Camden and Islington Crisis Care Concordat Local Action Plan Camden and Islington Crisis Care Concordat action plan refreshed October 2015

The national Mental Health Crisis Care Concordat was published in 2014 by the coalition government to establish key principles of good practice that local services should use to raise standards and strengthen working arrangements for mental health patients who are approaching crisis, in crisis or recovering from crisis. The national concordat calls for all local areas to have an action plan to improve crisis care in line with the parity of esteem agenda.

The Camden and Islington plan was developed with partners in autumn 2014 and submitted to the national Concordat website in February 2015. Following submission Camden and Islington received a letter from the Care Minister commending the strength of the plan. Camden and Islington have made some fantastic progress in improving crisis care including the establishment of a 24 hour clinically staffed crisis phone line for the public, a separate line for the police and the development of patient held crisis cards

However, we know that there is more to do to achieve parity of esteem in crisis care. We want our local action plan to be about co- produced continuous local improvement. With the help of all our local stakeholders we refreshed our plan in October 2015 to include new areas for development. Newly added actions are indicated with a * next to the action number.

Camden and Islington Crisis Care Concordat Local Action Plan

Please note that actions which are fully completed move to ‘appendix A’ completed actions

1. Commissioning, strategy and infrastructure to support responsive high quality crisis services No. Action Due by Led By O Update u t p u t s 1.1. The As strategies a) Camden and Islington Public Health T a) ON TRACK: Camden’s refreshed JSNA aspiration are reviewed b) C&I FT h and Health and Wellbeing Strategy include to meet but no later c) Joint commissioners e mental health as a priority and are Concordat than expected to be signed off In early 2016. standards December J for crisis 2015 S AWAITING COMPLETION: Islington will care N refresh its JSNA by February 2016. should A feature in , b) COMPLETE: The C&IFT clinical partners’ C strategy was signed off in December 2015. local & strategic I c) COMPLETE: CCG commissioning plans F intentions already address the intention to including: T robustly respond to the Crisis Care a) JSNA Concordat b) Camden c and l Islington i Camden and Islington Crisis Care Concordat Local Action Plan Foundation n trust i clinical c strategy a c) CCG l and Local s Authority t commissio r ning a intentions t e g y

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c a r e . 1.2. In Camden T COMPLETE: The feasibility study has now an analysis All partners contributing data with h been published. It has provided a of needs, Camden feasibility study team e comprehensive analysis of current needs services March 2015 consolidating r and services and has outlined a number of and Complete for e areas for improvement which pathways Camden commissioners and C&IFT will be will be w reviewing as well as options for produced Islington i investments to improve crisis care. Camden and Islington Crisis Care Concordat Local Action Plan by an report to be l external finalised l The findings of the study are currently organisatio February b being reviewed and an engagement n as part of 2016 e process is underway to confirm next steps. a Crisis Care a AWAITING COMPLETION: Islington have Feasibility commissioned a review of acute system Study c management which will cover Camden commissio l and Islington. The final report to senior ned e managers will take place in February through the a 2016. Camden r CCG mental u health n mandate. d Performan e ce, activity r and s qualitative t Information a from n services d across the i crisis n pathway g will be bought a together to c give us a r robust and o timely s picture of s what is working p Camden and Islington Crisis Care Concordat Local Action Plan well and a what areas r need t improveme n nt. e Islington r will use the s learning from this i exercise to n build on its existing C crisis a models of m care d review. e n

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d e v e l o p m e n t 1.3. Where July 2015 for Camden MH Investment team T ON TRACK: Camden CCG are working in appropriate commissionin Islington MH Programme Board h conjunction with Camden and Islington new g intentions e Public Health to consider how mental training r health training should be resourced and programme March 2016 e commissioned from 2016 onwards when s on crisis for the current provision ends. assessmen completion of w This will be Mental Health First Aid and t and procurement i Mental Health Awareness training manageme process l available in both boroughs so that nt to be l universal services are able to identify developed; b people who may need help and refer them linking in e onwards. with the Recovery a Camden commissioners are also College reviewing how the Team Around the where r Practice model could include crisis and possible. In a suicide prevention training for GPs Camden n this will be g delivered e under the Health o Camden and Islington Crisis Care Concordat Local Action Plan Mandate. f In Islington m this will be e delivered n by the MH t Programm a e Board l h e a l t h

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w Camden and Islington Crisis Care Concordat Local Action Plan i l l i m p r o v e . 1.4. Commissio August 2015 Joint commissioning C AWAITING COMPLETION: In Camden ners will Now due l the primary care IT system is not due to be ensure that March 2016 i recommissioned but commissioners are new IT n working with clinical leads to review the systems i Mental health sections of the current commissio c information system. This work is now ned for a expected to be complete in March 2016. primary l care use C include o information m about m patient i mental s health s needs and i service use o in their n specificatio e ns r s

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s y s t e m s 1.5. The Ongoing with All partners I ON TRACK: Camden CCG are developing concordat a review in n CIDR which is a system that will allow any will be September f Camden clinician to see another providers used to 2015 o record for the patient. C&IFT have worked facilitate r closely with the CIDR team and CIDR now the m includes data from C&IFT records. implement a However, this action is continuing to be ation of t monitored as C&I FT have transitioned to better i care notes and the islington data sharing information o model develops. sharing by n supporting Camden and Islington Crisis Care Concordat Local Action Plan and s feeding h into a specific r workstrea i ms across n the CCGs g and Local Authorities p r o j e c t s

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c a r e 1.6. * C&I will be March C&I FT (Aisling Clifford) A ON TRACK: The Trust Strategy is due to able to 2016 be signed off in February and will then be recruit and T presented to commissioners retain the r Camden and Islington Crisis Care Concordat Local Action Plan best quality u staff within s crisis t services w o r k f o r c e

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c h a l l e n g e 1.7. * People March 2016 C&I FT (Peter Kane, substance misuse) T ON TRACK: The policy and strategy is on with a dual h track to be delivered by March diagnosis e of substance t misuse will r Camden and Islington Crisis Care Concordat Local Action Plan receive u high quality s care that t takes w account of i their l holistic l needs r e v i s e

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1.8. * People December Camden CCG (Francesca Gasparro) W ON TRACK: A review and development of with a 2016 C&I FT (Dr Angela Hassiotis) e commissioning intentions will take place learning Peter C over the next financial year Camden and Islington Crisis Care Concordat Local Action Plan disability w will receive i high quality l care that l takes r account of e their v holistic i needs e w

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2. Improved information about crisis services and how to access them No. Action Due Led By Outputs by 2.1. A web page and paper document will March Camden and Service users and carers in Camden and COMPLETE: C&IFT be produced which clearly explain 2015 Islington Islington know where they can go to have launched a new what crisis support crisis teams Websi Foundation access support in a crisis. version of their provide, what the crisis team te Trust Referrers understand thresholds for crisis website thresholds are and what the compl care and the number of referrals which http://www.candi.nhs. alternatives to crisis services are. ete are not appropriate for crisis team uk/ . This website There will be a version for patients reduces includes an ‘I need and carers and a version for Decisi help now’ button professional referrers such as GPs on which directly links to and the voluntary sector. tree the crisis team pages due and also provides Febru information about Camden and Islington Crisis Care Concordat Local Action Plan ary other support 2016 services in the borough.

AWAITING COMPLETION: To add further value to this action C&IFT are also developing a decision tree which will assist all stakeholders to navigate mental health services and signpost them to the most appropriate location.

This decision tree will be available on the C&IFT and in a hard copy leaflet 2.2. * We will ensure that people Febru C&I FT (Ian Clear written criteria for the crisis ON TRACK: The experiencing a crisis and referrers ary Griffiths & teams including information on the Trust will provide understand who can be seen by 2016 Aisling offer for those who do not meet criteria draft criteria by the crisis team and who will be for Clifford) for a crisis response February offered alternative support. draft from trust May 2016 for agree ment Camden and Islington Crisis Care Concordat Local Action Plan with partn ers 2.3. * In Camden the mental health May Camden CCG There will be a Camden mental health ON TRACK: The programme team will work with 2016 Programme web site which will support people with website is expected third sector partners to consider team mental health needs, their friends, to be launched by the offer for people who do not family and supporting professionals to May 2016 band will need a crisis response but cannot understand what urgent, preventative link with existing offers such as wait for a community assessment. and general mental health support Camden Care they can access in the borough. Choices

2.4. * Commissioners will monitor the Febru Joint ‘deep dives’ on crisis care and ON TRACK: a deep responsiveness of crisis services ary commissioner readmissions will be reviewed through dive is on track to be and ensure that people receive 2016 s (Julia formal contract meetings. presented to the C&I timely support when they need it Chappell & The % of crisis referrals seen within 4 FT clinical quality Jenni Speller) review Group in and 24 hours will be reviewed through February 2016 contract meetings C&I FT Commissioners and the Trust will (Performance identify improvement actions following Manager) these reports 2.5. * We will ensure that GPs get high Marc C&I FT We expect to meet quality targets for ON TRACK: This quality and timely information h (Aisling 90% of people to have an updated has been included as about people’s needs 2016 Clifford) care plan held by their GP and for a ‘Commissioning for 95% of GPs to receive a discharge Quality and summary in 5 days. We will set Innovation’ scheme this year and will be recovery plans in required. monitored through the C&I FT clinical quality review group.

3. Improved urgent and emergency access to crisis care No. Action Du Led By Outputs Status Camden and Islington Crisis Care Concordat Local Action Plan e by 3.1. We will ensure that when people April C&I FT Commissioners and the Trust will review AWAITING attend A&E in mental distress they 201 (Aisling the resourcing of Liaison team and agree COMPLETION: will get the help they need 5 Clifford) how resources can be improved Through resilience Inter Camden informed by evidence based models of finding Camden im CCG service provision and local needs. commissioners have sup invested in an Programme port additional 10 band 6 in Team nurses to work plac (Hector across the Royal e Bayayi) Free and University New College London time Hospitals. scal Commissioners are e continuing to work TBC with providers to build an invest to save business model across North Central London (NCL)

COMPLETE: Islington commissioners have developed an Integrated Liaison and treatment (ILAT) service at the Whittington Hospital

3.2. * We will ensure that A&E is only May Camden We will review frequent attenders to A&E ON TRACK: used as a very last resort 201 CCG and consider how a different response Programme team 6 Programme can be developed for frequent attenders and provider are Camden and Islington Crisis Care Concordat Local Action Plan Team who have mental health needs scoping a model that (Hector We will monitor the provision of home supports a reduction Bayayi) treatment to ensure it is available for in the use of ED as a C&I FT those who need it single option when (Aisling users are in crisis. They hope to deliver Clifford) a business case and a fully specified service by March 2016 subject to consultation and CCG commissioning due diligence. This is also subject to sign up by the other NCL commissioners to present a coherent ED Liaison offer across the NCL conurbation 3.3. * We will ensure that when people Jan C&I FT The Trust will ensure there is a single ON TRACK: Trust need urgent help they are only uary (Aisling assessment process between crisis and will confirm that this assessed once 201 Clifford) liaison teams is within current 6 assessment processes 3.4. * Building on the local investment in Mar Camden and Commissioners and the Trust will agree ON TRACK: This will a 24 hour crisis line we will ch Islington a set of performance indicators for the be reviewed as part demonstrate the impact of the 201 commissionin phone line including qualitative and of the crisis deep service. 6 g (Julia quantitative information dive in January and Chappell and Commissioners and the Trust will develop Jenni The Trust will lead on ensuring the KPIs for 2016/17. Speller) phone line is well publicised to referrers Camden and Islington Crisis Care Concordat Local Action Plan

4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s 4.1. * The Trust will work to continue to Ma C&I FT (Aisling Clifford) T ON TRACK: A quarterly report is brought implement positive and proactive rch r to the Clinical Quality Review Group for care guidance 20 u C&I FT. An annual overview will be taken 16 st at the end of the year. to d e m o n st r at e pl a n s to i Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s m pl e m e nt p o si ti v e a n d p r o a ct iv e c Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s a r e g ui d a n c e a n d r e d u c e p r o n Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s e r e st r ai nt s to c o m m is si o n e rs 4.2. * Trust to outline plans to ensure Ma C&I FT (Aisling Clifford) T ON TRACK: Trust performance on acute patients are placed locally rch r occupancy is being closely monitored and wherever possible and in a safe 20 u is currently just above target. environment 16 st The trust anti ligature works across acute Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s to and older adult wards are on track to be d complete by February 2016. e m o n st r at e pl a n s to m ai nt ai n a c ut Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s e o c c u p a n c y at 9 5 % . T r u st to d e m Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s o n st r at e th e p o si ti v e w o rk th at h a s b Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s e e n c o m pl et e d to r ef u r bi s h w a r d s Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s a n d r e d u c e li g at u r e p oi nt s. 4.3. * Commissioners will work with the Ma C&I FT (Elaine & Ian Griffiths) T ON TRACK: Revised standards to be Trust to ensure wherever possible rch Camden and Islington h shared by January 2016 with agreement there is continuity of care 20 commissioning (Julia Chappell & e by March professional 16 Jenni Speller) tr Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s u st w ill r e vi s e th ei r c o nt in ui ty of c a r e Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s st a n d a r d s w hi c h o ut li n e jo in t w o rk Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s in g a rr a n g e m e nt s a n d s h a r e th e s Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s e w it h c o m m is si o n e rs fo r a g r e e m e Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s nt 4.4. * We will continue to encourage and Ma C&I FT (Aisling Clifford, Ian Griffiths) T ON TRACK: The trust will initially visit support the service user role in y h existing user groups to find volunteers. quality assuring crisis services and 20 e co-producing future models 16 tr u st w ill le a d o n r e - e st a bl is hi Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s n g a u s e r g r o u p s p e ci fi c al ly fo r cr Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s is is c a r e 5. Improved quality of response when people are detained under Section 135 and 136 of the Mental Health Act 1983

No. Action Due by Led By Outputs Update 5.1. The Camden and May 2015 Head of security at The use of police AWAITING Islington section 136 Delayed due to C&IFT working with stations as a place of COMPLETION: protocols will be national workstream the MPS and LAS at safety remains 0 in The local section 136 reviewed to ensure now due March 2016 Criminal Justice Camden and Islington protocol is being they are in line with Liaison meetings Section 136 Protocols reviewed by the Head the national section in Camden and of security at C&IFT 136 Action plan & Islington are in line and agreed through national section 136 with national Criminal Justice protocol and that standards and are meetings involving protocols are being followed appropriately C&I, the Police and followed locally. on the ground London Ambulance Service. This work had been delayed as greater national Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s guidance was previously expected. The policy is now expected to be agreed by March 2016 in line with the work to review section 136 data.

5.2. * Partners will review January 2016 Camden CCG A baseline of local COMPLETE: a section 136 data to programme team section 136 use is baseline audit of build a detailed (Zofja Zolna) to be established section 136 useage understanding of and data flows for has been presented what local usage is 136 useage to be to the Concordat steering group and how it may be Camden CCG mapped reduced programme team Once a baseline March 2016 (Zofja Zolna) has been mapped C&I FT (Adele partners will agree McKay) an ongoing reporting and monitoring process ON TRACK: A task for local section 136 and finish group is Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s being established 5.3. * Partners will June 2016 C&I FT (Deborah Whilst considering ON TRACK: audits of consider what Wright) current resourcing AMHP response timeframes can be Camden and and external factors times and reasons for put in place for Islington Commissioner and delays have been AMHP responses commissioning the Trust will agree added to local authority reporting under the current (Julia Chappell & a feasible local and following review team resources Jenni Speller) timescale for AMHP of these audits responses discussions will be analysis on the had about performance of the appropriate response AMHP service will times. be added to the local authority reporting schedule 5.4. * Building on the March 2015 Joint Commissioners and ON TRACK: This will local investment in commissioners the Trust will agree be reviewed as part a 24 hour police (Julia Chappell & a set of of the crisis deep dive advice and support Jenni Speller) performance in January and line we will indicators for the Commissioners and the Trust will develop demonstrate the C&I FT phone line including KPIs for 2016/17. impact of this (Performance qualitative and service. Manager) quantitative Camden and Islington Crisis Care Concordat Local Action Plan 4. Improved experience of crisis care No. Action Du Led By O Status e u by t p u t s information

6. Improved crisis prevention and planning No. Action Due by Led By Outputs Status 6.1. A borough Standard will be June 2015 Camden A borough standard for AWAITING COMPLETION: C&IFT is agreed for crisis plans to ensure Now due and crisis plans is agreed and reviewing its existing crisis plan standard they are drawn up to Concordat February Islington crisis plans are being to ensure it meets all the Concordat quality standards and are 2016 Foundation produced in line with the requirements. accessible to service users, Trust standard. carers and other professionals The number of crisis plans which evidence of collaboration with service users and other professionals will increased (measured through CQUIN) 6.2. * Building on the development of March C&I FT A project plan will be ON TRACK: Everybody on CPA will have a template for local crisis cards 2016 (Andy produced with targets been offered a card by 31st march. the Trust will ensure every Stopher, for the roll out of crisis Annual CPA meetings will check a card is service user has a Keith cards. Monthly updates in place and ensure it is refreshed personalised crisis card. McCoy) of progress against the Following March all other service users in the Trust will be offered a card. plan will be shared with Camden and Islington Crisis Care Concordat Local Action Plan commissioners until the role out is complete. 6.3. * We will continue work to February C&I FT The Trust will ON TRACK: The trust will present work to reduce readmissions 2016 (Ian demonstrate plans to the Clinical Quality review group meeting. Prenelle) reduce readmissions to commissioners 6.4. * In Camden we will ensure May Camden Following consultation ON TRACK: The Programme group monies from the Camden 2016 CCG and a review of the anticipate that they will have a draft mandate are utilised to support (Hector evidence presented business case ready for scrutiny in by the crisis prevention Bayayi) through various MHPG in December 2015, with the full independent studies, we business case presented end of February 2016 and to go through the due diligence will have a clear project by April 2016. This will subject to getting plan for investment the appropriate data and sign off from available as part of the stakeholders. Camden mental health mandate. This plan will include outcome focussed measures to monitor and review spend against. 6.5. * We will embed mental health March Camden We will monitor the ON TRACK: Commissioners are working support in primary care so 2016 CCG impact of the Team closely to share learning around primary more people get good help (Terilla Around the Practice care models. early Bernard) service in Camden and Islington Primary Care Mental CCG health service in (Jenni Islington to ensure a Speller) difference is being made and that area for C&I FT shared learning are (Emily Van identified. In Camden there is a task and finish Der Pol) group commencing to look at remodelling Camden and Islington Crisis Care Concordat Local Action Plan In Camden we will also the assessment and advice service consider the around primary care and discussions will development of practice be concluded during the 2016/17 based teams for people contracting round. with psychosis

*Please note the children and young people’s plan will be refreshed once CAMHS transformation plans have been signed off for both boroughs

7. Children and Young people’s action plan No Action Led By Camden update Islington . Update 7.1. Crisis planning CAMHS providers in collaboration with AWAITING COMPLETION: The AWAITING A protocol for crisis plans for commissioners Tavistock and Portman will introduce crisis COMPLETION: children and young people will planning into care plans for young people Islington has be developed. The protocol will at risk of crisis. Guidance will be adopted the Care include the need to evidence the developed to support this which stresses Planning voice of children and young the importance to involve and evidence the Approach at both voice of the child. people in plans, the need to This work will be captured through new Tier 3 Adolescent include wider professionals who KPIs included in the Tavistock & Portman Outreach Team work with them and the need for (main provider of Camden CAMHS) as well as In our all Mental Health Act contract and monitored through CQRG. local Tier 4 assessments to be completed by provision. a CAMHS AMHP The Clinical Director for Camden CAMHS (Services where has a meeting with the AMP training and YP in crisis will be Camden and Islington Crisis Care Concordat Local Action Plan development managers to secure training worked with) for 1 CAMHS staff member in late summer/autumn. The need for additional Young people are CYP staff to be trained as AMHPs will be invited to all highlighted in Camden’s CAMHS review meetings Transformation Plans in order to seek the additional funding required. as part of the CPA approach and are required to contribute if able agree with all actions within the plan before signing off the CPA review document.

Islington currently has no CAMHS staff trained as AMHPs, further enquires are required to discuss training and development in AMHP for CAMHS staff.

Appendix A Complete actions Camden and Islington Crisis Care Concordat Local Action Plan 1. Adult services complete actions

Category Action Due by Led By Outputs Update Meet with partners December 2014 Joint An action plan has been reviewed COMPLETE: The from across the crisis commissioners and agreed by Camden and Islington action plan was care pathway to with input from Foundation Trust, The Whittington signed off in February develop a local Crisis all partners Hospital, The Royal Free, University 2015 and submitted to Care Concordat College London Hospital, The the national concordat action plan for Tavistock and Portman, Camden and website. Following improving Crisis care Islington CCGs, The London submission partners in Camden and Boroughs of Camden and Islington, received a letter from Islington. Camden and Islington metropolitan the then Care police services and the London minister, Norman Ambulance Service Lamb, congratulating them on the strength of the plan.

Crisis pathways, care March 2015 Substance Care for those with a dual diagnosis COMPLETE: SMS and crisis plans for misuse services will be of an equal standard to care leads within C&IFT those with dual provided by for those without substance misuse have developed a diagnosis should be Camden and needs. pathway document for reviewed to consider Islington SMS services. This is how processes of Foundation currently out for assessment, care Trust and CRI comments from 1. planning and Camden partners and which Commissioning, interventions can be Feasibility study will be available on the strategy and better coordinated for team C&I website in August. infrastructure to people with substance support misuse needs The crisis care responsive high including third sector feasibility study quality crisis included a review of services In Camden this will be the crisis experience included is the Crisis for those with a dual Care Feasibility study. diagnosis and the findings of this will be Camden and Islington Crisis Care Concordat Local Action Plan followed up as part of the next steps

Mental health training June 2015 All partners There will be a clear understanding of COMPLETE: In available across contributing the training available to partners and Camden the CCG has partners will be data with Joint the uptake rate to inform workforce commissioned Mental mapped to capture Commissioners development Health First Aid what training is consolidating Training and Mental available to whom and Health Awareness what the uptake rate Training available to is. targeted partners in In Camden this will be the borough. Uptake led by the Mental of this training is being Health Mandate. recorded and analysed for gaps.

In Islington Mental health First Aid has been commissioned by public health.

C&IFT have mapped the formal and informal training they provide to partner agencies.

Commissioners have met with police colleagues to understand the training being provided to police in light of the Concordat. Camden and Islington Crisis Care Concordat Local Action Plan In addition to core training the MPS is offering a voluntary annual mental health briefing and developing an all staff presentation on suicide prevention.

2. Improved No complete actions information about crisis services and how to access them A 24/7 local mental December 2014 Camden and Service users and referrers will have COMPLETE: From health crisis phone Islington access to a local phone line which will December 2014 a line will be piloted until Foundation support access to crisis services. recruitment process the end of the year Trust Camden and Islington will achieve started to bring in using Department of Joint compliance with this element of the additional crisis team Health crisis monies. Commissioners London Crisis Commissioning staff to ensure the Information on usage Guidelines current phone system and feedback on its could be adequately effectiveness will be manned. shared with the external organisation This is an interim completing Camden’s solution until Crisis Care Feasibility September 2015 when Study and mental the existing phone health commissioners system will have been in both boroughs. replaced with a new single 24 hour crisis number staffed by local professionals. Camden and Islington Crisis Care Concordat Local Action Plan

3. Improved Camden and Islington March 2015 Camden and Service users and referrers will have COMPLETE: urgent and Commissioners will Islington ongoing access to a local phone line Camden has invested emergency consider the business Commissioners which will support access to crisis and additional access to crisis case for extending Camden services. £575,000 in crisis care crisis phone line Feasibility study Camden and Islington will achieve services for 2015/16. funding in 2015/16. team ongoing compliance with this element Camden is expecting In Camden this will be of the London Crisis Commissioning part of this resource to considered as part of Guidelines be used to fully the Camden Crisis implement the local Care Feasibility Study phone line as described above. Camden and Islington December 2014 Camden and A business case is produced which COMPLETE: A 24 FT will develop a Islington proposes models for A&E liaison with hour A&E service in business case for Foundation clear costs and expected outcomes to place at Whittington providing A&E liaison Trust assist Commissioners in making Hospital since April services across all decisions about future funding and 2014 three acute providers achieving compliance with the London which are 24/7 365 Crisis Commissioning standards. C&IFT has produced a days a year business case for improving A&E liaison. Review of inpatient April 2015 Camden and Camden commissioners will review COMPLETE: Six bed capacity. Islington capacity and ensure that demand is additional local acute In Camden this will be Commissioners met or identify additional resource if beds have been considered as part of C&I required. This will be part of a wider provided through a the Camden Crisis review of the crisis pathway to ensure local efficiency Care Feasibility all elements are effective. scheme which Study. repurposed a rehabilitation ward where patients had been moved to more appropriate Camden and Islington Crisis Care Concordat Local Action Plan community settings.

In addition, as lead commissioner, Islington has entered into a risk share with C&IFT. The Trust will utilise this resource to increase local bed capacity and work to an occupied bed rate of 95%. As part of the risk share an external review of acute be capacity has been commissioned for Camden and Islington and an initial report has been shared with commissioners. 4. Improved Commissioners will May 2015 Camden Service users will have a direct role in COMPLETE: In experience of support the ward Borough user shaping crisis services Camden crisis care inspections led by Group (CBUG) Service users will have a better commissioners are both boroughs’ Islington experience of inpatient care. receiving copies of all service user groups Borough User Patients Council ward and work with Group (IBUG) rounds and have Camden and Islington Joint attended a ward round Foundation Trust to Commissioners with service users. implement Camden and C&IFT have agreed a recommendations Islington memorandum of from the inspections. Foundation understanding with Trust Camden borough User Group to ensure there is a complete Camden and Islington Crisis Care Concordat Local Action Plan feedback loop following each ward round.

Islington commissioners will also be attending ward rounds.

C&IFT are also developing new systems for service user led appraisals of their services and in addition will be reviewing their user involvement policy during 2015.

An AMHP operational March 2015 MPS and People within a police station who COMPLETE: C&IFT’s policy will be Camden and need a Mental Health Act existing AMHP developed which Islington Assessment will be assessed in line operational policy has confirms that people Foundation with AMHP emergency assessment been reviewed to who have been Trust timescales ensure that it reflects arrested but require a existing good practice Mental Health Act around the urgent Assessment are assessment of those treated as emergency who have been referrals arrested but subsequently identified as needing an assessment. 5. Improved quality of To develop this action response when further Commissioners Camden and Islington Crisis Care Concordat Local Action Plan people are have agreed with detained under C&IFT that there will Section 135 and be a deep dive on 136 of the Mental factors causing delays Health Act 1983 to AMHP assessments which will be shared with commissioners and the police to understand the wide range of factors which may cause a delay to an assessment.

The referral June 2015 Led by the The referral and communication Complete There are processes between AMHP manager routes between mental health, liaison now quarterly groups the AMHP team, working with the and diversion and police services will in place for each Emergency Duty MPS, NHS be clearly articulated. borough which Team, Liaison and England, EDT examine the forensic Diversion Service and Team. interface between the Police will be partner agencies. reviewed to ensure they are clear and there is an effective interface with new NHS England commissioned services. Camden and Islington May 2015 Joint A decision will have been reached as COMPLETE: Both will consider the Commissioners to whether Camden and Islington Camden and Islington results of the (working with should pilot a local street triage have commissioned a Department of Health neighbouring service. If a street triage pilot is 24hr locally staffed street triage pilots and boroughs) agreed an implementation plan will be phone line which is consider if what model Metropolitan developed and commissioning solely for the use of should be developed Police Service resources identified. the police. This will Camden and Islington Crisis Care Concordat Local Action Plan locally. Camden and allow officers instant As part of the Islington access to advice and Camden Crisis Care Foundation support whilst they are Feasibility Study, Trust out on the beat. information will be gathered to underpin As per the crisis line a decision on street this service went live triage. on the 20th July 2015 and there has already been positive feedback from officers. 6. Improved Camden and Islington July 2015 Camden and Service users will know where they COMPLETE: Crisis crisis prevention will develop crisis Islington can go for help in an emergency cards have now been and planning cards for all service Foundation completed and printed users who have crisis Trust and roll out has plans. Cards will commenced summarise where service users can get help in an emergency and also include preventative information and staying well advice. Camden and Islington Crisis Care Concordat Local Action Plan 2. Children and young people’s action plan complete actions

Action Due by Outputs Camden update Islington Update Early May 2015 There is a clear map of early interventions COMPLETE: All COMPLETE: All Intervention services which demonstrate positive Camden schools have schools and Early outcomes for children and young people with an allocated CAMHS children’s centres in intervention mental health needs link worker based within Islington have an services are the north and south allocated CAMHS available for locality teams. A worker operating as number of teams such children and as children’s centres, part of a virtual team young people, youth offending, to identify early so they can substance misuse have emerging MH issues. find and stay CAMHS workers as part engaged with of their multiagency Community CAMHS services which team. have developed a YP keep them friendly website that safe, improve In Camden we have signposts YP to their mental www.urlife.org.uk which services and explains health and provides information for CAMHS services and young people on local prevent further emotional support what they can expect crises. services and how to from a service. access support ie. self referral to the Brandon http://islingtoncamhs. Centre. whittington.nhs.uk/

As part of the Minding Islington has the Gap joint CCG & counselling and Council project there is therapeutic services increased outreach to engage non help available in our young seeking young people people’s youth hubs. and those who are http://brandon- below mental health centre.org.uk/ Camden and Islington Crisis Care Concordat Local Action Plan thresholds.

As part of the Resilient Families Programme, mapping and communication of ‘early help’ services is being undertaken. Workforce Children and young people with mental health COMPLETE: The COMPLETE: development July 2015 problems, including children in care, care Tavistock and Portman Islington has Camden and leavers, and those leaving custody in the provide a range of tier 1 dedicated CAMHS Islington youth justice system, should feel supported services including workers in all schools Commissioner and protected by all professionals at all times. INSET days at schools, (including the PRU s will develop a consultation and and special schools) capacity building baseline (monitored quarterly). and children’s centres understanding Multiagency teams across the borough of the skills working with at risk who have a role in and training groups such as YOS, training and currently LAC and children with supporting the available within disabilities have workforce to identify the CYP CAMHS staff located MH concerns as well workforce within them. as offering consultancy where Educational there are specific Psychologists run Mental health concerns. awareness and mental health first aid for those There are also working with children targeted specialist and young people – workers in YOS, audit is planned for later Leaving Care Service in the year. and the PRU to undertake direct work but also support professionals working with YP around MH. Camden and Islington Crisis Care Concordat Local Action Plan Places of May 2015 Children and young people are safe in the COMPLETE: Locally COMPLETE: Locally safety immediate event of a mental health crisis YP are taken to YP are taken to Ensure accident and accident and children and emergency either at emergency either at young people the Royal Free Whittington Health or should have Hospital or at UCLH at UCLH where they access to an where they have a do have a 136 Suite. appropriate 136 Suite. The RFH place of has indicated plans to (Isington would be safety. This refurbish this room. interested in should never exploring options with be a police cell (Camden would be Camden re a and only in interested in dedicated suite for exceptional exploring options with YP if that was thought circumstances Islington re a to be viable given the a police station dedicated suite for very low numbers.) YP if that was thought to be viable given the very low numbers.) Service user The voice of children and young people is COMPLETE: A COMPLETE: voice evident within local CAMHS services and tier system has been Advocacy is routinely The views of March 2015 4 provision introduced at Tier 4 offered to all YP in children should panel to check both Simmons House be listened to advocacy has been and to YP in the throughout offered to all YP who Adolescent Outreach their are discussed. Team. experience of crisis care. A protocol has been Children put in place at the T4 should be panel to check advised of their Advocacy has been right to an offered to all YP who advocate come through panel. Ensure that C&YP are placed in appropriate settings COMPLETE: Tier 4 COMPLETE: Tier 4 C&YP are not March 2015 Children and young people in tier 4 are able panel reviews all panel reviews all Camden and Islington Crisis Care Concordat Local Action Plan being placed to be supported by their families, carers and cases so we maintain cases so we maintain on adult services they know oversight of all oversight of all wards or far placements made by placements made by from home NHSE and would NHSE and would challenge any YP on challenge any YP on an adult ward. an adult ward.

A system has been introduced at Tier 4 panel to check family support for all YP who are discussed is recorded.