Research: LYPFT participating in EQUIP project

EQUIP: Enhancing the quality of user involved care planning in mental health services

LYPFT are pleased to be involved in the EQUIP trial, involving service users, carers and clinical teams in research. Here is an outline of the project and what it entails for participants.

• The EQUIP project is funded by the National Institute for Health Research’s Programme Grants for Applied Research Programme.
• A joint project between University of Manchester; Manchester Mental Health and Social Care NHS Trust; University of Nottingham; and Nottinghamshire Healthcare NHS Trust.
• 5 year programme
• Aim: to develop, evaluate, implement and disseminate a user/carer led training package for mental health professionals to improve user/carer involvement in care planning

Service user and carer participation:

1. Researchers and Trust clinical studies officers assess eligibility of service users for participation in the trial
2. Service users are written to, inviting expressions of interest to participate
3. Face to face informed consent is sought
4. Service user is asked to identify an involved carer, friend, family member
5. Care coordinator asked to complete a brief risk assessment
6. Baseline questionnaire data is gathered prior to team training
7. Questionnaires are repeated 6 months after team training

Clinical team participation:

1. There are 3 pairs of community teams identified across Leeds and York
2. Teams are randomly assigned to control and experiment groups
3. All Mental Health professionals and Allied Health Professional’s will be asked to participate in the training (80%+ participation required)
4. The training package – co-produced and co-delivered with users and carers – is delivered over 2 days (October/ November 2015)
5. Team clinical supervision is offered post training (6 hours)
6. At the end of the trial, training will also be offered to the control groups

There is opportunity for service users, carers and Mental Health professionals to participate in interviews to explore the impact of the training after the event.

If you have any questions or comments, then please do not hesitate to contact donna.kemp@nhs.net

Smoking in NHS Trusts – what’s your view?

Smoking is an emotive subject: health; choice; freedom; rights; collateral cost. Never more so than in the NHS, Trusts are increasingly going Smoke Free. At March’s Service User Network, the topic is ‘Leeds and York Partnerships NHS Foundation Trust’s smoking policy’ – all welcome to join in the discussion, but in the meantime:

What are your views about people smoking during an inpatient stay? 

What can and should Trusts do to support people to stop smoking?

What about NHS staff smoking?

Click here for the transcript of a WeMHN’sTwitterchat about Mental Health and Smoking.

Service User Networks – January dates

The next LYPFT York, Service User Network Meeting will be held on 30th January 2015. The network covers Easingwold, Selby and Tadcaster as well as York. I am pleased to inform you that a representative from the Charity Together: for Mental Wellbeing which is an initiative to tackle mental health issues working with vulnerable groups of people who as a result of mental distress are intensive users of council, police, ambulance and fire services is going to attend to provide an update of the project and how it operates within this area.

As ever all are most welcome.

The next LYPFT Leeds Service User Network meeting will be held on 7th January; the topic will be Spirituality. All welcome to come along; if you want to know a little more about what the meetings are like, then click here. The minutes from the December 2014 can be found here.

 

Integrated Care Pathways in Mental Health

Jo Fryer and Emma Metcalf explain what Integrated Care Pathways are and how these are being developed at Leeds and York Partnership NHS Foundation Trust (LYPFT):

Hi there, the trust is developing pathways that set out minimum standards of what people should expect and receive during their care. We thought it would be useful to outline work done so far, and what we are doing next. Below is some information that will hopefully be useful: 

What is an Integrated Care Pathway (ICP)?

An Integrated Care Pathway:

• maps what should be done, when and by whom
• sets a minimum standard of care
• incorporates relevant guidelines, standards and protocols

Why have LYPFT developed ICP’s?

ICP’s identify:

• the right people
• doing the right things
• in the right order
• at the right time
• in the right place

all with the attention to the individuals journey.

They also reduce unnecessary duplication and variation and are outcome and wellbeing / recovery focussed.

The trust has developed a ‘Core’ ICP that builds upon the information gathered at the assessment.  Areas of need anyone may experience regardless of ‘diagnosis’ will help develop individual care plans; other areas of need may include:

• Mental health and/or Learning Difficulties
• Physical health
• Social, Occupational & Vocational
• Medication
• Discharge planning
• Carers and Family interventions
• Finances
• Housing
• Supporting and Safeguarding children
• Safeguarding adults
• Engagement
• Advocacy
• Diversity
• Safety & Risk
• Advanced decisions
• Substance Use
• Mental Health Act
• Mental Capacity Act

In addition to these, specific needs based interventions describe the specific, expert interventions recommended by NICE and other best practice guidance for people with specific needs around Cognitive Impairment / Dementia, Psychosis and Common Mental Health issues.

We are currently working on how we can make the information meaningful and accessible for all and the best way of doing this eg the Trust web site. We will also be undertaking consultations with people who use our services.

Thank you for taking the time to read this and we hope you found it a useful introduction to ICP’s.

If you have any comments or questions please feel free to post them on here or email planningcarelypft@nhs.net

Jo, ICP Development Manager & Emma, ICP Developer

York Service User Network

The York Service User Network started in September 2014 and now meets monthly. The next meeting is on Friday 28th November at 1.15 and is at a new venue on Friargate. The meetings are relaxed and informal, the first half hour is devoted to welcoming people and sharing a cuppa. There is an agenda and this month there will be a discussion about Recovery, followed by a Q & A session. Some time will be put by to discuss the coming year and what the group would like to be included on the agenda. Everyone is welcome!

 

 

Choice: a priority for people accessing mental health services?

At Leeds and York Partnership  NHS Foundation Trust we are developing guidance for staff to help ensure that people are offered choice, including choice of worker. What is your view on people being offered a choice of worker? Please complete this quick poll, responses are anonymous.

If you would like to contribute to the development of this guidance or want to share your views to inform its development, then please contact donna.kemp@nhs.net Click here to read the comments from Twitter

Choice is a hot topic in Mental Health at the moment. People will be able to choose where they have their first outpatient appointment under choose and book, providing equal status between physical and mental health services.  This is a welcome move, but is only part of the story; Dr Sean Lennon writes about the broader picture of choice, of collaborating with service users, empowering people to make autonomous decisions about their own care and lives “Mental health service users are no different from anyone else in that they want to be able to exercise choice. They want to be treated with respect and be supported by skilled staff to receive high-quality care. Freedom of choice is absolutely fundamental to these aspirations”. You can read the full story here.

Locally, people attending the Service User Network (SUN) pulled together their views about choice and how they want to be treated within mental health services. The discussions were lively – clearly people had strong views about this and there were many stories highlighting the importance of choice and how it makes a difference to the persons experience and their progress. You can read about ‘Choice and how people want to be treated: key messages from SUN’ here.  There is more information about Leeds SUN here; you can click here for details about a developing service user group in York and there is also the Independent Mental Health Service User Forum, you can read about how to contact them and what they do here.

 

‘Service User Network’ York

Delighted to share that the next meeting of the York Service User Network (name yet to be decided) is 31st October; all welcome to attend:

What are your questions about bipolar?

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Advance Statements in LYPFT

“When I am ill, I am not quite me, I do not want to speak, I want to be left alone, my carers think I am being difficult but this is how I deal with my illness.  How can I convey this to my carers?” Diane  

Answer: through an Advance Statement

What is an Advance Statement?

It is a contingency plan or a wish list that a service user writes when they are feeling well in the event of them not being well.  It should cover what they would like to happen concerning their wellbeing and lists their choice in care and treatment.  It can let staff know what care needs/medications work for them and which one’s don’t.  It can also let staff know about any physical needs or disabilities they have ensuring these needs are met.  It can help in planning things to run smoothly whilst they are ill e.g. who is taking care of the children, bills, pets etc.

What an Advance Statement cannot do for the service user:

It cannot ensure they get their preferred treatment, as it is not legally binding.  It cannot stop them from being treated against their will if they are sectioned under the mental health act.

It is all about Choice:

It gives the service user more control in their recovery, making sure their choices over childcare, pet care, bills etc are know and so elevating any unnecessary worrying.

Choice is a key reoccurring theme that runs through the discussions we have at the Service User Network (SUN) which meet every month on the first Wednesday afternoon of the month, at St Chads Community Centre, Headingley.  Service users are encouraged to give their observation on services/care and these are addressed at the clinical governance group.  They are given the choice to contribute by having their say on how things are done.  This has resulted in changes in care delivery .e.g. Care Programme Approach.  So choices and using your voice can influence the services you receive which will also directly affect service user’s recovery.

Where can you get an Advance Statement? 

Easy, there is a template at: www.leedsandyorkpft.nhs.uk/service_users/Advancedstatements with guidance notes.

The service user’s psychiatrist, care co-ordinator, health support worker, or occupational therapist can help them fill in the form.   It is a good idea to discuss it with their friends and family as they might have advice which could help their plan. It doesn’t have to be written on an official Advanced Statement document for it to be valid but you need your family, friends and care worker to know about it and the Trust can hold a copy which should be reviewed every year.

How many advance statements are we aware of within the Trust? 

There are 57, which is not enough when you consider that approximately 20,000 people use Trust services.

What can we do to help promote advance statements? 

Make sure people are aware of them and encourage the use of them throughout the Trust.

If YOU were given a choice in care, wouldn’t you want to take up that choice?  

Of course you would, so please help promote Advanced Statements now.

Written by Anne Perry, Recovery & Social Inclusion Team

If you require further information about Advance Statements, then please contact Beverley Thornton on 0113 3056755/58  or email beverley.thornton1@nhs.net

Mental Health Peer Support in Action

Mental Health Peer Support in Action

A ray of sunshine arrived via email recently, it made me go “YES!” and the author, Andrew Johnson, agreed that it was ok to share. This reiterates the importance of  access to peer support for people experiencing mental health difficulties:-

Hi Donna – 

I was lucky enough to be around the other day whilst one of LYPFT’s Peer Support Worker’s was busy about their usual business.  What I witnessed was a brilliant, yet entirely ordinary piece of work and I felt I had to pass comment. 

The three parties involved (worker/patient/carer) had a prior knowledge of each other achieved through use of services and the therapeutic relationship was pre-established and well grounded. This enabled the PSW to freely discuss the benefits and disadvantages of a particular anti-psychotic medication that they themselves had experience of using in a way I had not witnessed before, seamlessly interweaving relevant clinical information with social themes and everyday off topic conversations. Familiar recovery barriers around professional distancing, stigma et al just didn’t stand a chance! 

The rapport, warmth and authenticity on display during this interaction made a real impression on me and really underlined the value of sharing Lived Experience in practice in an atmosphere of mutuality and collaboration.

Sure I understand that not all practitioners – and not all patients – value the ‘timid revolution of Lived Experience in practice’, but if we are really serious about improving health, improving lives then we must find a way of doing more. 

 Andy

Learn more about Lived Experience in the Workforce here.

Enhancing the Quality of User Involved Care Planning in Mental Health Services (EQUIP)

EQUIP are  now recruiting service user and carer participants to take part in the latest study in the EQUIP programme grant. The aim of the study is to develop a questionnaire to help us find out if you have been adequately involved in your care plan (or the care plan of somebody you care for).

• Take part: Online questionnaire (£10 voucher for taking part)
• Request a paper copy of the questionnaire
  Julie O’rourke (EQUIP Administrator)
  +44 (0) 161 306 7863

Further information

If you have any questions or would like more information about this study, please contact:

• Chris Gibbons (EQUIP Study co-ordinator)

chris.gibbons@manchester.ac.uk

• Claire Fraser (EQUIP Programme Manager)

+44 (0) 161 306 7882
claire.fraser@manchester.ac.uk

Want to increase your cultural awareness?

Ruby, the Diversity & Inclusion Project Manager at LYPFT kindly shares information about training sessions coming up over the next few months:-

The Diversity & Inclusion Team at Leeds and York Partnership NHS Foundation Trust are holding a series of development sessions for staff supporting people from different communities over the coming few months.  Named ‘Working Effectively With…’, these sessions aim to increase cultural awareness, skills and knowledge when working with people from the following groups:

• Deaf and Hard of Hearing
• Blind and Partially Sighted
• Refugees & Asylum Seekers                                                 
• Trans People (you can read a review of this here)
• Language Interpreters.

(Click on each to see details of the dates and session overview)

Our Trust provides services in a range of places across Leeds, York and North York; there are many communities, with a range of backgrounds and experiences.  We know that some communities are affected by inequalities in health: social isolation; struggle to access health services; may have poorer experiences and health outcomes; and, often poor communication and awareness of services can be barriers.

As a Trust, we are committed to Improving Health, Improving Lives.  We aim to deliver services that are inclusive – where staff have an understanding of the cultural, social, political and individual issues that affect people so that we can provide services that meet needs appropriately.

The development sessions are facilitated by professionals with expert knowledge and experience of working with these groups of people and offer invaluable scope and opportunity to share learning and best practice. Key, current issues, communication, language, culture, acceptable/unacceptable traditions and behaviours, the impact of barriers to accessing services and poor experiences form the basis of interactive discussions.

A case study approach and discussions relating to real-life issues or difficulties enhance learning and expert facilitators are on hand to provide guidance for any service related issues or cases.

Feedback from previous sessions remains consistently positive and rated highly by staff who feel these have provided a rich and invaluable learning experience and can confidently state they have gained new knowledge as well skills to assimilate the learning in the workplace.

Firm commitment to taking forward the learning and sharing with other team members is made and role model the behaviours and cultures discussed. The increase in knowledge and awareness enables staff to communicate sensitively whilst not making assumptions and to confidently ask open questions on matters or issues on which there is less clarity.

If you have any questions please post here, or email ruby.bansel@nhs.net

Leeds learning disability week June 16th-20th

World Cup 5-a-side tournament, picnic in the park, photography competition – just a few examples of what’s going on in this busy week of campaigning and awareness raising in Leeds, visit the website here for more events and the details.

Nationally, Mencap are asking ‘Do you remember your first time?’, inviting the sharing of stories and experiences of overcoming adversity, prejudice and ignorance to experience some fab firsts. Click here for more information about how to share your story.

Information for people accessing services and carers about CPA

Care Programme Approach (CPA) is the term used to describe the way that a person’s care, support and treatment is arranged when they have a range of needs.  This is done through assessment, coordination, care planning and review.  Some people will have straightforward needs; their care, support and treatment are described as ‘Standard Care Plan’.  You can read our policy: The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan) here.

Information for people accessing services and carers about CPA

The single most important thing about CPA is that you should be at the centre; it’s about you; it’s about what you want to do with your life; about what you want to achieve and how you want to achieve it. This may involve support, care and treatment from others – people that support you, carers, your friends, family, it may also include mental health services, health services, social care, and other organisations near where you live. Some people also get support from others going through similar difficulties – this is often called ‘Peer Support’. You can access peer support in a number of ways, for example, Mind, local groups or online support.

 

There are four stages to CPA:-

1. Assessment
You will be asked questions about aspects of your life and past, for example: personal; health; social;  about your safety (this is sometimes called risk); about what you enjoy doing; about what you do to help manage; about anyone else all ready involved in your care and support, including any carer. Carers can have their own assessment.

 2. Care Coordination

A care coordinator will be named to work closely with you and your carer to arrange care and support and to work with you to agree goals.
3. Care Plan
This describes your health and social care goals.  The care plan says which services will help with recovery and wellbeing; and what you do to help too.

The care plan is about you. It is developed with you and includes your goals; what support is being offered; who is giving the support and when the support will be reviewed.  The carer will be included too if you want this.

You may write the care plan yourself, or write it with your co-ordinator, either way, you should have a copy of your care plan.

4. Review
These are sometimes called CPA meetings; they happen at least every 12 months but can be more often. This is where the care plan is reviewed.  This is done by discussing with you, your carer (with agreement) and any others involved in your care plan about what is working well and what may need to be changed to support your recovery and wellbeing. The review is usually held in a way that you prefer – for example, some people prefer more of a relaxed discussion with their co-ordinator, others prefer a full meeting with everyone involved present.

Have you recently had a review? If so, let us know how this was for you by completing a brief survey (12 questions) – click here for more information and the survey. Results tell us what we are doing well and where we need to improve.

Standard Care Plan

If you have straightforward needs and are seen by one mental health worker then your care, support and treatment is described as ‘Standard Care Plan’.

You can expect:

• A lead professional identified – this will be the person that you see
• A letter – this is the care plan
• Review – this is a chance to talk about how things are going and any further care plan agreed.

More written information

Click here for an information leaflet about CPA

Click here to read an information booklet on CPA – for people in Leeds

Click here to read an information booklet on CPA – for people in York and North York

These booklets are also available in Urdu, Farsi, Czech and Polish – contact donna.kemp@nhs.net for these.

Want to get involved and keep up to date about what’s going on?

The LYPFT Planning Care Network is a digital space for people who access services, carers/supporters, staff and partner agencies to share their ideas and experiences around care coordination and care planning.  Click here to visit the network; you are most welcome to post comments and to share your views and experience. If you want to write your own blog post, then contact donna.kemp@nhs.net to discuss.

You can also join the Service User Network – they meet monthly in a range of venues across Leeds; click here for more information.

 

If you require any further information regarding CPA or Standard Care Plan then please contact donna.kemp@nhs.net

LYPFT Trust Wide Care Programme Approach Policy

The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan) has now been published at Leeds and York Partnership NHS Foundation Trust following a review of the outgoing CPA Policy; it identifies best practice as outlined by the Department of Health, Nice Guidance and the various frameworks supporting practice. There was consultation across Leeds and York – clinical groups, service user and carer groups, social care and partner agencies.

Of note, the following are included within the policy:

• The term ‘Standard Care Plan’ will be used to describe the arrangements for people not on CPA (this replaces the term ‘care plan’)
• Involving people in developing their Care Plan and writing the care plan in a way to reflect this
• The person (and their carer if agreed) should be provided with a copy of their Care Plan
• Agreeing with the individual the best way to arrange their ‘Review’ – CPA or Standard Care Plan
• Guidelines for Section 117 Aftercare including template for discharge or transfer – these have been agreed across the local authorities in Leeds, York and North Yorkshire

You can find a copy of The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan)  here.

The policy will be reviewed again in 2016, work on that will start in the next 9 -12 months. In the meantime, please feel free to leave your comments or feedback, they will be considered in the review. Nearer the time, I will be asking for people to express interest in getting involved with the review……..

Donna Kemp | CPA Development Manager | donna.kemp@nhs.net