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South Ayrshire Health and Social Care Partnership South Ayrshire Health and Social Care Partnership REPORT Meeting of South Integration Joint Board Ayrshire Health and Social Care Partnership Held on 13th June, 2017 Agenda Item 11 Mental Health and Learning Disability Services – Pan- Title Ayrshire Change Programme Summary: This report details the progress being made in the redevelopment of the mental health, addictions and learning disability services throughout Ayrshire. Thelma Bowers Head of Mental Health, North Ayrshire Presented by Health and Social Care Partnership Action required: That the Integration Joint Board notes progress and supports the continued development of the Pan Ayrshire Mental Health and Learning Disability Services Change Programme. Implications checklist – check box if applicable and include detail in report Financial HR Legal Equalities Sustainability Policy ICT Directions required to NHS Ayrshire & 1. No Direction Required Arran South Ayrshire Council, or both 2. Direction to NHS Ayrshire and Arran 3. Direction to South Ayrshire Council 4. Direction to NHS Ayrshire and Arran and South Ayrshire Council 1 SOUTH AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP INTEGRATION JOINT BOARD 13th June 2017 Report by Head of Mental Health, North Ayrshire Health and Social Care Partnership MENTAL HEALTH AND LEARNING DISABILITY SERVICES – CHANGE PROGRAMME 1. PURPOSE OF REPORT 1.1 The purpose of this report is to update the IJB on the progress of the Mental Health and Learning Disability Services Pan-Ayrshire Change Programme. 2. RECOMMENDATION 2.1 It is recommended that the Integration Joint Board notes progress and supports the continued development of the Pan Ayrshire Mental Health and Learning Disability Services Change Programme. 3. BACKGROUND INFORMATION 3.1 A number of these projects are led by the North Partnership as the Lead Partnership, but affect services on a Pan Ayrshire basis. 3.2. Where relevant the report states whether the work is taking place in North, South or East Partnership. 4. REPORT 4.1 Mental Health Services has a long term vision of integrated services with timely access and responsive services building on prevention and early intervention. 4.2 A wide programme of redesign is in place as a result of recognising the co- dependency’s between services which were identified during the development of Woodland View. 4.3 Due to the ambitious nature of the programme and the interdependencies between mental health services and the wider Partnership services, for example a parent affected by addiction issues and Children & Family Services, it is a complex and ever changing position. 4.4 An additional level of complexity arises as some services are delivered on a Pan Ayrshire basis. As a result a Pan Ayrshire Strategic Planning & Mental Health Change Programme Steering Group has been formed. This Group is chaired by Thelma Bowers and is attended by service managers, staff side representatives, carers and service user representation from North, South and East Ayrshire. 2 4.5 The South Ayrshire Health and Social Care Partnership has developed a new Strategy for Adult Community Mental Health Services in South Ayrshire for the period 2017-22 and this document has been submitted to this meeting of the IJB for consideration and approval. 4.6 Similarly East Ayrshire Health and Social Care Partnership are working on an ambitious transformation plan across the whole of the Partnership. 5. Current Position 5.1 Woodland View – Opened April 2016 Woodland View is a recently built Mental Health Inpatient Facility in Irvine which serves the whole of Ayrshire. It replaces some wards in Ailsa Hospital and Crosshouse Hospital, although some patients have remained at Ailsa Hospital for the time being. The move to this purpose built facility gives an opportunity to review the models of care for patients and subsequent bed modelling to suit the demands of the population. Woodland View is now recognised both nationally by the ‘Building Better Health Care Awards 2016’ and locally at ‘North Ayrshire Achieves 2016 – Building Community Capacity’ as an exemplar in design and new ways of working. In the planning stages of the Woodland View development significant gaps in the nursing workforce had been identified within the old hospital facilities of 33wte required to safely manage the dispersed, multiple site clinical environments. The implementation of new models of care, however in the context of the new therapeutic environment of Woodland View has demonstrated that there is now a gap of only 14wtes band 2 staff in providing acute mental health inpatient support safely. This is evidenced by the re-implementation of the national workforce planning tool and is also in alignment with business case assumptions made in 2015. The recruitment of staff to support the new adult male forensic low secure model on Ward 6 at Woodland View is complete and the medical model has been agreed. The North Ayrshire Partnership as Lead Partnership has successfully developed a business case to host and deliver a new national forensic unit for adolescents at Woodland View. This will be a national centre of excellence and is a significant achievement. The Government team recognised the exemplary partnership work which is already taking place and felt confident that NAHSCP and NHS Ayrshire and Arran can deliver this new approach. The business case has been approved at a national level and is progressing through the final stages of sign off. 5.2 Drug and Alcohol Recovery Service North Ayrshire 3 The Integrated service has launched and is being well received. The service is now testing a single referral, risk management and allocation process. The service is also testing its locality approaches with a pilot working with the GP Practices in the Garnock Valley. The integrated service has demonstrated many quality outcomes and benefits alongside a financial saving. This has been achieved with a new streamlined management structure, by incorporating methadone cessation support into core service delivery, by increasing prescribing support and requiring less Opiate Replacement Therapy medication and by the service delivering additional Alcohol Brief Intervention activity. ORT (Opiate replacement therapy) At a Pan Ayrshire level, the service continues to develop the model of opiate replacement therapy with a range of new prescribers. These include ANPs, Pharmacists and GPs. The uptake has been steady and the service well received. Evaluation is being carried out by the Prevention Service and Support Team and is ongoing. Funding for this work is being addressed by a phased implementation of the service and is negotiated on a yearly basis. South Ayrshire With the additional resource made available and to enhance the work already underway delivering ORT, the service has increased the GP prescribing sessions and has recruited a Peer Recovery Worker. The Peer Recovery Worker Role is an exciting new development which aims to: provide peer support to people with lived experience of drug and alcohol issues on an individual & group basis; work with people in a way that promotes equality, facilitates recovery and supports the development of the persons sense of control over their lives and recovery journey; through personal lived experience of drug and alcohol issues, to act as a role model for stakeholders; and promote, contribute & embed an environment which encourages & supports recovery principles & recovery approaches both within the organisation itself & working with individuals. The funding for this post is short term for 12 months however plans are in place to evaluate the impact of the role over the period with a view to reviewing this part of the service and workforce planning review. East Ayrshire In conjunction with South Ayrshire colleagues, East Ayrshire NHS Addiction 4 Services have identified 2 Peer Recovery Workers to support recovery interventions across East Ayrshire. It is anticipated that these posts will enhance recovery based practice throughout the Partnership and dovetail with the already established Addiction Worker Training Programme provided and supported nationally by the Scottish Drugs Forum. East Ayrshire ADP already fund and provide workplace placements for this educational and skills based programme. This initiative embeds the ethos of supporting individuals furthest away from the labour market with opportunities to gain valuable experience and qualifications to enhance their employability potential. Drug Related Deaths Initiative Due to the concerning National upward trend in Drug Related Deaths, East Ayrshire ADP has developed a low threshold approach with emergency services to support vulnerable individuals engaging with specialist support services at the earliest opportunity. This initiative will provide proactive support to individuals in the context of accidental overdose and onward referral unless the person chooses to “opt out”. This approach will be fully evaluated for impact and it is hoped will see a reduction in the number of preventable deaths. Partner Agency Prescribing Clinics/ Digital Transformation Due to challenges at transition from core NHS treatment services to third sector ADP partner organisations, East Ayrshire ADP’s Advanced Nurse Practitioner (ANP) has been provided with a laptop/VPN to enable prescribing clinics to take place in non NHS premises (Addaction). This approach has received Caldicott approval. The anticipated benefits from this proactive approach are that more people will be engaged with recovery opportunities and as a result more people will
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