Mental Health Services in Hillingdon

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Mental Health Services in Hillingdon Dr Julia Palmer, Consultant in General Adult Psychiatry, Mead House CMHT, and Lead Clinician, Hillingdon Adult Mental Health Directorate, CNWL NHS Foundation Trust 28 th April 2010

Central and North West London NHS Foundation Trust 1 One of the largest specialist Mental Health Trusts in England Provides a wide range of mental health and substance misuse services for a population of 1.8 million people Across eight London Boroughs, serving more than 100 sites University Teaching Trust Consistent record of financial stability and an annual turnover of 220 million Workforce of over 3300 staff Achieved Foundation Trust status in 2007 Hillingdon joined the Trust in 2006 after leaving Hillingdon PCT

Central and North West London NHS Foundation Trust 2 Awarded Top Employer Providing Mental Health and Learning Disability Services by the Nursing Times for two consecutive years Awarded good for quality of care and excellent for use of resources by the Healthcare Commission (HCC) in 2009. One of only seven trusts out of a total of 70 in London achieving the highest HCC combined rating, putting the Trust firmly in the top 10% in London In 2008 the Trust was also rated as excellent in the Healthcare Commission s largest ever review of acute inpatient services for people with mental health problems. The Trust was ranked third in England and is the only Trust in London and the South East to receive the top rating The Trust works within the Strategic Health Authority of NHS London, and works closely with over 100 statutory and voluntary organisations to provide local communities with a range of mental health services The Trust recently won the contract for the management of Hillingdon Community Services (currently managed by Hillingdon PCT) which is very exciting for us

Mental Health Services in Hillingdon 1 Three CMHT s:- Mead House, Hayes Pembroke Centre, Ruislip Mead House, Uxbridge

Mental Health Services in Hillingdon 2 Crisis Resolution Team (based at Maple Lodge, Hillingdon Hospital) A & E Liaison Team Early Intervention in Psychosis Team (based at Pembroke Centre, works across Harrow and Hillingdon) Assertive Outreach Team (based at Old Bank House, Uxbridge) In-patient services, Riverside Centre Psychology services

Mental Health Services in Hillingdon 3 Older Adults Service, Woodland Centre, Hillingdon Hospital Hillingdon Drug and Alcohol Service, Old Bank House, Uxbridge Child, Family and Adolescent Consultation Service, Redford Way, Uxbridge

Proposed reconfiguration of community mental health services in Hillingdon 1 Wellbeing Centre located in Boots, Uxbridge opens late June 2010 CNWL has lead responsibility Multi-agency with prominent role for voluntary sector Offers information on local mental health services and access to self-help IT programmes, also financial, employment advice Can refer people to CMHT s No medical presence Only Hillingdon residents can receive services others will be sign-posted

Functions of Wellbeing Centre (cont d) 1 A mental health screening service by an experienced mental health professional and a range of self-help, guided self-help (via Primary Care Graduate Workers) and Computerized Cognitive Behavioural therapy (provided by staff from the Primary Care Mental Health Team) Substance misuse clinics Individual service assessments Provision of brief interventions An information base supported by the partners Access to the internet and online programmes of help and support Housing advice and support Employment advice and support, including volunteering opportunities

Functions of Wellbeing Centre (cont d) 2 Welfare benefit advice and support Physical health advice / health checks Advocacy Complimentary therapies Debt management and advice Guided self help and counseling Carers support and advice service Training and workshops Outreach programme that will focus on mental health promotion working with target groups in the community, so reaching people who may find it difficult to attend mental health services or who may not normally hear about the service

Proposed reconfiguration of community mental health services in Hillingdon 2 Primary Care Mental Health Team (not yet funded) Will screen all referrals and carry out new patient assessments Will carry out time-limited treatments such as counselling and CBT Will refer complex/long-term cases to CMHT s

Proposed reconfiguration of community mental health services in Hillingdon 3 Complex care CMHT s Will manage complex/long term cases, mainly people on CPA Will carry smaller caseloads than now but work more intensively with patients

Service line management 1 CNWL needs to prepare for major financial restriction while also improving the local service Patients are in the process of being clustered along HoNOS PbR lines in preparation for Payment by Results There will be a major reconfiguration of service organisation with directorates identified by function (eg in-patient, complex community care) rather than geographical area, as now

Service line management 2 The community service lines will need to work closely with GP s and other primary care staff in order to provide the best care for patients Discharge notification is one of our CQUIN (Commissioning for Quality and Innovation) targets for 2010/11 (notification to be sent to GP within 48 hours)

Medical staffing in Hillingdon Hillingdon has fewer medical staff than any other Adult Directorate within the Trust NHS Hillingdon have asked for more information about this All consultant posts are filled except for 1.5 WTE (0.5 WTE Mill House, 0.5 WTE CRT, 0.5 WTE in AOT from 1/7/10) Substantive recruitment to Mill House/CRT post is in progress CNWL has funded an extra specialty doctor post at Mead House to cope with high workload

Good wishes Julia Palmer