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Dr Geraldine Strathdee, National Clinical Director for Mental Health, who today addressed the National Psychosis Summit, details NHS England’s ambitions for the next five years:
I have been fortunate to work with people with psychosis, and am full of admiration for them and their families.
Admiration for how they live with this challenging condition in the face of the stigma more often than compassion. Yet they manage to be good neighbours, contributing citizens and good employees when they are given those life opportunities some of us take for granted
The leadership challenge for NHS England and its system partners is how to “industrialise” improvements in commissioning and care for people with psychosis to deliver the outcomes and value for which there is such a clear evidence base.
The transformational change in the care of those who have suffered a Stroke shows that it can be done, and we are keen to learn from this. We can use similar methodologies, adapted and co-produced with service users. Over the next five years, our ambition is for continuous, sustainable, and feasible improvement in the care of those who suffer from psychosis, with them and for them.
There are very clear standards of care, including NICE guidelines and robust peer accreditation schemes. There are examples of excellent practice, but there are major variations in quality.
The variations in care are in seven core standards:
- Timely access to reliable information, so the person understands their condition, the treatments and how to self-manage;
- Safe medicines and support for monitoring;
- Access to psychological therapies;
- Better physical care to reduce premature mortality,
- Employment support;
- Recovery interventions;
- Rapid response in crisis.
So what actions have we taken?
Through a range of commissioning levers and support for provider improvement, in 2014/15 we are tackling:
- Accessing physical care to reduce the 15 to 20 year prematurely mortality: Today’s National Psychosis Summit launches the NHS England physical health CQUIN. From this week, every inpatient unit in all mental health providers will start to embed systems to ensure that every patient has the physical assessments and treatments for the cardio-metabolic conditions that cause the premature deaths. This is the largest ever international improvement programme for people with psychosis, and we need all hands on deck, and to share the good practice to deliver this better care.
- Accessing psychological therapies for people with psychosis: Our Improving Access to Psychological Therapies (IAPT) programme development for people with psychosis continues, and is embedding improved assessment and outcome measurement into routine mental health practice. This year, we have a quality premium incentive to increase commissioning of psychological therapies. (ref Quality Premium).
- Access to employment support: We have the Clinical Commissioning Groups Outcome Indicator Sets (CCGOIS) lever to promote CCGs commissioning the highly effective evidence based intensive employment support programmes and treatment. (ref Centre for MH).
- Promoting better outcomes, better value, and least restrictive care: We need good information to improve care. In June, with PHE partners, we will see the launch of the Mental Health Intelligence Network which will provide data, CCG by CCG, on the level of psychosis in England, and the current commissioning and care standards against best practice.
- Personalised care planning and personalised budgets: Pilots are showcasing best practice for future roll out.
In the NHS England standard contract this year we have incentivised improved data quality, and we should see 100 per cent recording of rates of detention under the Mental Health Act. This will then enable us to work to identify the people who are detained more often, so that we can, as part of the development of NHSE care pathway and integrated care programmes, find ways to review care plans and enable more recovery orientated care that will promote resilience
We can’t promise instant improvement, but in working with partners across the system, with the CCGs, and our Strategic Clinical Networks and Academic Health Science Centres, today starts ‘England on the Move’ for the (transformational) improvement in the care of those who suffer from Psychosis.
- You can follow Geraldine Strathdee on Twitter: @DrG_NHS