Secondment to CNWLAndrew KlimanSenior Communications Advisor

13.05.15

GOV.UK/monitor

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Secondment to CNWL

• Central North West London• Community and Mental Health FT• Camden, Hillingdon, Brent, Islington, Chelsea and

Westminster, Hammersmith and Fulham, Harrow, Enfield, Hounslow, Kingston, as well as services in Milton Keynes, Bucks, Surrey and Hampshire

• Employ approximately 7,000 staff to provide more than 300 different health services across 150 sites and in many other community settings

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Secondment to CNWL

I gained experience of several services• Peer Support Workers• Sexual Health• Street Triage Unit• Use of telehealth and pilot to expand it• Transit lounge for A&E patients presenting in

mental health crisis• Electroconvulsive Therapy Unit• Recovery and Wellbeing College• CAMHS (Children and Adolescent Mental Health

Services)• St Charles Hospital Inpatient Mental Health Unit

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Secondment to CNWL

Peer Support Workers (PSW)

• Previous service users employed to work in service provider teams

• 25 PSWs currently employed – looking to grow this• Positive role modelling• Positive impact on the clinical team• Promotes a person centred approach• breaks the hierarchy between staff and service

user• helpful for ex-service users who want to use their

experiences positively

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Secondment to CNWL

Sexual Health

• Marketing at-home HIV testing kit • Freedom-shop website• Target audience and media channels• Ethics of live test on This Morning

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Secondment to CNWL

Street Triage Unit

• Pilot project • Aims to reduce the number of people who end up in a police

cell as a place of safety by reducing the number of inappropriate uses of Section 136 (of the Mental Health Act) and unnecessary A&E admissions

• Mental health nurses accompanying and supporting police and ambulance services where people present to these service in mental health crisis

• In the first 3 months of 2015, there have only been 6 uses of Section 136 during triage operational hours, versus almost 40 during the same period in 2014

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Secondment to CNWL

Telehealth pilot• Successful MK pilot project extended to Hillingdon and

Camden• A remote monitoring and clinical triage service for patients to

use in their homes • triaged by level 5 nurses • The initial pilot in 2010 found 168 hospital admissions and 85

GP visits were avoided based on 108 patients enrolled in the service within 1 year

• 79% of patients said they had experienced major benefits.• 88% of carers said having the system had resulted in major

benefits (12% said it had minor benefits)

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Secondment to CNWL

Transit lounge for A&E patients • A dedicated assessment unit located within the Mental Health Unit at

Northwick Park Hospital • Intended to reduce long waits in A&E, mental health breaches,

admissions to acute mental health wards and improve the experience of patients presenting in crisis

• A calming room with 4 recliner chairs and an additional quiet interview room. Blankets, food, medication and TV are provided and relatives can visit.

• It is staffed 24 hours a day with a specialty doctor and two nurses • Funded with Winter Pressures money• mental health breaches have virtually ceased. • In 2013 the average was 28 per month • In the past 4 months there have been only 4.

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Secondment to CNWL

Electroconvulsive Therapy Unit

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Secondment to CNWL

Recovery and Wellbeing College• Runs courses for people living with physical and mental health

conditions• Recently added the ‘wellbeing’ element of the college to promote

effective self management• Free service to those who have used CNWL services in the last 12

months and their carers, friends and family, and staff of CNWL• Around 80 courses• Run with peer support workers• Very practical life skills, e.g. getting back into paid employment

through condition management.

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Secondment to CNWL

CAMHS (Children and Adolescent Mental Health Services)• CAMHS in Milton Keynes recently acquired and doesn’t have

effective branding or marketing material• They need to use the same branding as the rest of CNWL CAMHS

but feedback from service users is they find it patronising

• Use of the service is up over 100 per cent in three years and the service is stretched

• Want more information on their website to offer alternatives to using CAMHS where appropriate

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Secondment to CNWL

St Charles Hospital Inpatient Mental Health Unit• Interviewed Stephen Parker, effectively a turnaround director• Unflattering CQC inspection in late 2013• Stephen brought in by CNWL to fix it and has spent time introducing

new procedures and ways of working for staff.• 3 Years ago 30 per cent of patients had been sectioned, now it is 90

per cent – patient population is sicker• CQC re-inspection successful but feels CQC care plan requirement

isn’t nuanced enough• Looking to bring in peer support workers• Can delay release of patients as social care packages aren’t in place• “We have great relations with the councils we work with but the

amount of money in mental health just isn’t enough. Unfortunately you have to be really ill to get great quality services, those who aren’t quite ill enough get forgotten and so relapses are more likely.”

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Secondment to CNWL

What worked well• Fairley well planned out in advance• IT infrastructure basically in place• Clear idea of what CNWL wanted• Team were on board• Got out to experience a lot of the service first hand• Humanises Monitor – not just faceless bureaucrats

What could be improved• Need to get remote email/diary access• Unavoidable delays (e.g. arranging meetings) mean three weeks is

better than two• Very hands on and not very strategic – doesn’t use the full range of

a senior comms person’s skills