Crisis and Intensive Home Treatment Team – Lincs Partnership NHS Foundation Trust

Inpatient units for children and young people are always full to capacity. Our local children and young people when admitted had to travel hundreds of miles to receive care. We developed a 24/7 crisis and intensive home treatment team to support young people to stay within their community during a mental health crisis and provide intensive home treatment to the young person and their families. We aimed to prevent hospital admission by positively managing risk, almost immediately this was successful resulting in no Tier 4 admissions for almost 4 years.

Co-Production

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

Evaluation

  • Peer: Yes
  • Academic: Yes
  • PP Collaborative: Yes

Find out more

 

What We Did

Inpatient units for children and young people are always full to capacity. Our local children and young people when admitted had to travel hundreds of miles to receive care. We developed a 24/7 crisis and intensive home treatment team to support young people to stay within their community during a mental health crisis and provide intensive home treatment to the young person and their families. We aimed to prevent hospital admission by positively managing risk, almost immediately this was successful resulting in no Tier 4 admissions for almost 4 years.

 

Wider Support

We recognise that others may be the first to be involved in a young person’s crisis therefore it is important for us all to work together.

Through the development of this team and the mental health concordat we have developed collaborative working with various agencies and now have excellent interactions particularly with the police, ambulance and A&E. We now work together to actively avoid any unnecessary hospital admissions. We learn from experiences so that we can improve joint working – We have lessons learnt meeting after any Section 136 so that we can improve communication and ensure the best care of the young person

We have points of contact at the hospital, in the police and with school nurses. We continually deliver training to the Hospital and School Nurses.

Co-Production

We recognise that it is important to respond to local need and feedback so that we can continue providing safe, effective and compassionate care.  Patients have been involved in developing this service. We use outcome measures to inform and improve our service delivery. We have an active Patient Participation Group (our lead member is a young person who has been through our CAMHS service and also experienced a Tier 4 admission, and found access to the CAMHS Crisis Team to have been essential in keeping well – he feels it is also a preventative model)
The Patient Participation Group have been instrumental in developing our service; setting interview questions, being on interview panels, running the logo competition, designing self-help material and leaflets and are now heavily involved in designing a new website. We also have a parent carer participation group who have helped in developing our service further.

Looking Back/Challenges Overcome

There were no models for us to use to develop this service. We have had to make radical changes to the whole service to be able to deliver this. We received no additional funding, lost some experienced staff who were unwilling to change the way they worked. Furthermore,  we moved from the nationally recognised CAMHS tiered system to a core service.
Getting staff to work in these new ways, which involved using evidence based practice within new pathways, was a challenge. Strong clinical and operational leadership and management helped to move staff forward and to positively embrace the change.

 

Sustainability

All staff within North East Lincolnshire CAMHS teams are leaders in their own right however this service has been successfully fully operational for over 4 years and is fully embedded within the practice.

 

 

Evaluation (Peer or Academic)

We have received an Outstanding rating from the CQC which we have retained on a second inspection.

NHS England have named us as one of the best case practices in their Crisis Guidelines.

Crisis and Intensive Home treatment service audit is out for peer review with journals.

Norman Lamb was very impressed by the whole of our service and believes we have an excellent model.

 

Outcomes

We have data both qualitative and quantitative for the past 5 years which supports our success.

 

 

Sharing

Other providers and commissioners often visits our service to look at our model and how they can adopt this to achieve similar results in their area.

National presenting and conferences (NHS England)

 

Is there any other information you would like to add?

We have retained the same staff for over 4 years. We have very low sick rates. We have successfully supported our local children and young people and families to stay in their own homes, still in education with family and peer support whilst we help them manage their mental health crisis.

 

 

 

 

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