Pathway Advisors are the first point of contact for visitors to the Life Rooms; through a social prescribing model they spend time getting to know the individuals before signposting them on to appropriate Mersey Care or partner services. They also form a wrap around service with our Individual Placement services (IPS) so that all our service users have access to employment support; a key strategic priority for the organisation is supporting service users and carers to access employment. In addition the Pathways Advisors help those looking for employment to sort out associated problems such as debt reduction, income maximisation, benefits advice and housing support.
Highly Commended in #MHAwards18 - Addressing MH Inequalities
From start: Yes
During process: Yes
In evaluation: Yes
PP Collaborative: Yes
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Jane Holland - Head of Participation and Inclusion Development
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
The co-produced Life Rooms model seeks to transform mental health care so as to promote both recovery and social inclusion for the benefit of the individual and for the benefit of the communities we serve. The model offers a place of welcome, a one stop shop for information, a centre for recovery education and vocational learning, support for volunteering, employment and social enterprise, as well as free library and IT provision. The focus of the model is on self-management of health through learning and social resource empowerment. Since opening (Walton 2016, Southport 2017) there have been 37,000 visits; Life Rooms Bootle is planned for November 2018. Over 50 partnerships have developed involving the statutory, voluntary and private sectors; many are cost neutral and represent the advent of a genuine social economy through a community focussed, asset-based approach. An internal evaluation has already taken place and a further two-phase service evaluation has been commissioned that will assess the impact of the model on clinical and recovery progression as well as on patient experiences. One significantly successful part of the Life Rooms model is the Pathways Advice Service. Pathway Advisors are the first point of contact for visitors to the Life Rooms; through a social prescribing model they spend time getting to know the individuals before signposting them on to appropriate Mersey Care or partner services. They also form a wrap around service with our Individual Placement services (IPS) so that all our service users have access to employment support; a key strategic priority for the organisation is supporting service users and carers to access employment. In addition the Pathways Advisors help those looking for employment to sort out associated problems such as debt reduction, income maximisation, benefits advice and housing support.
What makes your service stand out from others? Please provide an example of this.
The Life Rooms model and the Pathways Advice service stands out from other services because it is entirely co-produced with service users and carers; they helped to produce the Pathways Advisor job descriptions, and the subsequent Life Rooms Advisory Group leads on the evaluation and development of both the role and the model. In addition, the wrap-around employment service provided by IPS and Pathways Advisors enables us to offer employment support to all our service users (CPA and non-CPA) through a model that we refer to as IPS Plus. We have seen an improvement in the number of service users and carers in employment since inception of this model and since our partnerships have included referrals from the Pathway Advisors to employment support organisations. One of our partners, Liverpool in Work, stated ”I have funded clients for work clothes, travel a taxi badge, and various tools and health and safety clothes”.
How do you ensure an effective, safe, compassionate and sustainable workforce?
Lived experience is a desirable component in the job descriptions of the Pathway Advisors and many of the other Life Rooms roles. Our Advisors have monthly 1:1 supervision, monthly team meetings and monthly reflective practice sessions. Advisors have access to corporate essential mandatory training, further training is routinely provided around safe-guarding, personal resilience, boundaries training, and DWP and benefits training.
Who is in your team?
1 x Project Manager Band 5 3 X WTE Pathway Advisors Band 4 1 x 0.7 Pathway Advisor Band 4
How do you work with the wider system?
As previously stated the Life Rooms model has over 50 partnerships involving the public, private and voluntary sectors and covering benefit and debt advice, housing support, social activities such as walking and gardening groups, and counselling services to support those addicted to gambling to name a few. Although the model itself is a non-clinical model, it is firmly embedded into mental health clinical pathways at entry and egress. Although the model is solely funded for secondary mental health service users it aspires to strengthen the opportunities for support at a primary care level, thereby reducing the amount of time spent with GPs and encouraging preventative work with those who may not yet have sought formalised help for their distress. Over 40 GPs now refer directly into the Pathway Advisors and we feel that we have a real potential, through our econometric evaluation, to demonstrate savings to the public purse alongside real and substantial life outcomes for individuals and the wider society. Mersey Care NHS Foundation Trust has recently become responsible for community physical health services. The Pathways Advice service will be a natural receptor for referrals from community teams and the recovery college is designing physical activity courses and nutrition based information.
Do you use co-production approaches?
The Life Rooms model was conceived by service users and carers and iterated in the People Participation Plan 2014/2015. Within the plan service users and carers identified the need to develop a centre for recovery and social inclusion, designed to address the social detriments of mental distress and provide a signposting service to appropriate organisations based under the same roof through a ‘warm handover’. Service users and carers co-produced the design of the model and subsequent buildings as well as the variety of roles; they also had equal voice on interviews panels for all of the posts. They volunteer with us in both Life Rooms and co-deliver courses through the Recovery College. They continue to be actively involved in the evaluation and expansion of the model through the Life Rooms Advisory Group. Service user and carer involvement is core to the ethos of Mersey Care NHS Trust and lived experience is a desirable component of our job descriptions. It has been particularly beneficial for the development and growth of the Life Rooms model and the Pathway Advisor role as these were both ‘leaps of faith’ and completely new ways of working. Service user and carer belief in the model and role helped to strengthen the Trust’s resolve to try something new.
Do you share your work with others?
We have hosted a range of fact finding visits from groups and individuals seeking to learn more about our model. This includes clinical leaders, CCGs, other Trusts, NHS England, King’s Fund, and local councillors and politicians. An article describing the model has featured in the International Journal of Recovery Ontario Shores – University of Toronto. HRH the Duke of Cambridge expressed interest in our model and visited Walton to officially open the Life Rooms in September 2017.
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
We are currently implementing SWEMWBS within the Life Rooms service through the Pathway Advisor role so will be collecting our first dataset for this over the next few months. We are also in the process of undertaking a qualitative piece of work, working alongside Life Rooms users, to explore what ‘outcomes’ mean within the context of the Life Rooms. Our aim is to work towards developing a bespoke outcomes measure for the Life Rooms, based upon a user perspective on the service.
Has your service been evaluated (by peer or academic review)?
Liverpool John Moores University have undertaken an SROI evaluation around the Recovery College provision and the Pathway Advisor role. In addition, an internal evaluation has been undertaken by Trust staff and a two-phase econometric service evaluation is underway that will assess the impact of the Life Rooms and Pathway Advisor role on clinical and recovery progression and measure the economic impact of potentially switching off costs both in secondary and primary care areas.
How will you ensure that your service continues to deliver good mental health care?
The Life Rooms model has been formally recognised as an integral part of clinical pathways in Mersey Care NHS Foundation Trust in that it is essential to assisting the effective transfer of care from secondary to primary care services. The Trust’s Operational Plan 2017/2019 states that one of the key priorities will be to ‘strengthen the Life Rooms’ in order to provide support to people outside of the traditional models of service delivery and enable people to take more control over their health and recovery’. It is hoped that our econometric evaluation will enable us to prove the financial advantage to primary care commissioners of developing our service.
What aspects of your service would you share with people who want to learn from you?
The main challenge has been the unexpectedly fast growth of the model. It was never envisaged that Life Rooms Southport would come on line so quickly after Life Rooms Walton. The staffing of two buildings has been challenging with a minimal staffing component. In addition, the role of the Pathway Advisor has been one of the most popular and pivotal roles within the model and continues to outperform expectations. Our recommendation would be consolidation before expansion.
How many people do you see?
in the past twelve months the Pathways Advisors have seen 1,310 individuals.
How do people access the service?
People access the Pathways Advisors through referral from secondary services, community services and primary care services as well as through referral by external organisations and self-referral.
How long do people wait to start receiving care?
There is not a waiting list to see Pathway Advisors; all appointments are on a ‘drop in’ basis.
What is your service doing to identify mental health inequalities that exist in your local area?
We are linking with partner organisations to collect comprehensive data and working with our Life Rooms Advisory Group to understand localised needs.
What is your service doing to address and advance equality?
Our Pathway Advisor role has been developed to extend additional support to those experiencing mental distress who need to retain or get back into employment. The role achieves this through working with partner organisations to address the associated determinants of unemployment and mental distress, for example housing and debt issues, in one place.
Hours the service operates *
9:30am – 16:30pm Monday to Friday
Brief description of population (e.g. urban, age, socioeconomic status):
Life Rooms Walton sits in the Warbreck Ward of Liverpool. There are 6909 households with an average household comprising 2.3 people. 31.5% of working age residents are economically inactive and 28.9% of adults have no qualifications. 22.1% of residents are disabled or have a long-term illness that restricts their day to day activity. Life Rooms Southport sits in the Sefton metropolitan borough of Merseyside. Sefton has a population density of 18; over four times higher than that of England as a whole. In its entirety it is in the most deprived quarter of English Local Authorities with five of its lower super output areas in the top 1% nationally; yet other parts of the Borough are some of the least deprived areas. between January and December 2015 18% of all households in Sefton were workless.
Size of population and localities covered:
Life Rooms Walton and Southport cover the entire population of Liverpool and Sefton; 466,415 and 203,000 respectively. `
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England): *
Provided by (e.g. name of NHS trust) or your organisation: *
Mersey Care NHS Foundation Trust
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