As a New Care Model (NCM) South London Mental Health and Community Partnership Provider Collaborative first looked at the data and used insight from service users and stakeholders to set very clear objectives, including priorities for the gaps they needed to address and where they could improve.
This gave them a clear context for bringing together service users, children and young people, families and carers, clinicians and operational staff across inpatient and community services, and colleagues across public services and sectors to co-produce and develop new ideas and services. They have changed how they work and introduced new services, such as transformed crisis care, to better support children and young people in the community, and address shared goals.
The South London Mental Health and Community Partnership Child and young people mental health service Provider Collaborative launched on the back of a culture, and proud track record, of improving services and making a difference for children and young people across the 3.6 million people the three mental health trusts serve. Together, Oxleas, South London and Maudsley, and South West London and St George’s have discovered, developed and delivered new ways of working – in collaboration not competition – with a clear focus on patient outcomes.
In just over two years, they made a significant difference. Overall bed days for children and young people in South London in mental health inpatient wards are down by a third.
- Enhanced and new Crisis Care teams working from each Trust
- New South East London Oxleas-led Dialectical Behaviour Therapy (DBT) service
- Out-of-hours crisis line telephone service staffed by specialist CYPMHS Crisis Practitioners
- 24/7 Centralised Bed Management: manages referrals and enables system-level monitoring of occupancy and effective use of capacity to ensure CYP are accommodated in area.
- New eight-bed Adolescent Psychiatric Intensive Care Unity (PICU)
- Enhanced Adolescent Outreach Team
- South London-wide specialist Community Forensic CYPMHS service
For service users, outcomes have included:
- 32% reduction in South London for children and young people (CYP) in mental health hospital beds
- Reduced lengths of stay in PICUs, reduced crisis escalations and resulting A&E attendances of known service users
- Overall a 93% reduction in out of area bed use
- Service users receiving dialectical behaviour therapy (DBT) interventions through the new Oxleas service led to reduced attendances to A&E departments (was 23 in a year, reduced to 2) and reduced hospital stays (from 605 occupied bed day in a 12 month period to 0): Suicide attempts reduced to 1 (was 24); A&E attendances 2 (23); Occupied Bed Days 0 (605)
“I called the crisis line at the weekend. The clinician was amazing and so helpful. Without their support I would have otherwise taken my child to A&E” – Anonymous Service User
The collaboration also made a massive difference to how they responded – alongside the rest of the NHS – to the challenge of COVID-19 in 2020. They rapidly extended their local crisis line to cover not just CYP known to services, but to all across south London, their families and carers. Feedback and benchmarking data has shown this has helped reduce A&E attendances, as well as de-escalating crises, and supported local families and young people with practical help, interventions, crisis plans, advice and guidance.
Clinical Director Dr Sarah Bernard, Consultant Psychiatrist said: “There is still much more we can do. Our regular service user groups, and focus on population health issues, highlights more opportunities to improve at scale. As a new NHS-Led Provider Collaborative we have the impetus and real commissioning power to do even more of what’s right for our children and young people.
We look forward to the next stage of our journey to unfold which we know will continue to be collaborative and in partnership with commissioners, providers and, importantly, with young people and their families.”