south eip programme & nhs quality improvement
TRANSCRIPT
SouthRegionEarlyInterventioninPsychosisProgramme
SarahAmaniSeniorProgrammeManagerWinstonChurchillFellow2016
@Time4Recovery
2 ProgrammeOverview
3
Content
ReferraltoTreatment
1 BriefBackground
4 NICEConcordance
5 NextSteps
• CommissionedbyNHSEnglandin2015-16tosupporttheregiontoachievetheEIP
accessandwaitingtimestandardsby1st April2016;
• Taskedwithraisingawareness,benchmarkingEIPservices,supporting
commissionersandproviderstodevelopeffectiveplansthataddress:
1. Investment;
2. WorkforceCapacity&Competencies;
3. PerformanceandOutcomesData
BriefBackground
• 15.4 million population• 50 CCGs• 16 mental health providers• 32 Early Intervention in Psychosis (EIP) teams• 476 EIP clinical and administrative staff• Serving 4,204 people with ARMS and first episode psychosis at end of Quarter 3
AbouttheSouthEIPProgrammea.k.a Time4Recovery
Hosted by
EIPPreparednessProgrammeBoardChairedbyFionaEdwards
EIPPreparednessProgrammeClinical&TechnicalGroupChairedbyProfBelindaLennox
NHSEngland(South)MentalHealthPriorityProgrammeBoard
ChairedbyJuliaDavison
OxfordAHSNBestCareProgramme BoardChairedbyChandi Ratnatunga
SouthEastEIPClinical &
TechnicalGroupChairDr Stuart
Clark
SouthWestEIPClinical&
TechnicalGroupChairDr Frank
Burbach
Denoteslineofaccountability
ReportsprovidedforInformation
SouthCentral EIPClinical&Technical
GroupChairDr Helena
Laughton
Governance
Meets 1st Week of Month
Meets Every 3 Months
Meets Every 2 Months
Meets Monthly
Providers + Commissioners + Strategic Clinical Networks + Health Education England+ Academic Health Science Networks
Wessex EIPClinical &
TechnicalGroupChairPaulTabraham
WhyOxfordAHSN?
Source: http://bmjopen.bmj.com/content/6/10/e012611.full.pdf+html
South EIP Annual Report 2015-16: https://time4recovery.com/wp-content/uploads/2015/06/2015-16-South-Region-EIP-Programme-Report-Final.pdf
BaselineReport2015
ReportInformsParliamentaryDebate
2015-16BenchmarkMainFindings
EIPInvestmentPerPersonAccessingEIP– Sept2015
NICEConcordance– Sept2015
EIPWorkforceWTE– Sept2015
EIPProgramme2016-17InJanuary2016,NHSEngland(South)extendedtheSouthRegionEIP
Programmeforanotheryeartoprimarilysupportprovidersandcommissioners
toaddressthesecondelementofthestandard:
NICEConcordance.
Purpose • Workinpartnershipwithprovidersandcommissionerstosupportachievementofbothelementsoftheaccessandwaitingtimestandards
Objectives
• SupportandmaintainQualityImprovementNetworksthatprovideaplatformforsharinggoodpractice,
• SupportTrustsandcommissionerstoevidencedeliveryofNICEinterventions againsttheregionalandnationalbaselineestablishedin2015;
• Allocate£250,000HealthEducationEngland(HEE)fundingtodeveloptheworkforce’scapabilitiestodeliverNICEinterventionsforpsychosis;
• SupportNHSEnglandlocalteamstodriveandmonitorimplementationofthestandards,ensuringthatbothelementsofthestandardsarebeingmet.
SouthEIPProgramme2016-17
Deliverables• EIPQualityImprovementNetworks• QuarterlyreportsonEIPworkforce&NICEconcordance• EIPservicedevelopment&assurancetemplates• PeerExchangeVisits- Goodpracticeexamplesandcasestudies
SouthEIPAccessandWaitingTimes
Early Intervention in Psychosis Waiting Times
Period: October 2016Source: Unify2 data collection - First Episode PsychosisBasis: CommissionerPublished: 8th December 2016Contact: [email protected]
Regional Level DataThe number of patients started treatment by week
since referral
Region Code Region Name >0-2 weeks >2-6 weeks >6-12 weeks 12 plus
Total number of completed pathways
(all)
% within 2 weeks
Y54NORTH OF ENGLAND COMMISSIONING REGION 311 76 13 6 406 76.6%
Y55MIDLANDS AND EAST OF ENGLAND COMMISSIONING REGION 233 68 16 15 332 70.2%
Y56 LONDON COMMISSIONING REGION 189 38 13 2 242 78.1%
Y57SOUTH OF ENGLAND COMMISSIONING REGION 230 39 6 2 277 83.0%
- NHS ENGLAND
New data: 8th DecemberLatest data: September -16
%Seenwithin2WeeksofReferral
SouthEIPNICEConcordance&Outcomes
InformationsubmittedbyEIPTeamleadsviatheEIPMatrixbetween1st July-12th August2016
EIPMatrixV2.0
Source: https://eip-matrix.time4recovery.com
EIPMatrixSampleReport
NICEStandardforEarlyInterventioninPsychosis Value* %* RequiresSubstantial
Improvement
RequiresImprovement
Good Outstanding
1.ReferraltoTreatment - Percentageofserviceusersreferredwithsuspectedfirstepisodepsychosisthatwereallocatedto,andengagedwith,anEIPcarecoordinatorwithin2weeksofreceiptofreferralinAugust2016
100% <25% ≥25% ≥50% ≥60%
2.CBTforPsychosis - PercentageofserviceuserswithFirstEpisodePsychosisthattookupCognitiveBehaviouralTherapyforpsychosis(CBTp)* 1 12% <12% ≥12% ≥24% ≥36%
3.FamilyInterventions – PercentageofserviceuserswithFirstEpisodePsychosisandtheirfamiliesthattookupFamilyInterventions
20 13%<10% ≥10% ≥20% ≥30%
4.Clozapine- Clozapineisprescribedtopatientsforwhomthistreatmentisindicated(orvalidreasonisgivenfornotprescribingclozapine) 5 100%
5. Employment&Education - PercentageofserviceuserswithFirstEpisodePsychosisthattookupsupportedemploymentandeducationprogrammes 112 85% <10% ≥10% ≥20% ≥30%
6.PhysicalHealth - PercentageofserviceuserswithFirstEpisodePsychosisthathavehadallofthebelowphysicalhealthchecksinthepastyear:
• BodyMassIndex(BMI)• Bloodpressure• Glucoseregulation(HbA1corfastingglucoseorrandomglucoseasappropriate)• Bloodlipids
70 70% <70% ≥70% ≥80% ≥90%
7.SmokingCessation - Percentageofthosewhosmokewhowereofferedsmokingcessation45 100% <25% ≥25% ≥50% ≥75%
8.CarerEducationProgrammes - Percentageofcarersofferedcarer-focussededucationandsupportprogrammes
21 50%<25% ≥25% ≥50% ≥75%
EPIC EIPTeamFirstEpisodePsychosisCaseload 100 InvestmentPerPatientAtRiskMentalState(ARMS)Caseload 20
£3,478.90TotalCaseload 120
*Pleasenotethatallvaluesandpercentagesusedintheabovetablearefictitiousandusedforillustrationpurposesonly*
NextSteps
#PHforSMI
StrengthenCCG&ProviderNetworks
SupportingEIPStafftoAccessHEEFundedTraining
Table MHS101• Referrals starting after 31/12/2015• Primary reason for Referral = ‘01’
Table MHS102• Referrals from MHS101 cohort
• Service or Team type referred to = ‘A14’
Table MHS201• Referrals from MHS102 cohort
•ConsMediumUsed in (‘01’,’02’,’03’,’04’)• AttendOrDNAcode in (‘5’,’6')
• Min CareConDate >=ReferralRequestRecieveDate
Table MHS006• Persons from MHS102 cohort
• CareProfServOrTeamTypeAssoc = ‘A14’• Min StartDateAssCareCoord >=
ReferralRequestRecieveDate
CareContDate >= StartDateAssCareCoord then CareContDate else StartDateAssCareCoord end as max_contact_date
EarlyInterventionforPsychosis(EIP)SuspectedFirstEpisodePsychosis(FEP)
MentalHealthServicesDataSet(MHSDS)From01/01/2016
©HSCIC2016
EIPPathwayfromReferraltoEnteringTreatment(ClockStop)
Clock Start
Clock Stop
MHSDSMonthlyReportTable2ReferralsonFEPpathwayenteringtreatment
EIP05TotalReferralsEIP06TreatedIn2weeks
EIP07TreatedOver2weeks
FirstContactwithPatient
AssignedtoMHProfessionalorTeam
PrimaryreasonforReferralis(Suspected)FirstEpisodePsychosis
ServiceorTeamtypereferredtoisEarlyInterventionTeamforPsychosis
ContactDatemustbeonorafterAssignedtoCareCo-ordinator(uselatterofthetwotoensurebothhavetakenplace)
ContactmustbewithPatient,andAttended,andonorafterReferralDate
AssignedDatetoEarlyInterventionTeamforPsychosismustbeonorafterReferralDate
ContactDatemustbebetweenReportingStartandEndDates
WaitingTimeisfromReferralDatetoAssignedContactDate
SupportingNHSEngland&NHSi Managers
ThankYouFormoreinformationpleasevisitourinformationsitesat:
https://time4recovery.com
@Time4Recovery
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