Wellbeing Matters – Midlands Partnership Foundation Trust with Mental Health Matters – HC #MHAwards19

The Wellbeing Matters team have made a real difference to local people by offering high quality, easily accessible evidence based psychological therapies to people living in the Tamworth area and achieving excellent recovery rates. The team is delivered in partnership between MPFT and MHM bringing together the best qualities of a highly performing Trust and a national charity experienced in providing quality IAPT services across the country. Our commitment to offering care within community settings means we challenge stigma and encourage conversations about mental health in schools, workplaces and community centres.  We work with adults with anxiety and depression, aiming to reduce stigma and provide talking therapies in a timely way.

https://www.mpft.nhs.uk/

Hours the service operates: 8-5pm Monday-Friday, extended to 8pm on Tuesdays and Thursdays

Highly Commended #MHAwards19

Co-Production

  • From start: No
  • During process: Yes
  • In evaluation: No

Evaluation

  • Peer: Yes
  • Academic: No
  • PP Collaborative: Yes

Find out more

Please briefly describe your project, group, team or service, outlining What you do and Why it makes a difference

The Wellbeing Matters team have made a real difference to local people by offering high quality, easily accessible evidence based psychological therapies to people living in the Tamworth area and achieving excellent recovery rates. The team is delivered in partnership between MPFT and MHM bringing together the best qualities of a highly performing Trust and a national charity experienced in providing quality IAPT services across the country. Our commitment to offering care within community settings means we challenge stigma and encourage conversations about mental health in schools, workplaces and community centres.  We work with adults with anxiety and depression, aiming to reduce stigma and provide talking therapies in a timely way.

 

In the previous year, we successfully bid for £200k to introduce a service for people with co-existing long term physical health conditions, providing more holistic care.  This has now developed and we are working alongside Oncology service to deliver workshops to patients who are at the end of their treatment journey.   The team have delivered a workshop with the Ehlers Danlos Syndrome support group and co presented an IAPT-LTC webinar with people with lived experience.  We work in the local community (libraries, supermarkets, and fire stations) as well as clinics to make it easier for people to attend.  We have successfully introduced telephone and online therapies for those unable to attend in person due to work, caring commitments or physical health issues.  We provide wellbeing courses and workshops to local organisations and colleges to promote positive mental health and the message ‘It’s Okay to talk’, including delivering workshops to Mental Health First Aiders employed by Drayton Manor theme park.  Our recovery rates for people using the service are well above the national average.  We have pioneered adapting therapy materials for therapists and patients who are visually impaired.  We work seamlessly in partnership with other local organisations – e.g. MHM – a leading third sector provider of talking therapies, MPFT Recovery College, GP’s, midwives and physical health care colleagues.  Staff wellbeing has been addressed and has improved enormously over the past couple of years with lower levels of staff sickness reported than the previous year, as well as a focus on what we do well in meetings and supervision and personal development as part of the appraisal process.

 

What makes your service stand out from others? Please provide an example of this.

Wellbeing Matters is acknowledged as a well performing site on the IAPT-LTC project by NHSE and local commissioners. We have been delivering this integrated pathway since August 2017. We are seeing around 100 additional patients per month through this pathway and service user’s reports are very positive regarding receiving integrated physical and mental health care in the same place. We engage on a variety of platforms including social media, online, via community engagement events and advertising. We have a strong social media presence @mpftwellbeing and @ClinLeadWBM and also on Facebook and Instagram. We follow and are followed by fellow mental health professionals both locally and nationally and the accounts are unlocked for the general public to view – we post useful information for all. We promote a positive atmosphere for staff with a low turnover within the service. Our staff love their jobs and feel well supported! (MPFT Staff survey results for 2018 – top of the national tables!). Staff wellbeing has been addressed and is being maintained, with a focus on what we do well in meetings and supervision and personal development as part of the appraisal process. We have recently recruited a Peer Support Worker to work within the team co-facilitating courses as a lived experience champion – aiming to now develop a mentoring scheme between past and new service users. The peer support worker now regularly sits on interview panels and has become involved with the PWP training programme.  We acknowledge this is unusual for IAPT services and believe it will improve staff knowledge and ongoing co-production with patients. It also enables TPWP’s to interact with people with lived experience and gain insight from a service users perspective.  During interviews the Peer Support Worker offers insight regarding prospective candidates interpersonal skills from their perspective.

The service Clinical Lead and the peer support worker were invited to present at the IAPT 10 conference in London, and gave a presentation entitled “Impact of Accessing IAPT”, which was extremely well received.

 

How do you ensure an effective, safe, compassionate and sustainable workforce?

Our annual CPD programme, regular clinical and caseload supervision, daily duty supervision to assist in decision making. We have Introduced a staff wellbeing programme including Wellbeing Champions whose first task is to organise team building and wellbeing events over the summer. We are introducing brief staff mindfulness exercises to our PWP forum events and the Champions will meet regularly with managers to proactively discuss ideas to promote staff wellbeing – e.g. the introduction of a compliments board. Our first peer support worker is developing his role, co-facilitating courses as a lived experience champion, being a member of the interview panel for new staff and peer support.  Some of our courses are co-run by ex-patients from our team– who can use their own experiences to teach and encourage others. Our aim is to have our experts by experience helping us develop all aspects of our service. We would love to have the resources to widen this to a training programme for all professions working in mental health in the region.

There are now 5 team members who have completed the LTC Top-up training, and regular LTC specific supervision is provided.  Along with in house training from the clinical lead to the whole team, this has enabled better understanding of how physical health and mental health cannot be separated and has led to adaptations to therapy to be more inclusive to people with additional cognitive, sensory or mobility needs and to people who are in chronic pain, experience high levels of fatigue or may be unable to leave the house.

We remain a teaching team and regularly take therapy trainees on placement from local universities, of which we currently have 2 trainees on placement within the service.  Several colleagues teach or have previously taught on approved teaching programmes in the region to reach out to the next generation of therapists with evidence and good practice. We run regular training events which are open to colleagues from other disciplines.

The Senior PWP was involved in the launch of the West Midlands Senior PWP, which has links with other forums nationally and aims to address and understand the local and regional topics relating to the National IAPT picture, share best practice, consider regional and local training needs and areas of development for the PWP workforce, provide and develop SPWP with leadership skills, to consider regionally challenges of the PWP role – such as recruitment and retention.  The SPWP forum meets regularly with the local Expert Advisory Group, which consists of clinical leads and West Midlands Clinical Network representatives.

There is a member of the team who has attended “Train the Trainer” workshops and is now due to co facilitate workshops with MPFT Recovery College.

 

Who is in your team? Band/gradeNumberWhole-time equivalent
E.g. Clinical psychologist8a21
MPFT staff • Clinical Lead

Senior Step 3 Lead 1.0wte band 8a

Liaison lead nurse – 1.0wte Band 7

CBT/EMDR therapists – 5.0wte Band 7 •

Counsellor – 1.0wte band 6

Trainee CBT therapists

Admin – 2.0wte Band 3 MHM staff

Senior Psychological Wellbeing Practitioner

Psychological Wellbeing Practitioners

IAPT workers 1.

Trainee Psychological Wellbeing Practitioners

Trainee Clinical Psychology Placement

Student Counsellor Placement

8c

 

8a

 

 

7

 

7

 

6

 

6

 

 

3

 

6

 

 

5

 

4

 

4

1

 

1

 

 

1

 

10

 

1

 

2

 

 

2

 

1

 

 

7

 

2

 

2

0.8

 

1

 

 

1

 

8.08

 

1

 

1.8

 

 

2

 

1

 

 

6.6

 

1.4

 

2

 

 

 

 

 

 

 

 

 

 

How do you work with the wider system?

We have created an interface document to smooth the transition between our service and secondary care pathways for young people, adults and older adults considering individual needs. In the past twelve months we have attended team meetings or training events with most secondary care teams – CAMHS, perinatal mental health team, community mental health teams, older adults team, Access and Crisis teams – to provide training and discuss ways to improve transitions for service users. We have a Liaison Nurse Prescriber in the team who manages transitions for service users and we have found this to be highly effective in reducing their anxiety about changing teams. He works in both pathways and so has expert knowledge and skills to assist people at this vulnerable time. More recently we have extended our community engagement and are now working alongside the local Food Banks, baby massage and yoga groups, at the local shopping centre and in local libraries to support identification of people who may benefit from using the service and providing easy access to therapists.

In June, our Clinical Lead will be undertaking a training programme for all new Apprentices with Francesco hairdressing chain to identify and signpost people with anxiety and depression to the Wellbeing Services. Drayton Manor theme park have asked us to be their staff wellbeing trainer and we have completed 2 tailored training workshops to some members of their staff.  During the summer months we are about to embark on a series of workshops with the staff at colleges across the region with a view to extend this to students.  As part of the LTC expansion Wellbeing Matters is now working successfully in diabetes, respiratory care, sexual health (HIV), neurology, oncology and cardiac care pathways locally to provide seamless mental and physical health care for people with co-morbid physical health issues and anxiety or depression. We attend teams meetings as appropriate and have provided and received reciprocal training with them to ensure close and consistent working. Our Clinical Lead has provided CPD training at the CCG GP Protected Learning time last year regarding mental health awareness, the service and how it works.  This year the SPWP is going to present at the GP CPD, discussing: IAPT – what is it and what does it do?

This has previously improved links with local GP’s and has increased referrals into the service as GP’s are well aware of the Wellbeing team and what we do. Once or twice a year we also write articles for the GP newsletter to keep the information up to date. Each GP practice has a linkworker in the team who works in the practice where space allows and this also improves our links with primary care.

The Wellbeing service also now produces a quarterly newsletter that is distributed in GP waiting rooms, service waiting rooms and taken to various community events.  The newsletter showcases the work the teams are doing and the positive impact they are having.

 

Do you use co-production approaches? 

Wellbeing matters works closely with the MPFT Recovery College – Train the Trainer courses have been undertaken in our building.  The evaluation of courses and groups is continually shaped by service user feedback via Patient Experience Questionnaires and informal discussions.

This year we are hoping to engage a group of volunteers and ex-service users to evaluate, report on and redevelop the workshops, literature and the Wellbeing websites.

 

Do you share your work with others? If so, please tell us how.

The Wellbeing Matters service is part of the National IAPT project (Improving Access to Psychological Therapies) and is recognised as a well performing site. We have provided advice to other services around the country undertaking the Long Term Physical Health Conditions project and are always willing to speak to others about what we are doing, both for feedback on how we can improve and to share what we have found works. We engage on a variety of platforms including social media, online, via community engagement events and advertising. We have a strong social media presence @mpftwellbeing and @ClinLeadWBM and also on Facebook. We follow and are followed by fellow mental health professionals both locally and nationally and the accounts are unlocked for the general public to view – we post useful information for all. Wellbeing Matters Sarah Watts (MPFT) and Sarah Wileman (MHM) were invited to speak with our Partners at Minddistrict at the Health + Care conference at the Excel Centre, London to talk about IAPT and digitally enabled therapy on the 27th June 2018. We remain a teaching team and regularly take therapy trainees on placement from local universities. Several colleagues teach on approved teaching programmes in the region to reach out to the next generation of therapists with evidence and good practice. We run regular training events which are open to colleagues from other disciplines.

 

What outcome measures are collected, how do you use them and how do they demonstrate improvement?

• IAPT MDS – plus Patient Experience Questionnaires and informal feedback after courses and workshops, to shape development of material • High levels of data completion and accuracy – usually in the 90%’s • Prevalence and recovery targets monitored monthly, hit all National targets for 2018/19

 

Has your service been evaluated (by peer or academic review)?

CQC inspection July 2016 rated MPFT as a ‘Good’ service overall the Senior Step 3 lead is currently engaged in advanced discussions with the MPFT research lead regarding more formal research projects with the service. We have been approached by the local Assistance Dog Association to set up a research project into the use of CBT for intolerance of uncertainty in blind and visually impaired service users learning to work with an assistance dog.

 

 

How will you ensure that your service continues to deliver good mental health care?

As part of the Five Year Forward View, the number of patients we see each year is increasing from 15% of the local population with a mental health condition up to 25% by 2021. To enable this, additional funding from the CCG will need to support the extra staff required to extend the service further. We are very excited to be able to broaden the service further as we expand. Funding from the commissioning CCG enabled the service to expand further in 2018/9 to move to 19% prevalence target, and we are currently considering how we will meet the move to 22% prevalence rate during 2019/20.

Close links with South East Staffordshire and Seisdon Peninsula CCG commissioners who have been very committed to the LTC project and our expansion to make the programme sustainable. Management structure enables change to be sustained – Step 2 and Step 3 lead, overall Clinical Lead plus Operational Management support from MHM our delivery partners. The service benefits from the Organisational Governance of both Partner organisations, ensuring staff and service delivery remains stable in order to promote innovation.

 

What aspects of your service would you share with people who want to learn from you?

The Wellbeing Matters service is part of the National IAPT project (Improving Access to Psychological Therapies) and is recognised as a well performing site. We have provided advice to other services around the country undertaking the Long Term Physical Health Conditions project and are always willing to speak to others about what we are doing, both for feedback on how we can improve and to share what we have found works. Challenges to establishing this have included co-locating in neutral environments, setting up pathways with colleagues working in physical health who may not understand IAPT and training a large number of staff very quickly. We have found that having a strong mix of experienced and new practitioners in the team enables us to provide most of our CPD training and all of our supervision from within whilst staying up to date with research, best practice and new ideas. Our staff are passionate about what they do and go above and beyond to promote and improve our service for service users and the wider community.

 

 

How many people do you see?

Serving a population of around 140,000 people across Tamworth and surrounding areas, we see around 2500 patients pa directly for therapy. These patients are aged 16 and over (no upper age limit) and have anxiety disorders (stress, post-traumatic stress disorder, social anxiety, obsessive compulsive disorder, phobias and health anxiety) and/or depression. In 2018/9 2710 people entered psychological therapy with our service of whom 57.9% reached recovery on objective outcome measures of mood (national target is 50%). Around 700 of these service users were seen through our LTC pathway.

 

How do people access the service?

100% of referrals are self-referrals although we will always discuss cases with other health professional where someone is unable to contact us to self-refer to find a method of contact that feels suitable for them. Self-referrals include people ringing into the service, but we are now looking at secure online self-referral as well.  All patients are assessed within 5 working days of contacting the service. This is managed via a central referral point, staffed by IAPT qualified staff completing assessments 5 days per week. The team is passionate about enhancing people’s wellbeing and reducing the stigma often associated with mental illness. We run a range of community events in Ankerside, the fire station, and local libraries where we give out free wellbeing advice and offer wellbeing checks to anyone who is interested to find out more for themselves or someone they know.

 

How long do people wait to start receiving care?

Patients are assessed within 5 working days of contacting us. Wait times depend on service required, can commence next day with some interventions (cCBT, courses), others have a wait time of 8-12 weeks (e.g. step 3 CBT). National target is treatment to commence within 90 days

 

How do you ensure you provide timely access?

Priority is given to mums and dads in the peri and postnatal period (up to 1 year) and veterans. The service operates with a fully staffed Step 2 and Step 3 IAPT compliant workforce. Due to the high performing nature the service recruits and retains staff at a very high level ensuring access is always in line with the in-service targets of assessment within 5 days.

 

What is your service doing to identify mental health inequalities that exist in your local area?

Serving a population of around 140,000 people across Tamworth and surrounding areas, we see around 2500 patients pa directly for therapy. These patients are aged 16 and over (no upper age limit) and have anxiety disorders (stress, post traumatic stress disorder, social anxiety, obsessive compulsive disorder, phobias and health anxiety) and/or depression. The team is passionate about enhancing people’s wellbeing and reducing the stigma often associated with mental illness. We run a range of community events in Ankerside, the fire station and local libraries where we give out free wellbeing advice and offer wellbeing checks to anyone who is interested to find out more for themselves or someone they know Previously we have run well received wellbeing workshops for students at local colleges regarding exam stress, and for Tamworth Borough Council staff regarding workplace wellbeing.  This has now been extended to deliver a range of workshops across the colleges in the locality for all the staff to access and which will then be rolled out to students.   In 2018/19 we have extended this further, and have been collaborating with the MPFT Older People’s team to improve access to therapy for this age group, including older carers. Our pioneering work with adapting Cognitive Behaviour Therapy materials for visually impaired staff and patients has enabled us to provide full services to an additional group. We also work regularly with interpreters and British Sign Language interpreters to ensure there are no barriers to access. We have a strong social media presence @mpftwellbeing and @ClinLeadWBM and also on Facebook. We follow and are followed by fellow mental health professionals both locally and nationally and the accounts are unlocked for the general public to view – we post useful information for all. Our aim is to enable talking about our mental health to become a routine part of life in the local community and to provide services to support those who need it.

What inequalities have you identified regarding access to, and receipt and experience of, mental health care?

We have started collaborating with the MPFT  Older Adult team to increase access for older people in June 2018, this will include running carers groups alongside Cognitive Stimulation Groups for people with dementia.  We have also been involved in the Older Adult Steering group, which incorporates joint working across both physical and mental health services to improve engagement with Older Adults and better understand their journey in health care, with an emphasis on reducing reliance on bed spaces in crisis situations.  Working specifically with people with autism to enable them to access talking therapies. This has been managed mostly at step 3 with the use of shorter and more frequent sessions, the use of brief relaxation at the start of sessions to help people focus when they may have been overwhelmed travelling to the session, the use of family members or friends as co-therapists as appropriate and with consent – to support learning and reinforcement outside the therapy room. Increased diversity in staff team this year from a race, culture and disability perspective is enabling us to engage more fully with Polish and Urdu speaking communities and with people with visual impairments. Our pioneering work with adapting Cognitive Behaviour Therapy materials for visually impaired staff and patients has enabled us to provide full services to an additional group. We also work regularly with interpreters and British Sign Language interpreters to ensure there are no barriers to access.

Within the team we have also identified Champions for LGBT, BAME, Older Adults, Peri-natal and Physical Health which will enable the team to focus on engaging with these groups and develop appropriate care pathways.

What is your service doing to address and advance equality?

We have carried out a great deal of community engagement to reduce stigma, working in fire stations, libraries, food banks, gyms and supermarkets, taking the service to where people are rather than focusing on mental health buildings. We have a member of staff who is blind who is carrying out pioneering work with adapting materials for therapists and service users who are visually impaired. This has caused us to think about people who are deaf as well and we hope to expand into making our service more accessible to this group of people shortly.

 

 

How do you identify the needs of a person using the service (such as their physical, psychological and social needs)?

Everyone is assessed as an individual when they self-refer to our team and this would include clinical assessment of cognitive, physical, social, spiritual, literacy, mobility and psychological needs. We use the full IAPT MDS plus any additional measures we feel will help to reflect a person’s situation prior to discussing therapy options with them,

 

How do you meet the needs of people using the service and how could you improve on this?

All of our therapy services are based on NICE guidelines for anxiety and depression and all of our therapists are either trained or training in IAPT approved courses. Our recovery rates are consistently above the 50% national recovery rate target. We work closely with neighbouring teams to ensure transitions go as smoothly as possible, and we have a Liaison Nurse whose main role is to assist people in transition between services to offer consistency during that uncertain period. Our seniors meet regularly with seniors from other teams to discuss cases and joint work where appropriate.

 

What support do you offer families and carers? (where family/carers are not the service users)

We can also offer services to carers and families and will ensure a different therapist is involved so as not to compromise anybody’s confidentiality. We often joint work in therapy with family members where this is appropriate and consent has been gained so that they know what is happening and can support their loved one between therapy sessions.

 

Have you implemented any of the mental health care pathways developed by the NCCMH (on behalf of NHS England)? If so, what were the benefits and challenges?

We have implemented the IAPT-LTC 2018/19

 

 Is there anything else you want to share about what makes you an example of positive practice?

We are so proud of our team and the atmosphere in the office is an example of the passion and commitment of all the staff to each other and to the local population in the work we do. It is an absolute pleasure to work here. The final word should go to one of our service users who has agreed for us to quote them ‘using this service changed my life in so many ways and I have loved coming into the Wellbeing Centre, it is such a great environment for support and helping you to move forwards with your life.’

 

Commissioner and providers

Commissioned by:  South East Staffordshire and Seisdon Peninsula CCG

Provided by: Midlands Partnership Foundation Trust in partnership with MHM (Mental Health Matters)

 

 

Size of population and localities covered:

Tamworth, Lichfield and Burntwood have a population of around 140,000. We see approximately 2500-2800 service users per annum.

 

 

 

 

 

 

 

 

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