Oxleas NHS Foundation Trust

1. Oxleas NHS Foundation Trust Agency Report to the Bromley Health & Social Care Partnership Board, 13th of February 2012

2. What services do we provide?

3. How we are organised Patients Families and Carers Multi-professional teams Forensic & Prison Services Adult Mental Health Acute & Crisis Adult Mental Health Complex Needs & Recovery Older Peoples Mental Health Bexley Community Health Services Greenwich Community Health Services Child & Adolescent Mental Health & Learning Disability Services OXLEAS Corporate directorates IT, HR, Finance, Estates, Communications etc

4. Oxleas Annual Plan Priorities 2012/13

5. Oxleas Annual Plan Priorities 2012/13

6. Adult Mental Health • On-going partnership work with London Borough of Bromley to reduce reliance on residential placements by effectively reviewing service user’s needs and developing flexible packages of support to enable people to live as independently as possible within the community. • Continued focus on efficiently managing acute bed usage by delivering crisis resolution and home treatment as an alternative to admission. • Expansion in 2011 of the Early Intervention in Psychosis Team enabling us to re-engineer the clinical pathway for individuals with a first episode of psychosis. • In 2010 a working group was established with GP colleagues from Bromley LMC/ CCG focussing particularly on referral and transfer pathways to improve service user and GP satisfaction.

7. Further Improvements to inpatient service for Older Adults MH currently underway, including: The creation of a centre of excellence for dementia at QMS with environmental improvements scheduled to be completed by the end of April. Similar improvements planned for Green Parks House where older people with other mental illnesses may receive treatment, Staffing levels, skill mix and training needs have all been reviewed and improved. A volunteer transport scheme is now operational for Bromley carers unable to easily travel to visit relatives/ friends at QMS Older Adults Mental Health

8. Older Adults Mental Health (cont.) • Data from POPPI/ PANSI and DoH suggests that in Bromley there are around 4,030 people of all ages with dementia, but only about 1,500 on QoF registers ie only around 37% of people with dementia have been diagnosed and are receiving  targeted support and help. • This figure is expected to grow to 4,790 by 2020. • The National Dementia Strategy sets a target of 100% of people being referred to memory clinics. Currently developing a business case to increase capacity within the service in order to meet demand.

9. Older Adults Mental Health (cont.) • Since 2011 we have been undertaking a project working with care homes. This involves MH staff working with care home staff to explore ways of working with signs of distress (challenging behaviour) without recourse to  anti psychotic prescribing or hospital admission. The Minister for Social Care , Paul Burstow visited Oatleigh Care Centre last week to look at the work we are doing. • We are planning, (with the support of the CCG) a pilot scheme to look at the effectiveness of working with people with dementia in A&E and on the wards at the PRUH to explore alternatives to hospital admission and early supported discharge. • We have met with and plan to develop closer relationships with Bromley Healthcare to work towards providing a more joined up approach to our mutual work with local people with dementia .

10. Adult Learning Disability • A Learning Disability liaison group is meeting regularly with SLHT and this is producing some good outcomes. Funding from NHS London has been agreed for a joint project with them aim of improving admission and discharge experiences of people with LD at the PRUH. • The mental health in learning disability team in Bromley have established nurse-led clinics and presented their work as a model of good practice at a national conference last November • Funding for the Directed Enhanced service for LD continues for another year and clinicians are working hard to engage GPs and increase the number of annual health checks completed. Bromley are also considering a LES to provide this service to individuals who cannot access it from their own surgery. • An ALD carers handbook has now been produced and is being disseminated across the borough.

11. Child & Adolescent Mental Health • Following the transfer of  the Tier 2 CAMHS service to Oxleas in 2010, work has been completed on developing a new integrated service model which will be implemented over the next few months.  This new arrangement will be more multi-disciplinary and will deliver more joined up support. • A new Obsessive Compulsive Disorder (OCD) service has been developed • Access to the Oxleas Non-Violent Resistance (NVR) programme for parents with violent children has been extended to Bromley. • The service has recently been benchmarked against 70 other CAMHS services nationally through the independent Clinical Outcomes Research Consortia (CORC) and has found to be clinically effective and better than most other services when rated for patient satisfaction.

12. Forensic Mental Health Services • The Bracton Centre continues to provide medium secure forensic services for Bromley and have contributed to work ensuring that very few Bromley residents are held in the private sector.  • A dedicated women's challenging behaviour ward has been created, partly in response to an identified need within Bromley for additional women's beds for this client group. • From February 2012, the Forensic community services are now going into Bromley Police Station each day to support the Police in identifying and better supporting people with mental health issues that have been arrested. • Oxleas now provides mental health in-reach services to all Kent Prisons plus primary care in the West Kent Prisons.