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APMH SERVICE DEVELOPMENT IN SOUTH CENTRAL

APMH SERVICE DEVELOPMENT IN SOUTH CENTRAL. Dr Alain Gregoire Clinical Director for Mental Health South Central SHA. South Central PCTs with birthrates. Distribution of MBUs: existing units. PMHOTs. Who can make this happen?. South Central SHA. 2006. South Central SHA.

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APMH SERVICE DEVELOPMENT IN SOUTH CENTRAL

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  1. APMH SERVICE DEVELOPMENT INSOUTH CENTRAL Dr Alain Gregoire Clinical Director for Mental Health South Central SHA

  2. South Central PCTs with birthrates

  3. Distribution of MBUs: existing units PMHOTs

  4. Who can make this happen? South Central SHA 2006

  5. South Central SHA PERINATAL MENTAL HEALTH NETWORK

  6. South Central SHA PRIMARY CARE & MATERNITY COMMISSIONERS GENERAL & PERINATALMENTAL HEALTH PATIENTS & FAMILIES

  7. Work programme 2006-2008

  8. Work programme 2006-2008

  9. Local Evidence: NICE Survey and PHRU Report • Very patchy services at all levels across SC • Current services inadequately resourced: PCT commissioning of: 1 PMHOT in S’ton/New Forest + PMHO sessions Hants + 6 MBU beds Winchester • Substandard care being delivered across most of South Central due to unavailability of services: • Mothers admitted without babies • Detection of high risk women not happening • No access to specialised services for high risk women • Care delivered by staff without required skills and expertise • Likely avoidable morbidity and mortality

  10. PHRU Specialised Commissioning Recommendations • Improve access to local MBUs and closely linked PMHOTs. • Existing MBUs under-resourced. • Estimated bed need, assuming PMHOTs throughout, = 22. • Future of MBU at Heatherwood Hospital should be reviewed, as does not meet standards for a mother and baby unit. • Increase awareness amongst all clinicians of importance of mother and baby unit admission, and agreement on clear criteria. • Develop clear referral pathways • Improve collection of data by future providers of specialised perinatal services.

  11. Work programme 2006-2008

  12. South Central APMH Pathway

  13. Work programme 2006-2008

  14. Care and Service Standards • S1: Primary care and Maternity Services standards • S2: Adult Mental Health Services standards • S3: Specialised Perinatal Outreach/Community Services standards Derived from East Midlands Standards • S4: Specialised Perinatal Inpatient Services standards Derived from Perinatal Quality Network Standards

  15. S3. PMHOTs Owned and shared For quality, cost effectiveness & equity Evidence based Deviance unusual and auditable Measurable (easily) data sets & documentation Achievable

  16. Work programme 2008-2009

  17. Perinatal Services: estimated need • *Assumes PMHOTs throughout and 85% occupancy • # Minor adjustment may be required for location of deliveries

  18. MBUsand PMHOTs Managed Care Network

  19. Work programme 2008-2009

  20. Specialised Commissioning Clinical Advisory Group/Network: standards, pathways, needs, priorities Head of Mental Health Specialised Commissioning Directors of Commissioning Group: PCT Directors of Commissioning Specialised Commissioning Board: PCT CEOs Commissioning of Services: 2009 round

  21. Next Stage Review… • CYP & Maternity Network & Mental Health Network both identified Perinatal Mental Health Services as a high priority for improvement • All networks, except cancer and neonatal, abolished • Clinical improvement programmes introduced as core work of SHA

  22. Mental Health and Learning Disabilities Programme People with learning disabilities have the same rights to good health and quality of life as everyone else Aims: • Reduce stigma • Increase the mental resilience of the population • Engage people in active self care • Join up the efforts of patients, carers, all services and agencies through care pathways • Deliver world class quality and efficiency of clinical care HUGE! No health without mental health Specific clinical areas: • Dementia • Healthy mind – healthy body • Offenders • Personality disorders • Perinatal mental health

  23. Mental Health and Learning Disabilities Programme Establish care pathways which: • Are used by all(patients, carers, clinicians, managers, commissioners, strategists) • Are evidence based • Define clinical quality standards and outcomes • Map needs and population numbers at key points • Incorporate all components(eg. psychological, social, physical)and sources(eg. self, internet, primary, 3rd sector…)of care at every stage of the pathways • Facilitate personalisation and choice by defining ‘tracks’ within the pathways for need clusters (eg. Psychotic illness + substance misuse or + poor engagement or + PTSD…) PCTs say YES!

  24. Clinical Leaders Network for APMH • Clinical leaders from: • Primary care (health visiting and GP) • Maternity (midwives and obstetricians) • Mental health (specialist nurses and psychiatrists) • Public health • Non clinicians: • Commissioners (PCT and specialised) • Providers (MH and acute) • Research (in particular child development, infant MH, mother infant relations)

  25. Clinical Leaders Network for APMH Aims: • Improved primary and secondary mental health care for women in pregnancy and postnatally • Increase equity of care • Develop leadership skills • National CLN programme: Future-engage-deliver • Support leadership activity • CLN; Action Learning Sets • buddies • Develop a new clinical network for sustainability

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