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Lancashire Care NHS Foundation Trust Early Intervention Service

Lancashire Care NHS Foundation Trust Early Intervention Service Improving Access to Psychological Therapies: Psychosis Dr James Kelly, Project Manager Dr Warren Larkin, Clinical Director Mr Neil Caton, Service User Development Worker IAPT for SMI Stakeholder Event

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Lancashire Care NHS Foundation Trust Early Intervention Service

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  1. Lancashire Care NHS Foundation Trust Early Intervention Service Improving Access to Psychological Therapies: Psychosis Dr James Kelly, Project Manager Dr Warren Larkin, Clinical Director Mr Neil Caton, Service User Development Worker IAPT for SMI Stakeholder Event Chelsea Football Club 7 March 2013

  2. Lancashire Early Intervention Service

  3. Lancashire EIS Catchment Area Catchment population 1.3 million – 773 current service users

  4. What Can Lancashire EIS Share? • Whole Service Ethos of Psychosocial Care • Matched care or tiered approach to delivering psychological care across whole workforce • Education & Training • PSI Training: All of our staff are trained in CBT-informed interventions (manualised, effective and accredited) • Behavioural Family Therapy: We have 20+ staff trained and have our own BFT trainers • CBT & CBFI: Cohort of staff trained to Masters & Diploma level • REaCh: Routine Enquiry about Childhood Adversity

  5. Psychosocial Interventions Training

  6. A Matched-Care / Tiered Approach to Psychological Care Psycho-social interventions Tier 1Specific PSI TrainingSupervision/ Consultation Case managers/ ST&R Staff with: Formal CBT training or COPE Msc (under supervision) Formal CBT or FI,Discrete Problems Tier 2 Tier 3 Cognitive Therapists Clinical Psychologists Complex / multiple problems longer term CBT or FI

  7. Phase 1: Solid Foundations for Demonstrating IAPT in SMI • Service User Engagement • Developing sustainable and consistent SU partnership • Service Delivery • Mobile solutions – efficient use of valuable Therapist time • Recruitment 2 therapists and Admin Assistant. • Service Evaluation • Assessed the feasibility of IAPT data set in Lancashire EI Service • Preliminary Data • Dissemination • Radio 5 live, positive local media coverage on Demo Site • North West IAPT Collaborative

  8. Electronic Care Record & Mobile Application • PROMS Forms built and available on the existing electronic care record • Contacts planned in electronic care record generate work list in therapist diary on the mobile device • PROMS forms available on mobile device can be completed by service users and / or practitioners • We are in the 1st phase of software development. • Through an agile approach further functionality will be developed during 2013

  9. Choice

  10. Service User Experience & Involvement • Childhood and teenage adversity • Experiences of psychosis • Lancashire EIS intervention • Service User Development Strategy

  11. Phase 2: What we will do next • Service User Engagement • Establish Service User Development Officer post • A collaborative approach to service development… • Service Delivery • Improve access to NICE compliant CBT and FI • Improve access to therapist support for Tier 1 PSI work throughout the system. • Refine and improve staff training at all levels in line with identified psychosis competencies.

  12. Phase 2: What we will do next • Service Evaluation • Systematic Data Collection with new cohort of SU’s • Refine and develop Electronic Care Record and mobile device solutions • Dissemination • Engagement workshops with Clinical Commissioning Groups in Spring • Planning a large scale event 4th June & update events to report progress Winter 2013 • Bespoke workshops with NHS and other organisations

  13. Data Completion

  14. Emergency Community Contacts

  15. Occupied Bed Days

  16. Challenges • Developing IT systems alongside significant IAPT CAMHS project. • Difficulty in recruiting therapists to 1 year posts. • Sessional measurement a culture change to existing clients and to therapists. • Weekly monitoring improved rates. • Influencing wider system

  17. Conclusions • Access to Psychological Therapies within SMI is inadequate across NHS • We need to train more staff to deliver high quality Psychological Therapies in SMI • Initial experience is that regular measurement of outcomes is possible in psychosis SU group • Innovative use of technology can enhance efficiency and SU engagement • Improving access in a changing NHS is possible through innovation and practice change

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