CONSULTATION DOCUMENT TRANSFORMING MENTAL HEALTH SERVICES IN CAMDEN AND ISLINGTON: Proposals for change to the Camden and Islington NHS Foundation Trust Estate 6TH JULY 2018 TO 12TH OCTOBER 2018 NHS Islington Clinical Commissioning Group, NHS Camden Clinical Commissioning Group and Camden and Islington NHS Foundation Trust TRANSFORMING MENTAL HEALTH SERVICES IN CAMDEN AND ISLINGTON If you require this document in an alternative format such as Easy Read, large print, audio, braille, and in languages other than English please email: [email protected] or call 020 3688 2900. 2 NHS FOUNDATION TRUST CONTENTS 1. Introduction 04 2. Our vision 04 3. An introduction to the proposals 07 4. SECTION 1: Inpatient beds 10 5. SECTION 2: Community services and development of community hubs 17 6. SECTION 3: Other non-Camden and Islington NHS Foundation Trust services providing services on the St Pancras Hospital site 26 7. How are we financing this? 27 8. What will happen to the St Pancras Hospital site if it is redeveloped? 29 9. Next steps and assurance 30 10. Timeline of completion of the community hub clinical model and building works 31 11. Consultation details 32 12. Appendices 34 3 TRANSFORMING MENTAL HEALTH SERVICES IN CAMDEN AND ISLINGTON INTRODUCTION This document outlines the proposals for transforming mental health care in Camden and Islington with a set of questions at the end of the document for you to answer. Camden Clinical Commissioning Group (CCG) and Islington Clinical CAMDEN AND Commissioning Group (CCG) are the local organisations that buy ISLINGTON mental health services from Camden and Islington NHS Foundation Trust (the Trust) on behalf of local people. The CCGs are consulting with have some of the you on changes to how Camden and Islington NHS Foundation Trust highest levels of provide some inpatient and community services in future. diagnosed serious mental illness in The Trust provides mental health care to people in their homes, in the England with a rapidly community, and in hospital. They provide services for adults of working rising population. age, adults with learning difficulties, and older people. To meet these challenges effectively, Camden CCG, Islington CCG and the Trust want to significantly improve the way in which mental health care is provided across the two boroughs. We have written this document to explain how this could be done and to ask for your views as part of a public consultation. You can read more about Camden and There are large areas Islington’s healthcare challenges in the Appendices on page 34. of deprivation and we have a transient Our vision: A place where no-one is left behind population with up to Camden CCG, Islington CCG, and the Trust want to provide the very best mental health care for the residents, carers and families of Camden and Islington by building services around their needs. We want to improve overall mental health outcomes across Camden and Islington, % and reduce inequalities for those with mental ill health, enabling more 20 people to live well and receive services closer to home, ensuring that we of residents entering are treating both physical and mental ill health equally. and leaving the area Our local communities have told us they want a more joined-up health each year. This makes it and care system, with care closer to where they live and work, delivered challenging to identify mental health issues by a professional and compassionate health and care workforce. and monitor how people respond to treatment. 4 NHS FOUNDATION TRUST We believe that the changes proposed in this There will be times when people will need specialist document provide an exciting opportunity to deliver support provided in a hospital environment and it on our ambition to improve mental health and is our aim that this is provided in environments that reduce the health inequalities in our communities. are safe, therapeutic and maintain individual privacy. By delivering more care in community settings and working in a more joined-up way with our health, Clinical model of mental healthcare social care and voluntary sector partners, we believe The North London Sustainability and Transformation that we will be able to deliver better outcomes for Partnership proposes a ‘stepped’ model of care, our patients. By supporting people closer to their supporting people with mental ill health to live homes and embedding services in the community well, and enabling them to receive care in the least our teams can help people earlier, preventing people restrictive setting for their needs. The aim is to from becoming unwell so that they require fewer reduce demand on hospitals which reduces the need hospital referrals and less crisis care. for additional mental health inpatient beds. We know that services provided in the community The Trust’s Clinical Strategy 2016-20211 sets out for people who experience mental ill health bring the clinical model for services provided at the Trust, many benefits and better health outcomes. both currently and in the future. This model has These are: been designed to keep community teams at the heart of service delivery, ensuring care is provided as • community services are less stigmatising and close to service users’ homes as possible. The Trust’s easier to access care model forms part of the broader North London • people receiving their health care closer to home Sustainability and Transformation Partnership can continue to receive the support of their ‘stepped’ model of care for mental health. families, friends and community We are at a stage in the redevelopment of the • where care is underpinned by strong, joined- inpatient unit at St Pancras Hospital and our up community services, people are likely to be development of the community hub model where referred to hospital less often and are likely to there is scope for you to further shape our proposals be discharged earlier following periods of illness and so we believe it is the right time to consult • providing treatment in the least restrictive with you. environment possible also means that fewer The community hub model is a new concept in people are likely to be detained under the Camden and Islington and, therefore, offers a Mental Health Act and those that do can come particular opportunity for us to work with you out of hospital as soon as possible. to further develop the details of this model and shape the hubs to meet your needs. This includes determining the location of the hubs. 1You can view Camden and Islington NHS Foundation Trust’s Clinical Strategy, 2016 to 2021 here: www.candi.nhs.uk/about-us/corporate- information/our-strategy-and-objectives/clinical-strategy 5 TRANSFORMING MENTAL HEALTH SERVICES IN CAMDEN AND ISLINGTON Living well in most appropriate Highly specialised care available when 7 8 Tertiary, 6 less intensive care is no longer /least restrictive setting complex, appropriate LTCs Acute Inpatient admission when community-based support is no 5 longer appropriate. For the shortest time necessary, connected inpatient to community services to support recovery to living well admissions and governance Urgent care pathway Urgent/crisis 24/7 support to anyone feeling in crisis, including including shared data including shared care to support 4 single point of access and timely assessment with – stabilisation more care and recovery at home and in the community Specialist community-based High quality specialist services for those 3 with complex and intensive needs that support require ongoing support close to home Increasing intensity of need Coordinated community, Continuity of care and support around the needs of the system across transitions Better coordinated primary and social care 2 individuals and communities, including co-produced care, case management, and multi-disciplinary support on the community Living a full and healthy life Support individuals and communities to 1 effectively manage their wellbeing, close to home, working to support integrated Enablers Whole systems model focused in the community with a focus on prevention and resilience North London Sustainability and Transformation Partnership Stepped Model of Care Expected benefits of the clinical model: The potential benefits of the proposed clinical model will vary according to which services a person is accessing, and include the following potential benefits: • community-based care: The relocation of new site as identified in the Equality Impact some services to the Camden and Islington Assessment. hubs offers the opportunity to access services • more joined-up care between physical care at a welcoming community-based, non- and mental health services: Locating mental hospital setting and reduce the need for health inpatient services and physical health patients to attend a range of sites. care facilities next to each other means the • improved patient choice: Service users will two services can work more closely together have a choice of which community location when caring for people in the emergency they attend. Therefore, they could be seen pathway. at the St Pancras Hospital site or one of the • better working environment for staff: community hubs. Developing new facilities and implementing • improved therapeutic environment: For the workforce plan provides an attractive inpatients at St Pancras Hospital, moving to working environment for our staff which a new facility ensures they receive care in a will help with recruiting and retaining staff. high-quality, specialised building with modern Delivering community services