Merton Home Treatment Team (MHTT) staff of Nurses, STaR workers, doctors and social workers provide safe effective care to people in crisis at home – helping preserve family roles, independence, promoting recovery and reducing stigma. Only 1 in 4 people referred to the team are admitted to a ward, meaning MHTT help 75% of people recover at home.
Merton Home Treatment Team (MHTT) staff of Nurses, STaR workers, doctors and social workers provide safe effective care to people in crisis at home – helping preserve family roles, independence, promoting recovery and reducing stigma. Only 1 in 4 people referred to the team are admitted to a ward, meaning MHTT help 75% of people recover at home. This provides excellent value for money and preserves resource for those in greatest need who cannot remain safely at home. The team excel in our Trust at achieving this with a range of services including clozapine initiation, community based alcohol detoxification, psychological support and signposting.
We are a welcoming team also supporting the education of medical, nursing, pharmacy and A Level work experience students. We have also developed an FY1 & 2 psychiatry training post that has been much valued and enjoyed by the trainees. This was showcased by at the Foundation Educators conference at the Royal College of Psychiatrist in Nov 2014.
We volunteered the team for a national peer review from the Home Treatment Team Accreditation service (HTAS). We were awarded accreditation by HTAS in June 2015 – we are the first HTT out of 5 home treatment teams in our Trust to be nationally accredited and have actively sought feedback from our patients and carers to help us develop and improve our service.
The Merton HTT piloted Real Time Feedback (RTF) into the Trust HTTs – using iPad devices to collect feedback from patients /carers at the end of an episode of care. This feedback is reviewed and discussed within the team and acted upon. Our data has been analysed and shown statistical significant improvement in our quality of service, based on patient and carer feedback. MHTT results were written up and presented at the 3rd HTAS national conference in Oct 2015.
Merton Home Treatment Team has also shown imaginative use of existing resources such as the Recovery College set up within the South West London & St George’s NHS Trust. We advise our patients to consider specific psycho-educational courses to equip them with skills to reduce likelihood of future crises.
We also signpost patients with housing or financial problems to the Trust Law Centre for support, recognizing that these are often the triggers for developing mental health crises for some in our population. We work closely with Merton Carers Group. Merton Child & Family services and also the Merton Young carers support project (AYCE).
We were awarded accreditation by HTAS in June 2015 – we are the first HTT out of 5 home treatment teams in our Trust to be nationally accredited and have actively sought feedback from our patients and carers to help us develop and improve our service.
The Merton HTT piloted Real Time Feedback (RTF) into the Trust HTTs – using iPad devices to collect feedback from patients /carers at the end of an episode of care. This feedback is reviewed and discussed within the team and acted upon. Our data has been analysed and shown statistically significant improvement in our quality of service, based on patient and carer feedback. MHTT results were written up and presented at the 3rd HTAS national conference in Oct 2015.
The progression of Merton Home Treatment Team has been a learning curve over 6 years for the whole team, building the skills and training of team members and also developing our team ethos and approach with our patients and carers.
We have been shaped by the changes around us in an era of reducing budgets and fewer beds and have had to develop to be more effective at offering an alternative to admission.
Merton Home Treatment Team has led on developing and implementing an innovative home treatment community alcohol detoxification policy to expedite early discharges of patients safely based on NICE evidence.
We have also worked closely with the Trust pharmacy to develop a safe community Clozapine initiation protocol, to reduce the need for admission to start this medication. This has already prevented unnecessary admissions.
In crisis and home treatment teams it is quite common to have staff turnover. However, the systems that have been developed in the Merton Home Treatment team are now embedded and even being rolled out across other Trust Home Treatment Teams.
All new staff are inducted in the processes and culture of the team when they start. We have already had to cope and adjust with losing valued members of staff, but have maintained and built on the improvements that have been introduced. To ensure continuity and consistency of approach, our annual away day is also an essential part of coming together as a group to discuss the service, share and renew our common understanding of our team values and mission.
As another mark of our commitment to education and training and developing staff, four former nurses in our team have gone on to be promoted to manager positions within Home Treatment Teams in the Trust. Two other nurses have been promoted to other managerial roles, two social workers to senior lead AMHP roles and three support workers have gone on to nurse training or OT roles.
We volunteered the team for a national benchmarking peer review from the Home Treatment Team Accreditation service (HTAS). We are the first HTT out of 5 teams in our Trust to be evaluated by the HTAS review process and have actively sought feedback from our patients and carers to help us develop and improve our service. We were awarded national accreditation for our quality standards as a HTT in June 2015.
We are happy and very keen to disseminate our practice. We have hosted visitors from overseas from Geneva, New Zealand, Australia and Toronto over the last 6 years to inform them of our model of care. We have also hosted guests from Barnet, Haringey and Enfield Trust and other teams.
We have presented to our own Trust Leadership Conference 2014 as a model team. Our team was promoted as a ‘Beacon service’ to CQC when they visited in March 2016.
We have presented our teams’ service innovations and data at the following conferences – RCPsych International Congress 2016 (Alcohol detox in MHTT); HTAS conference 2015 (Real Time Feedback in MHTT); St George’s Annual Research Day 2015 (RTF in MHTT); Foundation Educators Conference Nov 2014 (MHTT FY dr post); St George’s Annual Research Day 2013 (MHTT FY dr post); RCPsych International Congress 2013 (Voice Recognition Technology in HTTs)
