We have used the Crisis Care Concordat to completely redesign the service from scratch, linking all parts of the system together and ensuring that each part of the 'whole system' is working together to identify how they can change or improve the system. This includes making bids together, sharing resources, supporting each other and using the CCC action plan and meetings to identify creative and radical ideas and how to implement them.
What We Did
Police Hub Project Police response service based in First Response team Mental health criminal justice liaison based in the cells Redesign of Acute Care by NHS with help of social care Setting up the Sanctuary out of hours crisis support service Allowing NHS and social care staff to access LA resources Creating joint working links with housing providers, a housing discharge worker and access to homelessness services in the NHS development of the safe haven A and E liaison project redesign of A and E liaison with health and social care Access to residential care for people in need of short term respite
Impact: A 24 hour crisis response and Home treatment service No out of area placements for over a year reduced number of people in cells improved places of safety reduction in number of people in MH crisis in A and E reduction in S136 Improved crisis response especially out of hours Improved outcomes for service users in crisis major reductions in DTOC
Wider Active Support
Partners are: Bradford District NHS Care Foundation Trus,t Bradford Council Adult Social Care, Bradford Council Childrens Services, 3 Bradford and Airedale CCGs; 3 Voluntary sector orgs – Cellar Project; Bradford MIND; Sharing Voices BME MH service, West Yorkshire Police, West Yorkshire Ambulance Service, Bradford Hospitals NHS Foundation Trust, Airedale NHS Foundation Trust, Bradford Airedale Adult and Children Safeguarding Boards, Public Health, Police and Crime Commissioner.
We work really well with these partners because they all feel valued and have a place at the CCC and are part of the whole system redesign. Our partnership working has been recognised by a range of organisations as good practice. These include the DoH and crisis care concordat website. Many teams have come to visit our services to see how we have achieved this including Wales CCC development team, Cambridgeshire and Peterborough Vanguard, and the Chief Social Worker for England.
We have service users involvement via our VCS partners MIND, Shared Lives and the Cellar project and also our involvement of Healthwatch. We have worked very closely with people who frequently attend A and E and the police to understand what their needs and views are. The Sanctuary collects and reports the views of service users in crisis.
We have consistently used staff and service users feedback to help design the service. As an example, the experience of AMHPs was vital to the decision to co-locate health and social care crisis services and the need for alternatives to acute care was from the views of nursing staff, doctors and AMHPs
We should have done this earlier. We wasted a lot of time thinking it was not possible and waiting for funding rather than taking our opportunities. I would have concentrated on community mental health services earlier. we are doing this now, but we should have realised this was key to a permanent focus on recovery and prevention
We continue to struggle with maintaining the momentum and keeping moving forward. As an example, following a major drop in s136 and police arrivals at A and E, they started to rise again and police staff we had trained moved on and old habits returned. We had to restart the training and re-engage with senior officers to understand the issue and move forward again. Luckily the relationships we had formed helped with this.
We have developed a new management and partnership arrangement between the main partners through the Crisis Care Concordat. This is now developed through the Urgent Care Vanguard that is leading to a west Yorkshire approach, some based on the Bradford model
We have evaluation of the first response and police engagement project by Helen Haylor, clinical Psychologist. We are also evaluating through reports to the Police and Crime commissioner and Public Health
We have had the following visitors: Lyn Romeo – Chief Social Worker; Jon Rouse – DoH lead Welsh Crisis Care Concordat team; Leeds MH services; Kirklees MH services; Alistair Burt MP; Positive Practice in MH Collaborative. We have spoken or will speak at the following events: 2015 crisis care concordat conference; 2016 Health and Care conference 2016 DTOC learning event; 2016 Parliamentary enquiry into MH Some of us are now SIG leads for Positive Practice in MH Collaborative.
Is there any other information you would like to add?
We are now working on setting up a children and young people crisis care concordat and major improvements to recovery based community mental health services and the new Haven project for A and E and community resilience. having achieved this much we will keep trying to improve and develop through partnership based working until our services are the best they can be.