Feedback from the transformation engagement events

1. Introduction Seven large-scale events were held across the Trust’s localities during June and July 2013. Over 450 people’s voices were heard. A number of conversations took place and the output of these conversations had been distilled into six key themes:

• I want services which keep me in the centre and which focus on my potential

• If I choose to make use of technology, I want it to be available

• I want all organisations, both big and small, to work together so I don't see the joins

• I want people to recognise early on that I'm beginning to have problems and to help me

• I want you to offer me as much choice as possible and help me understand those choices

• I want you to support my family and carers

Each key theme has been summarised and is supported by a number of statements and ideas drawn directly from the events.

It has been agreed that a second set of events will take place in October across the Trust to on the theme of “You said…we are doing”.

2. Feedback

2.1. I want services which keep me in the centre and which focus on my potential

People feel that they want to be talked to as an adult, with honest conversations that focus on their potential, not their illness. If they have a long-term illness they want to be able to move back into services without complicated re-referral. They want to feel that they are in charge of their care plan, not the service, and that their whole life is taken into account when creating the plan. People want to feel supported right from the start so if they have to wait for specific treatment they need to know where they are and they need access to some kind of support while they are waiting. If people are asking for help, we need to really listen to that and recognise that even though someone may not meet the official guidelines for crisis intervention, they still need a rapid response. This is likely to prevent an actual crisis from developing.

Statements from the events: “Don't put me on a waiting list and just leave me” “If I say I need help, listen to me – I might not be in crisis but I need help now” “Recognise my expertise” “Wrap services around me, not me around services”

1 Some ideas:  Peer support networks  Holistic, service user held care plans  Support while on waiting lists  Start the Recovery conversations on day one  Resources to prevent out of area placement

2.2. If I choose to make use of technology, I want it to be available

People want to use technology to empower themselves, but don't want us to assume that this will suit everyone. The level at which people are comfortable with technology should form part of the assessment. We should consider equipping people with technology as part of their treatment - just like you might adapt someone's house for a physical problem, you might provide someone with a smart device. People want to be able to use technology to: • Share information and communicate with their care team • Improve access to professionals and support • Manage as much as they can for themselves • Find out what is available

Statements from the events: “Don't make me tell my story more than once!” “I need to be able to find information easily” “Don't assume technology will suit everyone” “Don't forget that older people can use technology too” “Make the most of the Facebook generation”

Some ideas: • Record the person’s story in the format of their choice (audio recording, video, writing) • Single information hub • One assessment, one care plan, held by service user, including service user-held diaries/communication logs and an integrated care plan app • Virtual clinics at GP surgeries (video links, SKYPE) • Self-management tools o Mood diaries, weight management, resilience building o Online or app based CBT o GPRS for people with dementia o ‘Self-service’ – self-prescribe own care o Book own appointment times online • Social networking and peer support – closed and open networks, online peer support forums • Carer support – online chat, discussion forums, advice and information • Assistive technology/telecare • Passport CD with essential information about the individual “This is me” • Online directory with connected, clear networks and pathways • Ability to communicate with care team via text, email • Use Skype, teleconferencing, web conferencing as alternative to face to face contact

2 2.3. I want all organisations, both big and small, to work together so I don't see the joins

People were concerned about how well statutory organisations were aligned at strategic and local levels and how they work together - police, primary care, secondary care, social services, and housing all need to work together. If they don't, care will continue to be fragmented. As a Trust, we are good at looking after people when they are ill. We need to extend the pathway so that we help people when they are just starting to become ill and when they are starting to get better. We also need to help people to stay well. There was a clear message that this can be done really well by the plethora of small, community based organisations that are already there. However, they need support to do this sustainablyin the longer term. These organisations asked us if the Trust has a key role to play in this.

We also need to achieve much better integration of physical and mental health services.

We need to be much more creative about how we use the whole community's resources - very small, local groups as well as the larger organisations. They know their communities.

We need to work with our partners to help create safer places to live.

Statements from the events: “Work together so that we can't see the joins!” “Extend partnerships beyond local boundaries - think regional, national, international” “Fragmented services can't deliver value” “Are all statutory partners signed up to the same vision?” “We need better integration of physical and mental health services” “We need a workforce that is fit for the future” “Be open and realistic about constraints on our resources and how we can use them”

Some ideas: • Use community resources and networks • One stop shops • RAID approach across the system • Recognise the value of friendly places that give access to creative activities • Community activity that is not illness focused • Better use of health and wellbeing services • Use voluntary sector organisations to deliver support • Develop dementia friendly communities and use the Butterfly Scheme to support this

2.4. I want people to recognise early on that I'm beginning to have problems and to help me 3 People spoke about the importance of early education about health and wellbeing, working in close partnership with schools, colleges and employers, housing and primary care. There is an important part to play in picking up issues earlier so that people don't get to a crisis point. It is also important for primary care providers not to allow diagnosis of mental illness to overshadow other conditions and also to understand the impact of long term physical conditions on a person’s mental health.

Statements from the events: “Schools and colleges are the place to start” “Carers need support and education”

Some ideas: • Increase partner skills in recognising and working with mental health issues • Invest in earlier preventative initiatives • Make it easier for men to ask for help

2.5. I want you to offer me as much choice as possible and help me understand those choices

People want their choices broadening out to include alternative solutions which might include access to more creative activities, and they want to understand more about how this can help them. We need to be more open to thinking through what someone wants to achieve and being as creative as possible in finding ways to help them do this. The decision about the service offer needs to be arrived at together. The message came across loud and clear that the key workerneeds to have access to comprehensive, up to date information about everything that is available in their community.

Statements from the events: “Broaden your minds! Don't just offer more of the same.” “It can't just be a matter of only getting what your key worker knows about” “Arts aren't everybody's bag - we need lots of alternatives”

Some ideas: • Peer support networks • More use of group work, co-facilitated by peer support workers, service users and volunteers • Use creative tools such as Life Story work • Encourage social prescription by GPs • Access to sport and creative activity

4 2.6. I want you to support my family and carers

Families and carers need more information, education and consideration from services. They recognise the need for confidentiality but feel that at present they are sometimes ignored and undervalued. They felt that they are an untapped partnership resource.

Statements from the events: “I want to make the decision on how to involve my family when I'm feeling well” “Don't forget about young carers” “If you support us, we can support our family member”

Some ideas: • Education and information for carers in relation to mental health • Bereavement counselling • Support for parents of children with additional needs • Carer support networks

3. Further information A more detailed breakdown of the emerging themes and ideas can be obtained from Service Improvement and Development on request.

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