Waltham Forest CCG CQUINs in mental health

ContactChristopher Soltysiak, Associate Director of Strategic Commissioning, Waltham Forest CCG
Telephone0203 6882623
Emailchris.soltysiak@walthamforestccg.nhs.uk
Websitehttp://www.walthamforestccg.nhs.uk/
AddressKirkdale House, 7 Kirkdale Road, Leytonstone, E11 1HP

Waltham Forest CCG CQUINs in mental healthWaltham Forest Clinical Commissioning Group is focussing on a small number of Commissioning for Quality and Innovations (CQUINs) in mental health and using these to aid strategic direction and development.

Next year Waltham Forest CCG plans to focus more on integrated care and recovery models.

Emergency department frequent attendees (CPA)

This CQUIN aims to review care plans for frequent attendees to Emergency Departments (ED) who are under the care programme approach (CPA).

A  local pilot project on crisis models of care identified a number of issues relating to people presenting with mental health problems at A+E without a physical health need.

People with  severe mental health problems frequently using A+E should be identified, and supported to develop alternative sources of help when experiencing mental health crisis where appropriate.

Download the Waltham Forest CCG CQUIN Emergency department frequent attendees (CPA)

Emergency department frequent attendees (non CPA)

This CQUIN aims to identify frequent attendees to Emengerncy Departments identified as having mental health problems, but not under the care programme approach of the  mental health services.

For some people attending A+E with mental health problems, their difficulties may be of a nature or degree where ongoing treatment and support from the specialist mental health services is not warranted.

Understanding the circumstances of this group would enable joint strategies to be developed by acute and MH providers to divert people from unscheduled care routes where appropriate to do so.

Download the Waltham Forest CCG CQUIN Emergency department frequent attendees (non CPA)

IAPT and LTC Training

This CQUINN aims to undertake a programme of training and awareness raising for CHS staff  and improve access to psychological therapies for people with long term conditions.

Many people with long term physical health conditions or medically unexplained symptoms also have mental health problems. Conditions such as chronic obstructive pulmonary disease (COPD), muscular skeletal disease, chronic pain, diabetes and cardiovascular diseases can lead to depression. Evidence suggests that 30 per cent of England’s population has a long term condition and of those, 30 per cent will also have a mental health problem.

People with long term conditions are the most frequent users of health care services. Those with co-morbidities tend to use services even more, reducing their quality of life and increasing costs to the NHS.

Among those with diabetes, depression is associated with a 50% to 70% increase in health service cost.

Identifying and referring people with LTC to evidence based psychological interventions can significantly improve health outcomes

Download the Waltham Forest CCG CQUIN IAPT and LTC Training

IAPT and LTC case recognition

This CQUIN aims to identify people known to CHS services who may benefit from IAPT interventions.

Many people with long term physical health conditions or medically unexplained symptoms also have mental health problems. Conditions such as chronic obstructive pulmonary disease (COPD), muscular skeletal disease, chronic pain, diabetes and cardiovascular diseases can lead to depression.

Evidence suggests that 30 per cent of England’s population has a long term condition and of those, 30 per cent will also have a mental health problem.

People with long term conditions are the most frequent users of health care services. Those with co-morbidities tend to use services even more, reducing their quality of life and increasing costs to the NHS.

Among those with diabetes, depression is associated with a 50% to 70% increase in health service cost.

Developing formal links between IAPT and ICM services would improve case recognition and subsequent referral rates referral rates to IAPT

Raising skills and awareness in both IAPT and LTC teams would improve the whole system ability to improve health outcomes

Download the Waltham Forest CCG CQUIN IAPT and LTC case recognition

Carers survey

This CQUIN aims to develop a system for capturing carer feedback on quality of care for people discharged from inpatient care and HTT episode.

The importance of understanding all patients and carer’s experience in key service areas throughout the year is further emphasised by recent reports, such as the Francis Report and Winterbourne View report.

The review and remodelling of acute care pathways locally is highly likely to result in a further reduced reliance on inpatient beds for people in acute mental crisis.

A key component of alternative to admission is the Home Treatment teams, which currently gate keep all admissions to inpatient beds, intensively support people to avoid admission where appropriate, and support people when discharged form hospital.

As alternatives to inpatient care involve treating people at home, in many cases the role of the carer is critical to the success of this.

Understanding the pressures/issues facing carers in undertaking this role, particularly when people are in acute crisis, would enable the mental health services to plan appropriate support strategies.

Download the Waltham Forest CCG CQUIN Carers survey

Pressure ulcer improvement

This CQUIN aims to improve clinical practice in managing pressure ulcer risk.

On the basis of national data, it is likely that most organisations will find that the majority of harm is represented by pressure ulcers.

Whilst the number for NELFT mental health services has been low, areas for improvement in practice have been identified, focusing on training, care planning and reporting.

Download the Waltham Forest CCG CQUIN Pressure ulcer improvement