Commentary on Enhanced Primary Care Mental Health Team (EPCMHT)
1. A care navigator may signpost for things such as pharmacy opening times, whether next prescription is due/ready, this is current process in GP practices across Suffolk.
2. If the service users’ needs are unclear the appointment should always be with a member of the practice team for example with a GP, or practice nurse.
3. The GP practice appointment should include advice, guidance and safety planning even if the outcome is further Mental Health input (for example call 111 +2 if things worsen or provide details for online self-help).
4. Whether a telephone triage or face to face triage is appropriate will be a decision made by an experienced clinical.
5. Multi-Disciplinary Team (MDT) discussions may be virtual or a physical meeting considering the urgency of the service users need. This is to be agreed within each practice locally.
6. An age inclusive triage by a senior mental health practitioner will take place to ensure an appointment with the appropriate clinician is booked. It may or may not involve a telephone call to the service user, carer or parent to establish further information. The Children, Young People and Family (CYPF) pathway will join up here to support young people and families accessing the right help without delay.
7. If coming from e-consult the mental health worker should be involved in the triaging to establish who the most appropriate next contact is. This includes the ability to book directly with countywide specialist teams (for example: eating disorder, early intervention in psychosis etc.) Ideally the triage from e-consult should include a CFYP practitioner.
8. A number of interventions can be delivered within the EPCMHT including:
- Mental Health workers for brief intervention (to be defined by needs typing and clinical interventions work but multiple professionals with different scopes of practice)
- Social Prescriber
- Social care input
- Practice nurse/specialist clinics
- School nurse
- Early help practitioner
- List not exhaustive
9. If under 16 appointment should be with the relevant practitioner from the CFYP service line when possible.
10. The ability to make an appointment with countywide recovery teams at this point to prevent delays is available.
11. Further support may be identified within the CFYP teams as social worker, Early Help, Youth Justice etc.
Commentary for Specialist Recovery
12. There can be a request for increased input after EPCMHT have utilised their options or an identified need at point of first contact (direct from Mental Health professional to specialist). There will be a practitioner identified in each locality to support these discussions.
13. It may be that the EPCMHT have supported an individual and intervention options have not met the service users need or during initial contact the Mental Health professional has formulated the need as requiring specialist recovery pathway.
14. It may be that a professional within the EPCMHT requires some support from specialist practitioners. This is an expansion of current Advice and Guidance process.
15. Building on the existing assessment, not a `reassessment` to support a deeper understanding of Mental Health need.
16. Formulation may be completed with the EPCMHT to support the understanding of needs/sharing of understanding where resource permits.
17. Care Plan Approach (CPA) level is still required to be allocated until there is national guidance stating otherwise, but this doesn’t mean the way of delivering interventions can`t be different.
18. Based on needs type and NICE/Best practice individual pathways such as Eating Disorders, Early Intervention in Psychosis (EIP), Perinatal etc. will overlay at this point.
19. Even if step down care isn`t indicated a discharge plan must include how services can be accessed in the future and guidance for GP.
20. There may be one MDT to support the flow of service users through the system, there does not need to be multiple MDT’s.