30 March 2016 Natalie Sutherland, NHS Lambeth CCG – Integrated Commissioning Mental Health

15 April 2016 Natalie Sutherland, NHS Lambeth CCG – Integrated Commissioning Mental Health

18 April 2016 Natalie Sutherland, NHS Lambeth CCG – Integrated Commissioning Mental Health

of 43

Recommendation Current work Proposed additional action Programme / Lead

Recommendation 1 Lambeth’s services must continue to develop a co-operative approach with residents to support and empower each other in order to enjoy better health and wellbeing. This should be underpinned by a long-term, integrated plan to ensure the best use of resources in creating and sustaining a life-course approach that supports people from conception to the end of their lives. Alignment with Lambeth parallel strategies and programmes e.g. Child and Adult Safeguarding, Lambeth Early Action Partnership will also contribute to improved outcomes. 3

• It is an explicit commitment by Lambeth Council and Lambeth Clinical Commissioning Group (CCG) to work:

o Cooperatively with citizens

o In partnership as 2 organisations And to integrate health & social care commissioning (e.g. the Better Care Fund).

• Lambeth Living Well Collaborative (LLWC) has developed a collaborative co-production commissioning framework to support better outcomes.

The equality impact assessment used to inform the trust’s involvement strategy identified the need to continue to improve involvement of African and Black communities across the trust’s involvement activity. This was informed by a range of evidence in relation to ethnicity including:

Analysis of the representativeness of feedback through PEDIC surveys (see recommendation 35)

Feedback from participants at joint event held with Lambeth BHWB IAG on 25th August

Key actions from the strategy include:

The Trust worked in partnership with NSUN and Lambeth BHWB IAG to benchmark current involvement across the trust with particular regard to the involvement of Black service users.

The Trust continues to monitor the ethnicity of people undertaking involvement register activities (ongoing)

The Trust is undertaking scoping work with a limited number of clinical teams (including the OASIS Early Intervention team in Lambeth) to assess current engagement approaches; developmental needs and resource implications of increasing community engagement by teams.

• Ensure consistent application of equality impact assessment in relation to all programmes of work.

• LLWC proposes to further develop the framework in collaboration with partners and users/carers. EIAs on relevant aspects of SLaM’s Five Year Strategy such as the Trust’s quality strategy and Adult Mental Health changes in Lambeth will be reviewed during 2016.

• Commissioning Cluster / Integrated Commissioning

• Living Well Collaborative

• SLaM

of 43


• The new integrated commissioning committee between the CCG and Lambeth council has been established for mental health and older people. It is chaired by the cabinet lead for Health and Wellbeing and membership includes cabinet lead for adult social care services, CCG governing body leads for mental health and older people and CCG Board lay member.

• The Health and Wellbeing strategy is currently being refreshed and will be presented at the HWB Board in April.

The EWMH Strategy was co-produced with young people and parents/carers. Key messages informed the priorities and the development of the CAMHS Transformation Plan. Ongoing focus groups and meetings have taken place with a range of young people including targeting specific BME groups to ensure their views around transition, access to services and delivery options are captured. A Co-production group will operate alongside the CAMHS JCG

One of the key actions from the CAMHS Transformation Plan is to complete a comprehensive review of all CAMHS (to be phased and completed by Q3 16/17) looking at clinical outcomes, feedback from service users and referrers, pathways, skill mix and staffing structures, demographic breakdown of service users partnership working, thresholds etc this will inform service development and commissioning to

• Moira McGrath / Commissioning for mental health and older people

• Adrian Smith / Health and Wellbeing Board

Chıldrens servıces

of 43


ensure services meet the needs of the population

Recommendation 2 To tackle the social pre-determinants of illness the Health and Wellbeing Board (HWB) and its members should work together to ensure: • A Lambeth Housing

Standard accommodation that is fit for purpose for everyone;

• A ‘good’or ‘outstanding’(as defined by Ofsted inspectors) ‘whole school’(as defined by National Institute for Clinical Excellence http://www.nice.org.uk/niceMedia/documents/whole_school.pdf) place for all;

• A London Living Wage paid job or training for everyone;

• That there is a mechanism to assess all policies to ensure that there has been proper regard to their

• The Mental Wellbeing Impact Assessment has been used to screen some policies and service redesign

• The Health Impact Assessment has mostly been used for planning and regeneration work rather than at a policy level.

• The LLWC big three outcomes explicitly include the wider determinants (social connections, housing, employment) in the recognition that these are pivotal to delivering better care. The Living Well Network has been implemented borough wide and includes work to improve connections with services and communities and resources via the ‘Connect & DO ’initiative (www.connectanddo.org).

• Holistic outcomes approach has been developed for people with complex needs who use rehabilitation services via the Integrated Personal Support Alliance that went live in April 2015.

• The Council has as part of its Procurement policy framework, social value clauses and expectations that contracted providers will pay London Living Wage. The Council became a Living Wage employer in November 2012 with full accreditation. The Council already engages in a number of activities to promote Living Wage, using not just its supply chain powers, but also relationships with businesses.

• Equalities Impact Assessment Panel has now agreed to include health as part of its work. All major policies could now usefully have a health and wellbeing impact assessment screening

• A Living Well Network communications plan is being developed and this will look at tailoring communications for different communities.

• A Living Well Network ‘open morning’ to go out into the community (Vassall Ward) to raise awareness of mental health services available in the borough.

• Evaluation work is taking place ensuring Whole School emotional wellbeing and resilience is a key priority of the Lambeth YP EWMH Strategy, with a focus on evidence-based programs. Mapping of all emotional wellbeing interventions

• Commissioning Cluster / Integrated Commissioning


• Procurement Team Lambeth Council

Children’s services

http://www.connectanddo.org/

of 43


impact on health and wellbeing.

commissioned by schools is currently underway due to be completed by June 2016. Training needs analysis of school staff is also being completed and will inform work going forward. It is proposed that a pilot in evidence-based whole school emotional wellbeing is carried via the children & young People Health Partnership (CYPHP) out to inform future roll out. All Primary schools are signed up to the Healthy Schools Programme

Recommendation 3 People in the community should be trained to promote good mental, physical and financial health and sign post people to relevant support services. Developing peer support in GP surgeries or the use of Health Champions (like those piloted by Well London) should be considered to unlock the power in communities across all age groups (inter-generational) and create supportive networks and environments.

• There is a manifesto commitment to Health Champions

• Some residents/TRA members attend Mental Health First Aid training, MH awareness, & Young Persons’MH First Aid commissioned by Lambeth CCG & provided by SlaM

• MHFA and YMHFA training is specifically targeted at members of small community and voluntary.

• Ethnicity of participants for sessions delivered in 15/16 (at Dec 15)

Ethnicity MHFA participants of 5 sessions in 15/16 (n=61)

YMHFA participants in 2 sessions in 15/16 (n=24)

Asian 4.9% 0.0%

Black 50.8% 33.3%

Mixed Race 9.8% 25.9%

Other ethnic group 3.3% 0.0%

White 31.1% 40.7%

• ‘Making Every Contact Count ’approach could be developed to include training for residents.

• Role of LVAC and London Community Foundation to assist re capacity building and encouraging VCS to skill up

• Co-design and co-deliver training with, for and to children, young people and parents. Align training programmes on with workforce development programmes and recruitment to build a wellbeing workforce

• Build on learning from Well London project

• As part of the Well London project, SLaM’s Mental Health Promotion Team has expertise in this area and could be commissioned to

• Staying Healthy Board

• SLaM

• Integrated Commissioning

of 43


SLaM aims to increase peer support across all its care pathways and to develop the Trust’s peer workforce. The offer of peer support will be through secondary services. SLaM will continue to work collaboratively with others offering peer support

• Public Health have carried out considerable scoping around ‘Making Every Contact Count’ but needs resourcing/development to implement

• Wellbeing network has a monthly e-bulletin and three events a year to promote action to improve wellbeing. This is open to all, including residents.

• Wellbeing & Happiness small grants scheme funds projects such as Streatham Drop-in for asylum seekers and refugees to do group work on emotional health and wellbeing, but these are short term projects.

• SLaM aims to increase peer support across all its care pathways and to develop the Trust’s peer workforce. The offer of peer support will be through secondary services. SLaM will continue to work collaboratively with others offering peer support

The Council funds a Money Champion training programme for residents and front line staff. This provides participants with the skills to identify people who are in financial difficulty and signpost them to appropriate support services. So far over 250 Money Champions have been trained, of whom 45% are Black.

provide support and training to Health Champions

• Further MHFA sessions will be delivered in Lambeth on 4th& 5th July

The Money Champions project is being extended to March 2017.

Recommendation 4 All Lambeth schools should teach children about staying mentally and physically healthy and what to do if they start to feel emotionally

• The Lambeth Health and Wellbeing programme is commissioned for schools and schools are now being encouraged to sign up to the London Healthy Schools programme and are supported by School Improvement Health and Wellbeing team to record provision in the HSL Bronze Audit tool. There will be a

• Keep a close eye on Welsh scheme for all schools to have a counselor and see what results are - CAMHS was piloted in Lambeth schools in 2007/8 but funding withdrawn after 1 year

• Integrated Commissioning - Children’s

of 43


unwell. This should be supported by a ‘Lambeth Education Wellbeing Charter ‘to promote social and emotional wellbeing. Schools should also develop relations with local mental health services to ensure good relations, timely and appropriate sign-posting/referrals. Lambeth schools should take a ‘whole school ‘approach to health and wellbeing as defined by National Institute for Clinical Excellence http://www.nice.org.uk/niceMedia/documents/whole_school.pdf.

push now for this because of the Flagship food bid monies (95% of primaries must be signed up by end of programme).

CYPHP and children’s commissioning are working together to develop a commissioning guidance for schools – this should be completed May 2016

Children’s commissioning working with CYPHP to pilot emotional resilience training programmes for school staff – currently undertaking procurement process. This will include signposting CYP to support services.

• Healthy Schools Lambeth Steering Group oversees the work and monitors impact

• Bounce Back resilience programme training delivered to teachers in the past with good feedback

• Mindfulness training for teachers pilot being scoped

• Schools invest in emotional wellbeing support, including SENco. Pastoral care, art and dance therapy, and teaching assistants

• Accessed by support from School Improvement Health and Wellbeing officers plus Janis Marsh (commissioned by Health and Wellbeing Programme). Healthy Schools’ programme is a universal offer therefore with 60% + pupils being black heritage, the schools’ provision applies to them

• Consider use of online counseling for those not eligible for CAMHs e.g. Mindfull

• Schools should also develop relations with local mental health services to ensure timely and appropriate sign-posting/referrals.

• Lambeth schools should build on work to take a ‘whole school’ approach to health and wellbeing as defined by National Institute for Clinical Excellence http://www.nice.org.uk/niceMedia/documents/whole_school.pdf

Recommendation 5 The Health and Wellbeing Board should develop a robust strategy to educate young people about the psychologically damaging impact of

• Gang membership at primary school age is anecdotally a rising concern for schools. Public health review on violence includes guidance interventions.

• CCG and LA joint funding Growing Against Violence programme in primary and secondary schools (not mandatory) to educate CYP about gangs, violence, self-esteem, CSE etc.

• Need to understand what preventive work going on in schools now.

• Young Person’s Substance misuse strategy has been co-produced with young people, parents and other stakeholders and an alliance has been

• Integrated commissioning (CYPHP)

• Public Health Commissioning

http://www.nice.org.uk/nicemedia/documents/whole_school.pdf

http://www.nice.org.uk/nicemedia/documents/whole_school.pdf

of 43


drugs, alcohol, violence, abuse and gangs. More support, including peer support and mentoring, should be targeted to those who are demonstrating risky behaviour and who want to change. It is important to note that girls join gangs for different reasons to boys and the route out of them is also different - The Centre 5 for Mental Health has done some noteworthy work on this area: http://www.centreformentalhealth.org.uk/pdfs/A_need_to_belong.pdf

• Health and Wellbeing programme in schools includes DATE (Drug/Alcohol/Tobacco/Education)

• CCG funding extended evaluation of the I-Dream alliance (Young People’s substance & alcohol misuse) in 16/17. The comprehensive evaluation will inform future commissioning intentions

• Healthy Schools London audit includes provision on DATE.

• Healthy Schools provide training on substances and alcohol as does Wise Up Sexual Health Service.

• Lambeth CCG Commissions the Well Centre in Streatham which provides youth services and an integrated one stop shop of health services, including CAMHS. Evaluation has shown an increase in young people accessing services and feedback from young people has been positive.

commissioned to support young people from 1st April 2015. They will be implementing an appreciative approach and the outcomes of the project will be formally reviewed and evaluated by the University of Brighton.

• The Centre for Mental Health has done some work on gangs: http://www.centreformentalhealth.org.uk/pdfs/A_need_to_belong.pdf the implementation of CAMHS strategy should consider implications of this work.

Recommendation 6 More needs to be done to ensure that the make-up of every Lambeth school reflects the local community it serves. An investigation should establish why some communities may be under/over represented in local schools and what practical steps can be taken to address it.

• Lambeth Council has an admissions policy for Lambeth’s Community Primary and Secondary Schools and Lambeth’s voluntary- controlled secondary school.

• As per recommendation an investigation could be undertaken to establish why some communities may be under/over represented in local schools and what practical steps can be taken to address it.


http://www.centreformentalhealth.org.uk/pdfs/A_need_to_belong.pdf



http://www.centreformentalhealth.org.uk/pdfs/a_need_to_belong.pdf

http://www.centreformentalhealth.org.uk/pdfs/a_need_to_belong.pdf

of 43


Recommendation 7 The Health and Wellbeing Board should examine how communities and public services can further reduce teenage pregnancies.

• See recommendation 4 regarding the health education programme in schools.

• A teenage pregnancy strategy is in place which has led to reductions in teenage pregnancies

• Link to young people’s route from school to higher education and training/apprenticeships to ensure aspirations are raised.

• Implementation of CAMHS strategy should consider implications of this recommendation.

• Staying Health Board

Recommendation 8 All parents, but particularly those in high risk groups, should be encouraged and given the opportunity to improve their parenting skills. The Health and Wellbeing Board should look at scaling up existing parenting skill initiatives and examine using models like ‘peer parenting’, ‘empowering parents, empowering communities’ and ensure these are a universal offer rather than stigmatising particular groups like the ‘troubled families’ initiative. ‘Empowering parents, empowering communities’ is a community-based programme, training

• Early Help & Prevention Strategy sets out the importance of commissioning the right parenting support

• The recent review of parenting programme in Lambeth led to a more co-ordinated approach and expansion of evidence-based programmes, including Triple P and Stepping Stones

• Manifesto commitment to ensure Children’s Centres remain open and are used as a hub for people to access a range of services

• SLaM Lambeth CAMHS run a Parent’s Group that offers support and training for parents, e.g. on ADH

• The LEAP programme will further role out Parenting programmes and support (i.e through Mellow Bumps and Dads and through the Parent Champion Model). These will be robustly evaluated as part of the LEAP programme and scaled up where impact and good outcomes are demonstrated.

• CAMHS Transformation Plan includes mapping parenting programmes for emotional wellbeing and mental health in 16/17 to further strengthen the current Lambeth Parenting Strategy.

• Develop effective communication strategy to improve awareness of programmes on offer e.g. with GPs and schools and parents/carers. The CAMHS Transformation plan identifies the need for clear and effective communication of programmes with clear referral pathways and signposting information. A


of 43


local parents to run parenting groups in schools and children’s centres. Developed in Southwark over the last 10 years, the programme has received a national Sure Start award for innovation and user involvement. The model assumes that parents find it less stigmatizing and more supportive to attend parenting groups run by local people who are in very similar circumstances to themselves. The Centre for Mental Health has done some noteworthy work on this area: http://www.centreformentalhealth.org.uk/pdfs/Parents_voices.pdf

comprehensive communication strategy will be developed in 2016/17

• Evidence should continue to be applied; The Centre for Mental Health has done work on this: http://www.centreformentalhealth.org.uk/pdfs/Parents_voices.pdf

http://www.centreformentalhealth.org.uk/pdfs/parents_voices.pdf

http://www.centreformentalhealth.org.uk/pdfs/parents_voices.pdf

of 43


Recommendation 9 Provide extra support such as mentoring and professional help to parents who: • Are young

(teenagers); • Have a mental health

condition; • Have a drug and/or

drink problem; • Have issues with

violence or abuse, including sexual violence;

• Are living in poverty; • Have been involved

with the criminal justice system.

• A number of programmes to support teenage parents (conception to two years) are commissioned in Lambeth – Family Nurse Partnership and St Michael’s Fellowship

• Range of evidence based Parenting Programmes commissioned in Lambeth (Triple P, Stepping Stones)

• LB Lambeth and NHS Lambeth CCG commission domestic violence services from the Gaia Centre

• Multi-systemic Therapy (MST) is commissioned to work with parents and young people at risk of family breakdown, offending and absence from education.

• There is a full range of substance misuse and alcohol support and treatment services in Lambeth, commissioned via public health.

• The 2015-18 child poverty strategy is currently under development and will be signed off in April 2015.

SLaM Services

• Secondary mental health care to children, adults and older people in Lambeth as well as substance misuse service to adults.

• Lambeth Addictions service work with a service user-led charity to offer peer mentoring to service users

• Lambeth Early Intervention service has a Vocational Specialist working within the team who works with individuals to either obtain or retain work/educational opportunities

• Promoting Recovery teams signpost to a number of services within the Trust and organisations within the community.

• SHARP (Social Inclusion and Recovery Project) work in collaboration with people on individual goals which may include vocational opportunities. SHARP have 2 service user posts and collaborate with Mosaic Clubhouse to achieve this.

• Alignment of Child Poverty Strategy with other local and national strategies. The child Poverty Strategy has been signed off by the Children & Families Strategic Partnership (CFSP). It has been developed to sit alongside existing strategies such as the Early Intervention /strategy, EWMH Strategy, VAWG Strategy etc

• Early Years commissioned programme is being re-tendered with new contracts starting on 1October. This includes course based learning and targeted support for parents who are struggling. This tender will be undertaken using a co-operative approach so that parents are involved throughout the process. This will help to ensure that contracts awarded are the most

• Integrated commissioning


• SLaM

of 43


• SLaM Community Mental Health Teams and inpatient services refer people to Vocation Matter for support to access/obtain work (paid or voluntary) or educational /training opportunities. This includes a carpet cleaning work training project that supports service users to gain work skills and gain confidence as well as offering a commercial carpet cleaning service.

• Vocational services in Lambeth have integrated two peer support workers to support service users on their vocational journeys through sharing their lived experiences of learning, change and growth.

• Lambeth Mental Health in Learning Disabilities Teams psychology service is about to begin a service user empowerment group in New Year that they hope will lead to mentoring opportunities. Their service user involvement group meets regularly, with recent focus on involvement in recruitment

• During 2015 work within the AMH community teams in Lambeth was undertaken with 300 Voices to bring staff and services users together to learn from service users as to what would make care planning feel more personal, support true coproduction and empower service users to achieve their own goals. This will continue in 2016.

relevant and effective for these families.

• CAMHS commissioners will look at EWMH specific parenting programmes following the Early Years review/tender

• Lambeth Mental Health in Learning Disabilities Teams psychology service is about to begin a service user empowerment group in New Year that they hope will lead to mentoring opportunities. Their service user involvement group meets regularly, with recent focus on involvement in recruitment.

• Work within the AMH model is looking to ensure that people are asked about goals and aspirations re: work and then an individualised plan as to how to achieve these are developed in collaboration with the service user.

of 43

Recommendation 10 Lambeth council and other agencies work to reduce the harm caused by seeking to limit the availability of:

• Off licence alcohol; • Very high interest,

pay-day type loans; • Fixed odds betting

terminals.

• Public Health has been working with the council on influencing their local development planning and supporting evidence to the planning inspector on healthy high streets.

• SLaM Services include the following to reduce the harm caused by alcohol in Lambeth:

• The Drug and Alcohol Service (Lambeth): assessment, treatment and advice for people, aged over 18, who have substance misuse (drug and/or alcohol) related problems:

• Tier 2 addictions assessment and brief intervention clinic, and a Tier 3 addictions assessment and treatment service.

• Tier 2 services provide drug-related information, advice, assessment, referrals, interventions (including needle exchange) and aftercare.

• Tier 3 services provide specialised drug assessments, treatment, care and referrals, delivered in the community or on hospital sites. The service provides people with a care plan and a key worker. This service is often delivered alongside Tier 2 services.

• The Drug Rehabilitation Requirement Service (Lambeth): specialist assessment, treatment and care for people, aged over 18, referred through the courts on a DRR Order. A DRR service provides offenders with fast access to drug treatment programmes where their criminal behaviour is associated with drug misuse. The aim of a DDR is to reduce drug-related offending. The treatment programme includes rehabilitation, counselling and prescribing alternatives to drugs. Advice and support on housing, relationships, employment and education is also provided. The service works with other teams in health and social care to help people maintain their health and their independence.

• As recommended in the Healthier High Streets Scrutiny Commission, the council’s Planning Policy team are examining whether it is possible to classify payday loan shops as “unsustainable development”.


• Community safety

of 43


Recommendation 11 Proper attention should be paid to the physical health of people with mental health conditions and vice versa. This would include those with chronic physical health conditions. Mental health service users should be offered a physical health check up and given support to improve diet and exercise and, where appropriate, to stop smoking, harmful drinking and drug use, address sexual violence. The British Heart Foundation have just published a new guide ‘Everyday Triumphs’to encourage mental health service users to be physically healthier and this should be given to everyone in this category in Lambeth.

• Everyone registered with their GP as having a severe mental illness is invited to have a physical health check annually by their GP. Coverage in Lambeth is over 90%.

• The development of the LLWC has renewed emphasis on holistic care for people with mental health problems in Primary Care including their physical health including the primary care community incentive scheme.

• SLaM has revised its approach to promoting physical health of service users to make it more streamlined and to improve outputs including: • % smokers offered interventions • % inpatients with documented medicine

reconciliation stated in their care plan within 72 hours of admission

• % service users in hospital/long- term health care for >1 year who have had their annual physical health check

• % new patients admitted to hospital offered a HIV test

• % inpatients who have had a nutrition screen SLaM became a Smokefree organisation on 1st October 2014. Since the introduction of the Smoke Free Policy:

Service users are screened for smoking status and offered an opportunity for support with smoking cessation.

Over 600 service users have been referred for smoking cessation treatment.

Audits will be undertaken in April that will analyse the ethnicity of people referred for treatment

There has been no increase in violence. Smoking related violence accounted for 5% of all the violence

• Additional efforts to promote parity of esteem for people with MH problems including targeted support to stop smoking and reduce other risks to physical health

SLaM will evaluate the impact of its Smoke Free policy on different ethnic groups by:

• Auditing identification of smoking status, referral for specialist support and the use of nicotine replacement therapy, varenicline and electronic cigarettes. To report in April 2016.

• Measuring the change of inpatient activity, untoward incidents and medication regime before and after the implementation of the smoking ban. To report in April 2016.

• Reviewing communications to ensure the Trust connects with and gets feedback on becoming Smoke Free from people of different ethnicities.

• This item will be on the agenda for the joint SLaM LBHWBC IAG meeting on 21st April to discuss the Trust’s physical health strategy and medication.

• NHS Lambeth CCG

• SLaM

of 43


in the year before the new policy. This has now dropped to 2.5%.

There has also been a reduction in the numbers of fires.

SLaM has developed a new physical health strategy. Within forensic services the GP, chiropody, podiatry and dentist comes to the patient to ensure that they are not disadvantaged by being within inpatient care, often without leave to access a GP in the community. Access to gym services is available on site again to ensure access that creates parity to those within community care. There is a specific focus and commitment on improving Physical Health care within forensic services.

• SLaM met with Lambeth BHWBC IAG during 2015 to share information on the Trust’s response to this recommendation.

Recommendation 12 The Health and Wellbeing Board should intensify work with the borough’s sporting and cultural institutions like Surrey County Cricket Club, Brixton Top Cats, South Bank Centre, the Old Vic etc to ensure that all children and young people have access to high quality sporting, arts and leisure opportunities.

• Young Vic offers free theatre tickets to Lambeth residents

• In Harmony orchestra (Larkhall) • Morley college work on community choirs ‘A Choir of

our Time’ performance at Southbank • LLWC has developed the ‘Connect & Do’ initiative

which aims to better connect people with the community, cultural, arts and sporting resources available within Lambeth and which people with mental health issues use less than other parts of the community. ‘Connect and Do’ is being formally launched on 23 Sept (see rec 2)

• Brixton Reel has, on occasion, run events targeted at young people as part of its programme and involved young people in making short films around the ‘five ways to wellbeing’.

• Public Health will be facilitating an integrated impact assessment on the Cultural Services by 2020 proposals.

• In January 2015, Lambeth Council launched a suite of consultation documents setting out proposals to invest £6.5m per year in cultural services with the aim of ‘helping people be healthier for longer’. The consultation runs to 24 April 2015, with decisions due to be made by Cabinet in July 2015. All partners through the HWB and Staying Healthy Board have been encouraged to respond. The proposals include options on how

• Commissioning

of 43


• Lambeth CAMHS continue to run artistic and creative activities with service users. Previous events include: • The CAMHS Young Vic project began in 2007. Over

100 children and teenagers have taken part from Lambeth and Southwark. Projects are facilitated by an experienced theatre director, assisted by a theatre director in training, other Young Vic staff, the CAMHS PPI Facilitator and clinicians from Lambeth and Southwark.

• The opportunity to spend some time making music in a working recording studio in Brixton. The young people played instruments and were able to produce and mix their own tracks before taking them home on CD. The young people who participated thoroughly enjoyed the experience and said they will be visiting the project again in the future.

• Helping organise a series of creative workshops for service users aged between 6 and18. Each workshop has concluded with a celebratory event/ exhibition; for example the 13-15 & 16-18 year old group curated and organised their own pop-up exhibition showcasing their work at the SLG.

• Forensic patients work collaboratively with the Bethlem Museum of the Mind – we have an annual month long program where work is displayed and discussed with evening seminars.

to use the sports/physical activity offer, the future of Lambeth parks and open spaces, a new model and focus for library services and the arts/heritage.

of 43


Recommendation 13 A sense of pride in Lambeth and its people, particularly its black people, should be promoted further. The opening of the Black Cultural Archives (BCA) in Windrush Square offers new opportunities and one action could be to investigate funding options for a mural (possibly on the gable end of the building between the BCA and the Tate library) depicting the history of Lambeth and people connected with it such as Mary Seacole, Nelson Mandela, Olive Morris, David Bowie, Viollette Szabo, William Blake etc

• Brixton Reel Film Festival aims to promote wellbeing and empowerment and positive images of BME communities, particularly African-Caribbean screening films such as Alice Walker: Beauty in Truth and ‘Get on up’(the life story of James Brown) with Q and A sessions. www.brixtonreel.co.uk

• Many organisations mark Black History Month running events to celebrate the progress, richness and diversity of people of African descent, and promote a greater understanding of Black and Minority Ethnic culture amongst staff, service user & the community.

SLaM held BHM events in October 15 in the following Lambeth teams:

Luther King ward

LEO Unit

Lambeth Addictions

Mental Health in Learning Disabilities Team

Forensic services

Lambeth Council has supported BCA in its development and refurbishment of Raleigh Hall. The Council continues to commission Black Cultural Archives to promote black heritage and culture.

• As part of the consultation on cultural services, due to end in April 2015, the Council has set out its resources as part of a 3 year commission for Black Cultural Archives.

• Public Health will be facilitating an integrated impact assessment on the Cultural Services by 2020 proposals.

• Public Health

• SLaM

Recommendation 14 Lambeth Clinical Commissioning Group (CCG) should build on the social-prescribing model (linking people up to activities in the community that they might benefit from) such as that developed by

• Promotion of ‘five ways to wellbeing’(connect, give, keep learning, take notice, be active) across the borough as means to signpost to activities

• A major objective of the Living Well Network is to enable and facilitate access to the many community sources available in the borough directly with people but also referral agencies such as primary care. This builds on the exercise on prescription service.

• Lambeth is now a Flagship Food Borough and has an extensive and growing network of people and projects

• Public Health could assist in sources examples from elsewhere and gathering the evidence for what has worked to date. Could link to the review of health improvement services (LEIPs)

• http://www.centreforwelfarereform.org/uploads/attachment/339/social-prescribing-for-mental-health.pdf

• Staying Healthy Programme

• Public Health

http://www.brixtonreel.co.uk/

http://www.centreforwelfarereform.org/uploads/attachment/339/social-prescribing-for-mental-health.pdf



of 43


the Lambeth GP Food Co-Op which uses unused land around GP surgeries to build a garden and grow food. GPs can ‘prescribe’for patients to get involved in food growing providing healthy food, social opportunities, strengthening community etc. Arrangements should be sought with other schemes like the Crystal Palace mental health football team, Blockworkout community fitness, local arts initiatives like Cooltan Arts and institutions like the Royal Festival Hall, Old Vic, Southbank, Tate Britain/Modern etc. If GPs and other professionals were able to ‘prescribe’courses and activities with these kinds of providers in addition to medication and talking therapy it would create more choice and enable people to come out of isolation and learn new

growing food and cooking from diverse communities as part of its Food Strategy

SLaM offers volunteering opportunities for service users, carers and members of the public. There was a large increase in the number SLaM volunteers during 2015. The proportions of Black and Mixed Race volunteers and volunteers who have lived experience of mental health both increased during 2015.

• The SLaM Recovery College offers a range of workshops and courses that aim to provide the tools to support people in their recovery journeys. All courses are co-designed and delivered by expects with lived experience and mental health professionals. The SLaM Recovery College offers workshops and courses that aim to equip people in their recovery journeys. Courses are co-designed and delivered by experts with lived experience and mental health professionals. It is open to people who use SLaM services their supporters and carers and staff.

• The Recovery College monitor the ethnicity of students that register to attend. This data is currently being inputted into a database for analysis as part of the Recovery College’s evaluation.

• Could develop a preferred supplier list of voluntary sector providers to refer to

• Develop opportunities so people feel they can join in without a ‘prescription’

• Lambeth Local Care Networks have been developed to work together to deliver co-ordinated care across the borough. This is achieved by working in partnership across health, social care and the voluntary sector organisations as well as linking in the patient participation groups. This new way of working provides the opportunity to improve quality of services and improve patient journey / experience. Ongoing and successful projects include:

Portuguese-speaking Community Project - to improve engagement and access to local health and other support services across Lambeth. 0020

Primary Care Navigators (PCNs) – linking in with the Royal Pharmaceutical Society (RPS), and the National Association of Primary Care (NAPC) on training and placement of primary care navigators in pharmacies and GP practices. The initial focus is on

• Primary Care Programme - CCG

of 43


skills. This approach could be reflected within the Lambeth CCG’s “Transforming Primary Care”strategy.

relatives and carers and patients with diabetes, by “sign-posting” to the wide range of other organisations across the borough

Safe and Independent Living (SAIL) - to strengthen the existing partnership between Primary Care and Age UK, and improve the number of referrals to SAIL from Lambeth GPs and pharmacies. SAIL is an Age UK service designed for our older population, signposting patients, carers and relatives to social groups and services across the borough Community Asset Engagement. This involves a process of community engagement with local people, organisations businesses, (schools, shops, police housing, etc) to build a local asset map, where their local knowledge and experience builds the asset map particularly for people with a mental health condition and other long term conditions.

Recovery College courses continue to be delivered to service users, carers and staff of the Trust’s Lambeth services. Details of courses are available at:

• www.slamrecoverycollege.co.uk

http://www.slamrecoverycollege.co.uk/

of 43


Recommendation 15 The eligibility threshold for accessing Children and Adolescent Mental Health Services (CAMHS) needs to be significantly lowered and flexible provision made for those currently deemed not suffering from a ‘serious enough’mental illness. Major efforts should be made to ensure that groups under-represented as CAMHS clients are given the support they need. This approach could be incorporated into the refresh of the local CAMHS strategy.

• CAMHS needs assessment • CAMHS Early Intervention Service is currently co-

located with the Multi-Agency Teams in Lambeth • Lambeth Community CAMHS teams published

ethnicity data on case load in 2014 and 2015 as part of the Trust’s annual equality information (see recommendation 37).

• Thresholds to the early intervention service have been reviewed, which has led to an increase in referrals and referrals accepted. Additional resource has been identified for the early intervention service to reduce waiting times and ensure C&YP are receiving the early help they need.

• The Young Lambeth Emotional Wellbeing and Mental Health Plan has been co-produced and incorporates a more obvious “Keeping Well”theme to designing and delivering services

• CAMHS service reviews will be undertaken from May 2016 looking at service structure, pathways for CYP, thresholds/criteria. This will inform future service shaping and design.

• The Trust’s Equality Manager is working with CAMHS to improve the quality of community teams’ ethnicity data.

• Gap around counselling provision for children and young people either face to face or online.

• Much of the burden of mental health is conduct disorder/problems which may be better addressed with parenting programme and other social support

• Co-producing care pathways as part of The Young Lambeth Emotional Wellbeing and Mental Health Plan (2015 –2018), including co-production of training, care pathways and service models

• The DoH has signalled additional funding for CAMHs. Details to follow.


Recommendation 16 The Health and Wellbeing Board should look at improving the transition between CAMHS and adult services and ensure this is linked with other transitions like moving out of care or criminal justice settings.

• CAMHs needs assessment • Ongoing transition work is taking place between

CAMHs and adult services. The young people’s emotional wellbeing strategy includes action on this.

• Funding sought to bring in additional resource to the south London Boroughs to scope and develop transition services across 4 south London Boroughs for CYP with additional needs (i.e. Looked After, YOS, disability)


of 43


Recommendation 17 The Well Centre for young people in Streatham is a model that should be examined carefully to see if other areas of the borough would benefit from similar provision and if so the approach should be rolled-out.

Commissioners are currently re-designing the monitoring and evaluation arrangements of this contract to ensure the impact of the provision on young people is properly assessed and learning can inform other areas.

Other options such as MAC UK that has been running in Southwark

Results of evaluation to be shared by end of April 2016

The work around the Wells Centre is informing the broader Children & YP’s Health Partnership (CYPHP), developing an Integrated Care Pathway model across Lambeth & Southwark


Recommendation 18 NHS Lambeth Clinical Commissioning Group (CCG) should ensure that the mental health services which it commissions are provided where possible within GP surgeries or in the locality. Where BME attendances at GPs are low work should be done to counter this.

• The LLWC is the driver for this in relation to adult MH services acting to bring together SLaM MH and other services including the Community Options Team (COT)

• The LWN has launched self-introductions since June 2015.

• Mental health promotion/awareness is included in GP protected learning time

• The GP+scheme is one method the CCG is using to build capacity in P Care to encourage more use of general practice and look after people with MH problems more effectively. The SLaM Low Intensity Treatment Teams (LiTT) work with this scheme to identify whose care can be transferred to Primary care

• Lambeth Talking Therapies Service is based in

Brixton and Streatham and provides services from a range of community based sites including GP premises wherever possible.

• More GP staff training on mental health awareness and Level 2 mental wellbeing training.

• Set out a clear care pathway for mental wellbeing showing range of opportunities in the borough to signpost around the ‘five ways to wellbeing’ could link to social prescribing work and review of health improvement services.

• Roll out CAMHs primary care toolkit to GPs

• This recommendation reflects SLaM’s estate strategy which aims to provide care in community settings wherever possible; people’s homes, other places where people gather, in GP surgeries, etc. The estates strategy will have an EqIA

• Integrated Commissioning • Primary Care Programme • GP Federations/Local Care

Networks • SLaM

of 43


• The primary care toolkit for CAMHs is available

• Lambeth Addictions Service have shared care teams in 45 GP surgeries in Lambeth.

• Lambeth Mental Health in Learning Disabilities Teams can provide 1:1 psychology appointments in a GP surgery

• OASIS Early Detection Service visits GPs, Colleges and faith groups in Lambeth to raise awareness of signs of ‘at risk for psychosis’ and particularly work with GPs on referrals and will see people in GP surgeries

• Lambeth CAMHS provide clinical sessions in a GP surgery in Brixton. This has proved very popular for patients and families.

of 43


Recommendation 19 NHS England and NHS Lambeth CCG should collaborate to reduce the variability experienced by service users in response to mental health problems when they attend primary care in Lambeth. Patients should be able to expect equivalence of standards of care; parity of service offer and appropriate timely sign posting to peer support, voluntary sector, secondary care and crisis services. For people who are particularly vulnerable sign posting will not be enough and link-workers may be needed to support them.

• The CCG is proposing to introduce peer support led review of the Primary Care Community Incentive Scheme (GP+), building on the fact that peer supporters are already a key part of the Living Well Network within which this service sits.

• A requirement of the GP+ is that each of the three primary care localities support practices which are unable to fully meet the requirements of the CIS and so ensure all people needing primary care support receive it to a consistently high standard.

• SLaM publishes information on the access and experience of Black service users within the annual equality information published to comply with the specific equality duties.

• HealthWatch to mystery shop mental health services and improve transparency and patient experience informing future commissioning

• SLaM is considering the access and experience of Black service users in the equality impact assessment and evaluation of the Adult Mental Health changes underway in Lambeth

• Primary Care directorate

• SLaM

of 43


Recommendation 20 NHS Lambeth CCG should work with member practices to develop local practice networks. These networks should: (1) Ensure that where a practice cannot offer a mental health service that the service will be available in a neighbouring practice and (2) Begin to develop links with the local community organisations.

• The development of local care networks is an expressed priority of LCCG and is in progress. There are 3 fully established local care networks with a developing governance structure in place – a dedicated chair and membership across health, social care, voluntary sector and the patient participation groups. With links with public health, the focus is an enhanced care for its local population. The local care networks also link into the wider SE London strategy in a co-productive approach to improve access, proactive care and coordination

• The development of General Practice federations is underway, whereby General Practice working at scale across local population areas aim to reduce variation /inequality.

• Primary Care will commission the Federations to provide a holistic healthcare for people 65 years and over and vulnerable adults. This involves a comprehensive health and social care review of the patient, implementation of a care plan and referrals into the appropriate service for on-going care

• The aim is to integrate mental & physical health

• Services could be commissioned via GP federations to meet local population needs and priorities.

• GP Federations/Local Care Networks

of 43

Recommendation 21 NHS England and Lambeth CCG should also be working more closely together to eliminate (unless for good clinical reasons) the practice of treating Lambeth residents in areas with very different ethnic composition like Bromley.

• The general position is CCG and Provider seek to accommodate in borough unless restriction on placement and availability of provision

• Monitor placement activity.

• Staying Health Board


of 43

Recommendation 22 Community leaders in places like churches, mosques, community centres, barbers and hairdressers should be offered training in ‘mental health awareness training’; recognising mental ill health; providing basic counselling, training in mental wellbeing and sign-posting people to professional help. As the mental health provider South London and Maudsley NHS Foundation Trust (SLaM) should also facilitate working with community leaders. Mechanisms should also be established for coproduction between members of the community and SLAM. There should also be mental health training for other professionals, such as physiotherapist and district nurses, so that they can signpost their patients.

• SLAM are commissioned by Lambeth CCG/Public Health to run two 10 week courses on 'Spirituality and pastoral Care Training in MH' per year for faith organisations.

• SLaM delivered another 10 week course on 'Spirituality and pastoral Care Training in MH' for members of faith organisations between January and March 2016 and will continue to deliver this highly valued programme.

• Brixton Reel Film Festival commissioned by Lambeth CCG/Public Health includes outreach work to restaurants, barber shops, market etc as part of delivery.

• Public health worked with Faiths Together in Lambeth to win monies from London Catalyst for mental health promotion work with faith groups, but this was a one off.

• MHFA training has been mostly targeted at staff to date and limited to three MHFA sessions, 2 Youth MHFA sessions and some half day and full day bespoke mental health awareness sessions per year.

• Certitude are leading work on promoting mental health services in community settings

• As part of CAMHS Transformation Plans a review of children’s workforce skills and training will be undertaken in 16/17. Following this a training programme will be recommended and/or rolled out.

• Expand mental health promotion work with resource from Lambeth council to match fund the CCG’s contribution (90k in the block contract with SLAM)

• Work with Lambeth Voluntary Action Council and London Community Foundation to encourage grant funding and projects that can undertake this work.

• Psychological wellbeing practitioners time should be used to help support set up of self help groups and other outreach work with community groups so they can do more on mental wellbeing

• 2 additional MHFA instructors from the VCS will be trained up this year to co-deliver a minimum of two sessions each free at the point of access for 2015-16 (additional 60 people trained)

• SLaM’s Mental Health Promotion Team will be piloting a bespoke Mental Health First Aid Course for members of faith groups in Lambeth and Southwark.



of 43

Recommendation 23 SLaM should also establish links with people working in the community, like community centres, tenants and residents groups, Brixton Soup Kitchen, and Blockworkout for example, so that individuals are linked to professionals and more people who are identified as needing help can be supported to access it.

• The LLWC undertook a review of crisis services in 2013/14 and is considering a number of options for developing a crisis retreat support service –indeed users and carers participated in a major review last year, including visits to the services such as Leeds. A key challenge is the revenue sources required to support this type of service and the need for the whole system to support this as a real alternative to acute psychiatric beds.

• SLaM have links with voluntary and community organisations e.g.: • A member of ‘Solidarity in a Crisis’(a peer support

project offering peer led crisis support) visits the Lambeth Triage ward weekly to let people know about the service and encourage people to access their help if they feel they need crisis support in the future.

Lambeth IAPT:

• Has links with Brixton library and has a weekly stall to promote wellbeing and the IAPT service and to reach out to under-served groups

• Provide the 'Buddy Service'; weekly support in Brixton library for clients to complete their therapeutic treatment. People can talk to volunteers who promote, encourage and signpost people to appropriate services.

• Lambeth Mental Health in Learning Disabilities Team held a well attended Mental Health and Wellbeing event for adults with learning disabilities, carers, families and professionals on 10th September 2014. Workshops, stalls, information and a chance to learn about autism, the role of medication, tree of life, what is mental health, mindfulness and CBT.

• This is a continuing programme of work for SLaM

• This recommendation links to intention to establish a black community advisory forum. The Primary Care locality networks are aiming to build better links with community organisations.


• SLaM

• Local Care Network

of 43


Recommendation 24 Lambeth CCG needs to ensure that through its commissioning plans talking therapies, and a wide range of therapeutic approaches (including Mindfulness training, a mind-body based approach that helps people change the way they think and feel about their experiences, especially stressful experiences) are made available to everyone who need it when they need it.

• Mindfulness is on offer through SLAM’s recovery college although only to service users and carers and staff at present.

• The Lambeth Talking Therapies Service has begun group workshops in the community re. sleep, depression, anger management etc. to help with triage and manage waiting lists

• Promotion of ‘five ways to wellbeing ’messages to residents

• Equality monitoring of the IAPT service and action to promote to underserved groups continues

• Commission Mindfulness for anxiety and depression as per NICE guidance. Current offer piecemeal.

• Promote Headspace app to residents

• Review take up of workshops and ensure they are promoted through BME networks, are relevant and appealing

• Use council communication mechanisms to do more to promote ‘five ways ’messaging

• Evidence base on schools base Mindfulness programmes being sourced and engagement with schools on this and other resilience focused programmes to be pursued.


• Primary Care Programme

of 43


Recommendation 25 More needs to be done to recruit, train and employ Black Caribbean clinical staff to support our diverse community. Across our local NHS Trusts there should be a commitment to target and stimulate local employment and maximise opportunities to recruit, develop and support local staff. To support the development of a professional clinical workforce that is reflective of the demographic population of Lambeth, Trusts should work more with schools to give our young people an understanding and experience of career opportunities within the health sector and create avenues into employment for them.

• SLaM included information on ethnicity and workforce in annual equality information and to approve revised workforce equality objective in May 2015.

• SLaM has responded to the requirements of the NHS Workforce Race Equality Standard.

• The Trust continues to participate in a London-wide initiative on mentoring individuals interested in working in psychological therapies from a BME groups.

• SLaM published workforce quality information for 2015 as part of its annual equality information. This is available at: http://www.slam.nhs.uk/media/409470/2015%20Workforce%20equality%20information.pdf

• SLaM is currently re-establishing a BME Staff network

•

• SLaM

• KHP • GP Federations

http://www.slam.nhs.uk/media/409470/2015%20Workforce%20equality%20information.pdf

http://www.slam.nhs.uk/media/409470/2015%20Workforce%20equality%20information.pdf

of 43

Recommendation 26 To support and sustain recovery and help gain confidence to engage in everyday social and workplace activities, people with mental ill health must have access to excellent and supportive training which improves literacy, numeracy, IT, communication and confidence skills. Our large group of black service users should be supported through Individual Placement Support and the Recovery College to use their unique experience to gain employment. Commissioners should work with both statutory (including Job Centre Plus; Adult Education) and community providers as well as users and carers to ensure that tailored support is available and in a setting and environment that people will be happy to access.

• Living Well Partnership Resource Centre provides support in this area.

• The Living Well Network Hub has co-located with JCP in Streatham from March 2015.

• Healthy workplace charter being promoted to employers through Lambeth Business network.

• There are a number of providers working with people with mental health issues to support their return to work including First Step Trust, Southside Rehabilitation Association, Vocation Matters, Status Employment and SLAM vocation services.

• Lambeth Council is working as part of a Central London initiative aimed at supporting people who claim Employment Support Allowance back to work. The ‘Working Capital’ project specifically supports people with mental health conditions and as such, in Lambeth the project is hosted by the Living Well Network Hub.

• The Council has prioritised people with mental health conditions in its target groups for employment support, including in the joint ‘welfare, employment and skills’ commissioned project with Lewisham and Southwark Councils and Jobcentre Plus.

• Wider work on workplace health and wellbeing and ensuring that workplaces are a supportive place and can promote mental health and manage mental ill health.

• Continue to progress range of initiatives.

This programme started in October 2015 and the Council is working closely with the provider (APM) to support its delivery. The first phase of this Pathways to Employment programme was completed in November 2015 and a formal evaluation has informed the development of Phase 2. This will be delivered for residents referred through Streatham Job centre in Lambeth by Green Man Skills Zone and other agencies.


of 43


Recommendation 27 More needs to be done to educate Lambeth residents about mental ill health in order to improve understanding and reduce stigma. A good first step would be to arrange a ‘Time to Change’(national anti-stigma campaign) village to visit Brixton. Stalls showcasing this Commission’s recommendations or providing mental health education could also be provided at events like Brixton Splash and the Lambeth Country Show. Ongoing work to tackle mental health stigma and discrimination within services and our communities must be promoted.

• New ‘five ways to wellbeing’ resources are available free to public sector and VCS staff through HPAC.

• Mindapples trees available to borrow from Reay House library

• SLAM have launched a Wheel of Wellbeing website at www.wheelofwellbeing.org with the aim of promoting actions that can help maintain and regain mental wellbeing

• Wellbeing e-bulletin promotes free resources and materials to network

• Mindapples and other materials will be at Lambeth Country Show 2014 and residents will be asked what they do to take care of their mental health. This has also been done in previous years

• Brixton Reel Film Festival is an annual outreach project using film to talk about wellbeing, reduce stigma and promote access to mental health services. see www.brixtonreel.co.uk for previous programmes

• SLaM Mental Health Promotion team commissioned to deliver training on Mental Health Awareness, Mental Health First Aid, and Young Person’s Mental Health First Aid.

• Lambeth Addictions Service attend public events throughout the year including Lambeth Country Show, Brixton Splash, Black History Month, international overdose day.

• OASIS Early Detection Service visits GPs, Colleges and faith groups in Lambeth to raise awareness of signs of ‘at risk for psychosis’

• Lambeth CAMHS run Mental Health Promotion and information sessions in a range of locations including local schools, libraries, sports centres and skate parkWork will be done with CAMHS and CCG Comms teams to plan mental health campaigns to raise awareness amongst young people

• Promote availability of resources more widely, including using Lambeth council’s communications mechanisms to get message out to residents e.g. through Lambeth Life

• Mental Health First Aid training could be expanded to residents but this would require resourcing

• Need local workforce development plan to encourage people to attend RSPH wellbeing level 2 course, mental health awareness or to develop bespoke content locally to cover these competencies.

• Locally have thought using the ‘five ways’ and Mindapples messaging more helpful to address stigma more generally around talking about mental health than the Time to Change campaign alone.

The information and resources are available for anyone to ‘have a go’ but many staff and residents feel unconfident in tackling the subject area. SLaM is working with a documentary film crew in its secure forensic psychiatric wards to produce a two part series of one hour documentary films. As the acclaimed C4 series BEDLAM successfully helped break down prejudices about mental illness, this series will aim to help the general public to understand

• Staying Healthy Programme Board

http://www.wheelofwellbeing.org/

http://www.brixtonreel.co.uk/

of 43


more about mental illness and personality disorders, and their relationship with offending.

Recommendation 28 Local African and Black Caribbean community members need better access to high quality information about what is available locally and nationally to support their aspirations. The opening of the Black Cultural Archives should be used as an opportunity to take this forward and the Health and Wellbeing Board should use its influence to work with the BCA.

• SLaM has developed a resource listing local equality related organisations that staff can use to sign post service users.

• The Council currently has a 3 year commissioned arrangement with BCA to promote black heritage and culture. The 3 year settlement is designed to support BCA as they work towards financial sustainability and independence as an organisation.

• The Living Well Partnership (managed by Mosaic Clubhouse) in Brixton provides information and advocacy support service in partnership with Lambeth and Southwark Mind.

• The Integrated Talking Therapies service (including IAPT) provides an outreach service to BME Communities

SLaM will publish local equality organisation database on SLaM intranet, promote its use, and update regularly

Commissioners

SLaM

Patient experience –improving the care and support experience

of 43


Recommendation 29 The Independent Commission on Mental Health and Policing (2012) recommendations, which aim to improve police leadership, police frontline work and working together with stakeholder community, must be fully implemented locally, monitored and reviewed regularly. The Health and Wellbeing Board should work with the relevant council cabinet lead to maintain an overview on progress in Lambeth. Additionally recognising that the police and the health and care services have strong shared interests and need to work together to manage issues such as mental health, the Health and Wellbeing Board should consider inviting a representative from Lambeth Borough Police Senior Leadership Team to be a 9 member of the Board. This would also encourage a joined up

SLaM works with Lambeth Police via:

• Lambeth Police Liaison Group, • Trust wide Mental Health and Police group • The bi-annual Borough Commander Group SLaM also works with the London Operational Partnership group which is working through recommendations made in the Independent Commission on Mental Health and Policing (2012) and the NHS crisis concordat.

• The police have expressed an interest in participating in the Health and Wellbeing Board

Metro police

SLaM

Health and Wellbeing Board

of 43


approach to a range of public health issues.

Recommendation 30 Metropolitan police officers should be trained with black African and Caribbean mental health service users, whom are local residents, so that they relate to people with mental health conditions and respond appropriately to situations involving these people. This should include training on de-escalation techniques. Gaining resources from the Liaison and Diversion scheme should be investigated.

• Some work was carried out by SLaM with the Met in previous years on mental health awareness.

• The Street Triage service and 24/7 Crisis line will include awareness training for front line police officers

• Police need to make this part of their training in partnership with Lambeth Living Well and be more active partners in the collaborative work.

• Metropolitan Police are currently exploring a community input for all new police officers joining the borough. Presently all officer training is conducted through a central MPS training programme. This includes Mental Health training, of which all officers are in the process of receiving an updated input. We have no local control over this training, nor the timetable - we are, however, exploring opportunities to introduce local training outside of this. Officers receive conflict and restraint training twice a year - we have also escalated the need for a review of this training to have an enhanced mental health input.

Metro Police

SLaM

NHS England

of 43


Recommendation 31 Mental health providers should aim to abolish physical restraint and minimise forced treatment. Training and techniques developed to support mental health professionals diffuse and de-escalate situations should be provided to all front line mental health staff. The ‘Respect’training and techniques developed by NAViGO to support mental health professionals diffuse situations without having to resort to physical restraint should, in particular, be examined for useful lessons learnt.

• There is a Trust wide committee – PSTS forum in which the levels of restrictive practices applied within in-patient services will be monitored. This includes restraint and the use of seclusion.

• The Trust is developing a Promoting Safe and Therapeutic Care Strategy (formerly referred to as the Violence Reduction Strategy). This will be monitored through the Quality Sub Committee which reports to the Trust board.

• PSTS (Promoting Safe and Therapeutic Services) training is training on the application of physical interventions. This refers not only to physical techniques but also the associated theory package.

• Baseline data is collected in regard to all incidents of violence and aggression for those wards that are undertaking the 4-steps to safety training programme. The levels of violence and aggression are variable across Trust services. For example PICU services have significantly higher levels of violence than acute services.

• The definitions would be in accordance with datix reporting categories in terms of verbal abuse, harassment and physical assault. Cultural differences in communication are part of PSTS training.

• De-escalation is not clearly linked to the Section 136 pan London policy. Section 136 detainees are managed as a patient in in-patient services would be in terms of de-escalation and violence reduction.

• All SLaM Places of Safety are directly linked to wards and therefore there is direct access to medications including RT. However the administration of RT would be as a last resort and if medication were required, Section 136 detainees would be encouraged to take oral medication.

• Patients experiencing side effects form medication is a serious concern. If medication is administered the

A further update on SLaM’s work to address this recommendation is scheduled for the joint SLaM LBHWBC IAG meeting on 2nd June

SLaM

of 43


monitoring of side effects is the responsibility of the nursing and medical teams. If side effects are observed or reported this would lead to an immediate review of medication to ensure that side effects were alleviated or eliminated.

• An update on SLaM’s work to address this recommendation was provided at meetings with Lambeth BHWBC IAG in 2015 and January 2016.

of 43

Recommendation 32 All calls made to the police from a mental health ward/premises where officers are called to attend to assist in the restraint/control of patients should be treated as a serious incident, and all serious incidents where the police are involved should be reported to both the Health and Wellbeing Board and to the CCG.

• Serious incidents that occur in SLaM services are reported to the CCG, but this would not cover all of these incidents.

• Reports do not go to the Health and Wellbeing board at present.

• SLaM has introduced a joint investigation system between the Trust and the police for serious incidents where the police are called. This is an internal process not intended to report to CCG unless by exception

• The care delivery system is now called 4-Steps to Safety The evidence of reduction of incidents of violence and aggression on those wards in which the 4-steps programme was piloted was taken from datix reporting.

• Alleged incidents of staff on patient aggression are reported through the datix system. Safeguarding training is mandatory for all clinical staff and the Trust promotes a culture that supports patients and staff to report suspected abuse.

• All incidents of police attendance to a Hospital service for the purpose of restoring order are reported via the datix incident reporting system. All incidents require a Fact find investigation report to be completed. Higher level incidents will require a higher level of investigative process.

• Lambeth adopted Operation Metallah in 2016 – this ensures that any call for police assistance by staff is triaged by the Duty Senior Nurse on site with a direct conversation between the DSN and officer in charge attending the scene. This ensures that there are clear lines of communication and a clear plan can be made between the Trust and police on the course of action to be taken.

• SLaM continues to work closely with other agencies on this issue

NHS Lambeth

SLaM

of 43


Recommendation 33 The Commission recognises and commends the work of the Lambeth Living Well Collaborative Services and strongly supports moves that enable service users and carers to design and deliver their own services. A good example of delivering services is Dial House, a survivor-led crisis service in Leeds which now has a BME specific centre in Chapeltown. The Board should consider whether a similar service would benefit Lambeth residents.

• A review of the options to develop a Crisis House was undertaken by LLWC during 2013/14. This included field visits by service users to help consider the options.

• Agreed to fund a on a pilot basis a crisis sanctuary for two evenings a week based on Leeds Dial House model at Living Well Partnership (Mosaic)

• Integrated Commissioning – Mental Health

of 43


Recommendation 34 Everyone being treated for a serious mental illness should be given access to support from trained peer-supporters who have recovered from similar conditions.

• LLWC has an ambition that peer support is available in all services/support settings

• See earlier comment re SLaM actions and development of their new Patient and Public Engagement Strategy; The new Adult Mental Health model being delivered in Lambeth has peer workers in their teams.

• SLaM Lambeth IPTT has a peer support development worker. They have run consultation sessions with service users and have developed a joint plan [with other borough IPTTs] to develop a team of trained peer support volunteers who can run group activities

• Integrated Commissioning – Mental Health

• Lambeth Living Well Collaborative

Recommendation 35 We suggest that Healthwatch Lambeth set up a sub-committee (or whatever mechanism they deem appropriate) to monitor mental health services as they relate to the black community in Lambeth including implementation of the recommendations set out in this report.

• See recommendation 18 • Healthwatch Lambeth are a member of SLaM’s

Engaging Patients, Involving Carers (EPIC) group which aims to ensure:

1. All service users and carers can feedback about their experience

Healthwatch Lambeth has appointed a lead for Mental Health Engagement with considerable experience of working with black and minority ethnic communities. This work stream has published ‘Finding Mental Health Advice and Support in Vassal Ward; December 2015 which captured the knowledge levels of more than 50 local people. Healthwatch delivers three focus groups to explore the mental health perceptions and needs of African and Caribbean men. We also have a regular presence on Galaxy Radio, where we engage more widely with the black community on mental health issues.

Janaki Kuhanendran Janaki Kuhanendran and David Pinder

of 43


2. Feedback improves services Healthwatch completed its first Mental Health enter and view visit to Mosaic Club House in March 2016. The report, including recommendations for service improvement will be available from June 2016. 3. People with experience of the services, and those

who care for them participate in improving the services

March 2016 – Healthwatch Lambeth Trustee Board approved a recommendation to support a new Black Wellbeing Partnership, including a recommendation to host the partnership team if funding is secured. We are working with the Social Finance team on the preparation of setting up of the Partnership.

Enter and View visits to community providers of mental health support will continue 2016/17. Preparation and setting up the Partnership April – July 2016 Consolidation of five-year work plan and submission of funding bids July – December 2016 Partnership team in place and work plan established – Jan 2017

Catherine Pearson and Janaki Kuhanendran

Recommendation 36 SLaM should form a local, independent advisory group that builds trust and relationships and seeks to address the concerns of the African and Black Caribbean local community in particular.

• Councillor Jacqui Dyer and Zoe Reed (SLaM) have jointly chaired SLaM and Lambeth BHWBC IAG meetings during 2015 to work collaboratively to improve the Trust’s response to the recommendations.

Dates and agendas of joint meetings have now been agreed for 2016.

• SLaM

of 43


Recommendation 37 SLaM and NHS England should ensure that excellent and clear patient experience data, with ethnicity data included, is available in an easy to compare format (e.g. website) to enable service users, carers and commissioners to make informed choices.

SLaM published a 2015 ethnicity report for Lambeth (and the three other boroughs. This is available at: http://www.slam.nhs.uk/about-us/equality/public-sector-equality-duty Following feedback from stakeholders such as Lambeth BHWBC IAG and others, some changes were made from the 2014 report with the aim of making this more informative and useful. These changes included:

• Adding details of where teams get their referrals from

• Providing more appropriate comparators for certain teams

• Providing examples of activity undertaken by teams to improve services for BME service users with links to further information

• Including feedback on the Friends and Family test for different ethnicities

Analysis of who gives feedback through SLaM PEDIC surveys has been undertaken in development of involvement strategy. An accurate picture is difficult to see because around 15% of inpatients and 10% of community service users didn’t disclose their ethnicity. When comparing the ethnicity of people who disclose their ethnicity with the SLaM’s inpatient and community service case load it appears mixed race service users are over represented in responses with all other ethnicities slightly under-represented. Teams get a breakdown of the ethnicity of respondents in the regular reports to enable them to compare this with the ethnicity profile of their service users.

The number of surveys completed by service users and carers has increased in 15/16. SLaM will continue to encourage service user feedback through paper, hand-held device and online surveys. We are working to develop easy-read versions of questions and translated versions in the most requested languages across the trust.

SLaM will continue to work collaboratively with LBWBC IAG to improve the way we use ethnicity information on the access and experience of service users to improve services and demonstrate accountability to Black African and Caribbean communities in Lambeth.

• SLaM

http://www.slam.nhs.uk/about-us/equality/public-sector-equality-duty

http://www.slam.nhs.uk/about-us/equality/public-sector-equality-duty

of 43


The trust will continue to encourage service users and carers to disclose ethnicity in surveys by demonstrating how we use the data to improve our services and explaining how this is kept confidential.

Recommendation 38 Where National Institute for Clinical Excellence (NICE) guidelines exist Lambeth CCG and SLaM should ensure that all treatment adheres to them.

SLaM aims to ensure all treatment adheres to National Institute for Clinical Excellence (NICE) guidelines.

SLaM included an update on progress in delivery of equality objectives in 2015 and annual equality information.

Psychosis CAG Promoting Recovery Teams in Lambeth have worked in partnership with the CCG and the 300 Voices project to deliver the local CQUIN on personalization. The aim of this was to improve recovery and support planning, with service users and young Black men in particular.

SLaM will be reviewing its 2013-16 equality objectives this year and working in partnership with service users, carers, staff and other stakeholders to develop objectives for 2017-20.


• SLaM

Recommendation 39 Public services should proactively identify those who care for people with mental health conditions including young carers and offer appropriate support.

• SLaM has developed a Family and Carer Strategy 2014-19.

• Young carers are identified as a priority group in SLaM’s Family and Carer Strategy

• SLaM surveyed staff activity with carers on wards; then surveyed carers to compare findings. Workshops were held to develop action plans which have been delivered and evaluated in Mar 16.

SLaM is developing a carer’s lead network for staff to support them in this important role.


• SLaM

of 43


Recommendation 40 Following the well-attended black health and wellbeing event held at Lambeth Town Hall on 15 March 2014 a further event should be planned to update interested parties; build momentum for the implementation of the findings and report on progress. A database of interested community members has been established to support this endeavour.

• Further stakeholder events to be planned.

• Health and Wellbeing Board

appendix 2 - lambeth black health and wellbeing commission ... updat… · • the lambeth health...

Documents