We’ve put together a list of queries we think you might have. If you’ve got a question that’s not on this list, please email us at wsh-tr.mhprogrammeteam@nhs.net
We’ll answer your question as soon as we can. And if we think your query would be helpful to other people, we’ll add it to this list. Don’t worry, though, all questions asked will be anonymous.
- General questions
- Questions on the Children’s, Young People’s and Families mental health service
- Questions on the Community mental health service
- Questions on the Crisis mental health service
- Questions on the Learning Disabilities and Autism service
General questions
1. What is the Vision?
Our vision is that ‘The people in east and west Suffolk can get help and support in the right place for them, when they need it, to stay mentally and emotionally well.’
2. Why are mental health services being transformed?
Despite the best intentions and hard work of many people, the system for mental health and emotional wellbeing in Suffolk is not meeting patients’ expectations or needs. The system we have is also not adequately designed to meet the changing needs of our population, therefore, work needs to be undertaken to improve services.
As part of #averydifferentconversation a number of themes were identified:
- Lack of access and unmet needs (especially in crisis)
- Access (increased waiting times)
- Support in the Community
- Information and Signposting
- Continued Support (especially post discharge)
- Listened to and understood
- Integrated Care (opportunities)
- Resources
- Support for Careers
- Digital Support
- Schools (lack of support)
- Transition from Child and Adult Services
The 10 year east and West Mental Health and Emotional Wellbeing Strategy captures the #averydifferentconversation themes and objectives of the transformation.
3. Is this just for Suffolk?
This Transformation programme is being led the Suffolk Mental Health Alliance covering Ipswich and East Suffolk and West Suffolk and covers all mental health services provided in Suffolk (excluding Waveney). This simply means that the whole system across Suffolk (commissioners, statutory and non-statutory providers, partners, and regulators) will be working more closely to support a population of circa 780,000.
4. What is the Alliance?
The Suffolk Mental Health Alliance in east and west Suffolk includes health, local authority and other partner organisations working closely together to share resources and decision-making leading to blurring of boundaries between commissioners and providers and between providers.
The Alliance partners are Suffolk and North Essex NHS Foundation Trust (ESNEFT), West Suffolk Foundation Trust (WSFT), Norfolk and Suffolk Foundation Trust (NSFT), Suffolk County Council, Suffolk GP Federation and Ipswich and East Suffolk (I&ESCCG) and West Suffolk (WSCCG). The Suffolk Mental Health Alliance is different to other Alliances and this is because it is supported by three co-production partners, these are: Suffolk Family Carers (SFC), Suffolk Parent Carer Network (SPCN) and Suffolk User Forum (SUF).
5. Will it make a difference?
We believe that, in order to achieve excellent mental health and emotional wellbeing, everyone should get the right support, at the right time, from the right people, in the right place and in the right way. Our principles for success are:
- Everyone’s view matters
- We will make children and you people’s mental health and emotional wellbeing the foundation of our strategy
- System-wide responsibility to deliver and support resilient communities
- Additional investment
- Prevention and early intervention is as important as treatment
- People should be supported to care for themselves
- Physical and mental health will be integrated
- Services will be need led
- Utilisation of digital and technology
- Recovery focused approaches
- Normalising mental health and emotional wellbeing
- Supporting the workforce
6. What timescales are being worked to?
The aim is to have all transformation plans in place for mobilisation from June 2021. This does not mean all the changes will happen by then; it means that all the plans will be ready.
May 2020 – Dec 2020
- A full suite of detailed pathways that document service user’s journey will be developed
- Each pathway will have a predicted demand/capacity, workforce and finance model developed
- Public and staff engagement on proposed pathways will take place
- Pathways reviewed by NHS England Clinical Senate
January 2021 – June 2021
- The pathways will be translated into a number of specifications which detail the how, who and when
- Process concluded to determine which Alliance partner(s) are best placed to take a lead on providing each specification
- A due diligence process will be undertaken
- New contracts signed/Mobilisation
7. What does this mean for me?
Due to COVID-19 a number of changes have already happened. The Crisis pathway has already seen the launch of the First Response service from March 20 and services moving to 24/7. However, most staff will not see any substantial differences in the way they work until post June 2021 and then this will be in a phased approach.
8. What will the changes look like/what’s different?
The changes are about a way of working across the Alliance influencing a cultural of more integrated working. Expectations around who can access services and refer into services will change as well as there being new roles, training across physical and mental health services, integrated teams, possibly co-location and trusted assessments.
9. Who will I be employed by?
We don’t anticipate your employment changing. The new models of care are more about integration and working together across the Suffolk system.
10. Will my work location change?
In the short term this is unlikely until a full review of estates has been undertaken. The aim will be to try and co-locate teams around the communities they will be working in as far as possible to enable more integrated working.
11. How have staff being involved
Staff have been engaged as part of the work developing the strategy in 2018/19 and have been included in the development of the new proposed models. Senior clinical leads for providers are invited to be part of all the relevant meetings to ensure representation across the system. Virtual engagement forums will run throughout September and October to gather more feedback.
12. How are service users and carers being involved?
#averydifferentconversation offered the residents of east and west Suffolk a role in creating a new strategy for how mental health services are delivered. The Alliance’s formal co-production partners Suffolk Users Forum (SUF), Suffolk Parent Carer Network (SPCN) and Suffolk Family Carers (SFC) with many other organisations that represent service users and carers being involved along the way working alongside the CCG in developing the transformation plans.
13. What process will staff have to go through?
Staff will be engaged and consulted with throughout any change process.
14. How does this fit with NSFT Strategy?
This supports NSFT’s vision of supporting people to live their hopes, dreams and aspirations and our strategic priority relating to co-production, partnerships and recovery.
15. How does this fit with SCC’s Priorities?
This supports SCC’s priority of caring for Suffolk’s vulnerable residents, enabling everyone to live long, healthy and fulfilling lives. Having thriving families and communities and thriving economies support each other.
16. How does this fit with Suffolk GP Federations Objectives?
This supports the objectives to successfully work with Alliance partners to complete the Most Capable Provider process for mental health.
17. How does this fit with the CCGs Objectives?
This supports the CCGs vision in achieving the deliverables in the 10 Year East and West Suffolk Mental Health and Emotional Wellbeing Strategy and supports the objective of Strengthening the support for people to stay well and manage their wellbeing and health in their communities.
18. What training and support will managers get to manage this transformation?
We will ensure that there is regular communication with managers regarding any changes to their teams and where appropriate we will provide training in areas such as communication skills, understanding and managing change, supporting staff.
19. What opportunities will this bring?
The new models will support rotational post, new skills and new roles and closer working with our NHS partner and the wider Suffolk system.
20. Are the Trade Unions aware of what is happening?
Yes, the TPM (Trust Partnership Meeting) has been updated on a regular basis with regards to the transformation plans.
Questions on the Children’s, Young People’s and Families mental health service
1. What makes an ideal worker?
From a service user’s perspective, an ideal worker should be someone who:
- Doesn’t expect too much from you
- Understands that not one size fits all
- Goes the extra mile
- Is able to give appropriate and sensitive response
- Has knowledge of conditions and services
- Praises achievement and gives back positive feedback
- Doesn’t use labels like ‘attention seeking’
- Is able to recognise sign of emotional and mental health problems
- Give you space when you need it
- Doesn’t cut you off or make assumptions
- Tries to understand your behaviour and doesn’t assume young people are just being naughty
- Is non-judgmental and takes you seriously
- Respect your individuality
- Has good signposting skills
2. What does the ‘Thriving’ element of Thrive mean?
All those children, young people and families who do not currently need individualised mental health advice or help are considered to be thriving. this group should receive community initiatives that support mental wellness, emotional wellbeing and resilience of the whole population.
3. What does the ‘Getting Advice’ element of Thrive mean?
Promotion of resilience, to build the ability of a community (school/family) to prevent, support and intervene successfully in mental health issues. Within this grouping would be children, young people and families adjusting to life circumstances, with mild or temporary difficulties, where the best intervention is within the community with the possible addition of self-support. , this provision should be provided within education or community settings
4. What does the ‘Getting Help’ element of Thrive mean?
This grouping comprises those children, young people and families who would benefit from focused, evidence-based treatment, with clear aims, and criteria for assessing whether aims have been achieved.
This grouping would include children and young people with difficulties that fell within the remit of NICE guidance but also where it was less clear which NICE guidance would guide practice.
Wherever possible, provision for this group should be provided with health as the lead provider with a greater emphasis on ending an intervention if it was felt not to be working or if was felt gains no longer outweighed costs or potential harms. Explicit agreement should be sought at the outset as to what a successful outcome would look like, how likely this was to occur by a specific date, and what would happen if this was not achieved in a reasonable timeframe.
5. What does the ‘Getting more help’ element of Thrive mean?
There is emerging consensus that some conditions are likely to require extensive or intensive treatment for young people to benefit. In particular, young people with psychosis, eating disorders and emerging personality disorders are likely to require significant input. his grouping comprises those young people and families who would benefit from extensive long-term treatment which may include inpatient care but may also include extensive outpatient provision.
6. What does the ‘Getting risk support’ element of Thrive mean?
This grouping comprises those children, young people and families who are currently unable to benefit from evidence-based treatment but remain a significant concern and risk. This group might include children and young people who routinely go into crisis but are not able to make use of help offered, or where help offered has not been able to make a difference; who self-harm; or who have emerging personality disorders or ongoing issues that have not yet responded to treatment. In terms of the support offered within this grouping, it would focus on supporting children and parents/carers during periods when they did not feel safe and were unable to take ameliorative action to regain safety. Service users would have access to support from someone whom they know, whom they had helped select and in whom they had confidence and trust, and who is responsible for coordination of the support backup-team.
7. What is Signs of Safety?
The Signs of Safety® approach is a relationship-grounded, safety-organised approach to child protection practice, created by researching what works for professionals and families in building meaningful safety for vulnerable and at-risk children.
8. How I support service user if I am not a qualified Mental Health Worker?
Early Help and Early Years teams (which includes pre-schools, nurseries, Children’s Centers, Health Visitors, and Family Support Practitioners) will be equipped with the skills, knowledge and understanding to identify need and provide early support and intervention.
The workforce throughout all education settings (mainstream primary, secondary, further and higher education) will have the skills to identify need and the capacity to support children and young people to remain mentally and emotionally well.
Training packages for the entire workforce are being developed and will be consistently reviewed, updated, shared and provided to all professionals (both health, care and education) to ensure those in contact with CYPF have the most up to date knowledge of the local offers and system.
9. What ages will the children, young person and family services see?
The new model will be from birth up to 25 years.
Questions on the Community mental health service
1. Will users still have a care coordinator?
They may still have a named care coordinator however the approach to supporting people in the community is more integrated and therefore users will work with a number of different professionals across their recovery. This enables all services users to access staff that can best support their identified needs.
2. Can users still see a psychiatrist?
Psychiatrists will still form part of the Mental Health teams and will work closely with all professionals to meet service users needs. They may not directly see a psychiatrist, but they will be continue to be involved in care when needed.
3. Does someone have to be in the children’s pathway if they are under 25?
Not necessarily. We are aiming to provide services that best meet the needs of the individual needing support. By ensuring that services are more integrated the service users needs will be , or discussed and agreed with the service user and or your family by the right professional. Transition to adult services will take place based on the needs of the service user and may occur earlier or later depending on the service user’s capacity.
4. Who does a service user contact for support with their mental health?
By creating a no wrong door approach for service users, the aim is to ensure that help and support by the right person, at the right time, in the right place is automatic. The user can contact anyone and be quickly signposted to the right support. Where the service user is not yet known to the service this may logically be theirr GP practice however they may be involved with other health and social care professionals that they can also approach, who can then support them to access what is right for their needs. Anyone that is receiving support will have a care plan which will clearly document who they have agreed to contact and in what circumstances.
5. How will someone know what is happening with their care?
If they are currently receiving support for a mental health condition they will receive communications from the team that are supporting them. We are working closely to ensure that when any changes happen to the community services, service users and families are fully aware of what is happening and are clear about how their needs will be met going forward. It is anticipated that the changes will take place across a number of months.
Questions on the Crisis mental health service
1. When will the First Response Service move to NHS 111?
Due to Covid-19 the First Response Service was required at speed and lots of the planning was already in place however the service was unable to utilise the 111 number. They are working with NHSE to switch to the 111 service as soon is safely possible. It will be communicated ahead of time and likely run alongside the existing number to ensure everyone can receive urgent support.
2. Can people still attend A&E for psychiatric support?
Yes, however we recognise that an A&E department is not always the most helpful place for someone in distress and urge people to contact First Response Service (when it is safe to do so) so the most appropriate place for assessment can be arranged.
3. What happens if a service user is open to a mental health team and needs crisis support?
In the event of needing additional support people will be encouraged to contact the team that supports them in the community first. However, if they are unable to, out of hours or it is an emergency then First Response will support all callers.
Questions on the Learning Disabilities and Autism service
1. What is the vision for the new service?
The workforce has been integral to the service model that we have in place at the moment. The four key pathways are:
- Inpatient care
- Intensive support team
- LD Specialist Community Services
- Forensic Support
We will be moving forward to have a specific service for people with a Learning Disability and/or autism and not seeing people with just a mental health problem. Health Facilitation and health inequalities are going to play a huge role in defining the transformation.
2. What will the benefits be for service users?
The biggest area of change will be the community services model for people with a Learning Disability and/or Autism.
At the moment, the service model predominantly represents a mental health service and not a service designed to meet people’s Learning Disability and autistic needs. The model will have a menu of opportunity and within this we will see programmes of work around behaviour, health facilitation, and health desensitisation.
By those terms we mean how do we support those people who need extra support to access primary and secondary health care and how do we, if people are frightened to access that care, provide them with a programme to make them less frightened. We will also provide support around communication and sensory care.
To build upon the high-level models that we have. Our provider, along with Suffolk County Council, are already providing some of the changes. Services are beginning to see those people with ASD and challenging behaviour and not just LD.
3. What opportunities/benefits will this bring for staff?
There will be different ways of working and different roles as we need less care in inpatient services but will need a very highly skilled team to deliver the care in the community. It is about utilising the specialist LD&A skills that we have in the current workforce to develop the future workforce.
