Case studies

CAMHS nurses from Northumbria Foundation Trust led on a project alongside to look at reducing self harm in children and young people. The aim of this project was to create an equality in how self-harm could be managed in schools.

This project based in universities and NHS services in Liverpool aimed to improve partnership approaches to student care by developing a standard operating procedure to ensure that students in crisis are supported in a joined-up and systematic way.

An innovation in London was to a pilot new service, the Mental Health Joint Response Car Pilot, which consisted of a paramedic and mental health trust trained crisis nurse. This pilot involved a joint mental health ambulance car service which operated in six ambulance stations across London and was linked to 111 in securing access to user co-designed care plans.

NHS England and Improvement partnered with mental health trusts in London, London Healthy Partnership and Thalamos Digital Innovations to improve the safety, care and efficiency of the Section 136 pathway in London for people in crisis.

Hampshire County Council have developed a protocol to help schools and colleges in Hampshire identify and support students who may be at risk of suicide, whilst promoting the mental health and wellbeing of children and young people living.

The Living Well Network Alliance is an agreement to provide mental health services for working age adults in Lambeth. The Alliance brings social care, housing and mental health service users, commissioners, and providers together, pooling their expertise and budgets to support all the needs of a person with an serious mental illness.

Open Mental Health is a multi-agency alliance of local voluntary organisations, NHS and social care services in Somerset. They work in partnership to ensure that residents of Somerset get the mental health support they need, when they need it.

The London Mental Health Compact is a shared statement of commitment to ensure that people in a mental health crisis had timely access to places of safety and mental health inpatient treatment. This includes services such as: The London Mental Health and Acute Trusts, London Ambulance Service (LAS), Approved Mental Health Professional (AMHP) services, Clinical Commissioning Groups (CCGs), NHS England and Improvement, local authorities, and police services in London.

iCope, an IAPT service in Islington, London, is dedicated to the provision of high-quality cognitive behavioural therapy (CBT). Due to patient referral rates increasing annually and in the hope to improve patient recovery rates, iCope developed an approach called recovery consultations. This was to ensure that they could meet the national target of having 50% of patients recovered, both across the service but on an individual clinician basis.

The Sandwell and West Birmingham Trust alcohol care team was introduced as part of their care pathway to support admissions to emergency departments and provide guidance for symptom-triggered withdrawal in patients.

Mental Health and Specialist Services in Australia’s Gold Coast undertook work in 2015 to implement a systems approach to suicide prevention using the Zero Suicide Framework (ZSF). This resulted in reductions in the rates of repeated suicide attempts and the number of deaths by suicide

The Life Rooms sits within Mersey Care NHS Foundation Trust, a mental health and community Trust in Merseyside. Across the Mersey Care footprint, clinical services are under increased pressure and many communities face poor health outcomes. The Life Rooms Social Model of Health is non-clinical in its aims and approaches, but is positioned to relieve some of the pressure that clinical services face, and work collaboratively to improve health outcomes within communities.

This programme is an example of how the systematic and transparent use of data can support system transformation, improvements in service delivery and ultimately lead to better outcomes for people experiencing psychosis. The programme co-produced a dashboard with stakeholders known as the EIP Matrix that enables NHS England regional managers, commissioners and providers to routinely access information on investment, performance, NICE concordance and workforce capacity against demand and outcomes. The tool has supported services to make improvements in waiting times, access to CBTp and better physical health monitoring.

‘Zero-rated data’ is an initiative that was introduced by the New Zealand government that enabled people to access essential digital health and well being services by sponsoring them with government paid phone data. This initiative was aimed at people in lower socio-economic groups who cannot routinely afford data payments despite having a smart phone. .

Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT) collaborated with Birmingham Community Healthcare NHS Foundation Trust, Midlands and Lancashire Commissioning Support Unit, Telefonica Alpha, West Midlands Academic Health Science Network, West Midlands Ambulance Service and West Midlands Police, to develop advanced technologies, services and pathways of care through the RAIDPlus project. RAIDPlus was developed as an innovative technology to reduce the incidence and intensity of mental health recovery, using predictive analysis to ensure people experiencing mental ill-health were supported towards their recovery.

In December 2018, a pilot was introduced in Blackpool, Fylde and Wyre to respond to people experiencing mental health crisis as a partnership between Lancashire Care NHS Foundation Trust, North West Ambulance Service (NWAS) and Lancashire Constabulary. This involves a senior mental health nurse, a paramedic and a police officer coming together as a crew in a NWAS vehicle to jointly attend to people experiencing a mental health crisis

Stigma Statistics’ Suicide Tracking Analysis and Reporting (STAR) platform enables the sharing of information relating to suspected suicides in real time. The tool allows data to be collected for any sudden death where suicide is suspected whether it be from the police or coroner and shares data with and notifies identified key stakeholders who can then input data they hold about the person.

The CQC assessment of mental health services in acute trust references the work of 27 London acute emergency departments to audit people presenting at emergency departments in August 2019 with a mental health related problem

The Bromley Home Treatment Team at Oxleas NHS Foundation Trust takes referrals from other services and self-referrals to provide community alternatives to admission to hospitals. The Outcome Measurement System was developed by the Bromley Home Treatment Team in partnership with service users and is a ‘state-of-the-art’ technology system which allows professionals to see real time severity of a patient’s mental health, allows monitoring of changes in severity, and uses this information to aid clinical decision making.

Connect My Community NHS is a project delivered by Lancashire and South Cumbria NHS Foundation Trust Community Asset Development Team. This project was put in place to sustain and develop a peer network across Central Lancashire, by connecting groups, projects, initiatives and individuals with other local assets in their community.

Smart Health Communities (SHC) is a concept that was developed through a series of interviews with leaders of prevention and well-being initiatives led by The Deloitte Centre for Health Solutions and the Deloitte Centre for Government Insights. SHCs have a focus on disease prevention through the use of data surveillance and concepts of behavioural science, helping to change health risk behaviours which ultimately lead to poorer health outcomes (e.g. smoking, poor diet, lack of exercise).

The National Institute of Mental Health (NIMH) developed a network of global research Hubs called ‘NIMH Scale-Up Hubs” to increase the reach, accessibility, quality, costs and effectiveness of mental health services.

Northumberland, Tyne and Wear NHS Foundation Trust have collaborated with Northumbria police forces on mapping and redesigning crisis care pathways leading to Northumbria being one of the areas in the country with the lowest numbers of people detained under Section 136 of the Mental Health Act.

The Mental Health Crisis Decision Support Tool was introduced into the Birmingham and Solihull Mental Health NHS Foundation Trust to predict the likelihood of mental health crisis.

The Mental Health Crisis Concordat was published by the Welsh Government in 2015 and is a shared statement of commitment in responding to mental health crisis with services such as the police, NHS, the Welsh Ambulance Service and Local Authorities.

The Concordat sets out how partners can work together to deliver a quality response when people with acute mental health crisis, need help, have contact with the Police and who are likely to be detained under Section 135 or Section 136 of the Mental Health Act 1983.

Mersey Care NHS Foundation Trust serves more than 11 million people offering specialist inpatient and community services that support mental health, learning disabilities, addictions, brain injuries and physical health.

MaST is a decision support tool developed by Holmusk in partnership with mental health providers enabling mental health staff to adopt a dynamic approach to prioritisation and resourcing. MaST provides insight into people’s Risk of Crisis and Complexity and identifies those who may benefit from a review of their care to improve quality and safety outcomes.

S12 Solutions is a digital tool (phone application and web platform) that was designed to support Mental Health Professionals to undertake Mental Health Act (MHA) assessments.

The Greater Manchester (GM) i-THRIVE Programme was created in 2018 as an initiative derived from the National i-THRIVE Programme. The GM i-THRIVE Team is hosted by Manchester University NHS Foundation Trust and work alongside each of Greater Manchester’s 10 Local Transformation Partnerships (LTPs) to improve the mental health outcome for the children and young people of Greater Manchester using the THRIVE Framework for system change.

The North East London NHS Foundation Trust (NELFT) introduced the Young People Home Treatment Team (YPHTT) due to closures of the Trust’s Tier 4 CAMHS Brookside Unit. The NELFT aimed to offer 24 hour crisis provision, increasing scope for positive risk taking, and to treat young people in the least restrictive environment possible. The YPHHT was created to work alongside inpatient units, and allowed Brookside to offer Tier 4 CAMHS provision in homes, therefore acting as a bridge between inpatient services and community services.

Southwark Council recognised the serious consequences that Covid-19 may have for many of their residents and that for some people this could mean that a loss of income could put people at serious risk of being evicted and becoming homeless. In response, they set up a dedicated go-to resource that provides information and expert advice on issues such as finding temporary accommodation, homelessness and financial support.

The PDU was developed to provide an alternative pathway for patients accessing emergency departments and other services, such as the police and ambulance services. The PDU is an ambulant assessment area which provides a calming environment for the assessment and development of treatment plans for more complex service users who are in crisis and are accessing emergency services.

The Mental Health Alliance for Excellence, Resilience, Innovation and Training (MERIT) provider collaborative was established in 2016 as a vanguard site in response to the Five Year Forward View for Mental Health and was initially comprised of Solihull Mental Health NHS Foundation Trust, Black Country Partnership NHS Trust, Coventry and Warwickshire Partnership NHS Trust and Dudley and Walsall Mental Health Partnership NHS Trust. Their focus is on proactive early intervention care rather than reactive crisis management, which is achieved by promoting a recovery culture and providing crisis care and reduction of risk, which is used everyday in acute services.

In 2016/17, Central and North West London NHS Foundation Trust commenced work to embed outcome measurement in routine practice through the Psychological Medicine Clinical Network. Adopting the Framework for Routine Outcome Measurement in Liaison Psychiatry transformed the reports the participants sent to commissioners and managers and enabled the services to analyse what they were doing, whether they were helping and include patients’ own words to describe their experience.

As part of the Urgent and Emergency Care Vanguard programme in Cambridgeshire and Peterborough, a pilot scheme commenced in September 2019 to extend the NHS 111 service to enable people who are experiencing a mental health crisis to dial the NHS urgent medical advice number and chose option 2 which will put them through to a member of Cambridgeshire and Peterborough NHS Foundation Trust’s First Response Service.

NHS England / Improvement have published a summary of work within London whereby people experiencing a mental health crisis will be sent a specialist blue light mental health car staffed by a mental health nurse and a paramedic instead of a traditional ambulance. By responding together, the specialist ambulance crew has an aspiration to reduce mental health hospital admissions from 58,000 to 30,000 per year once rolled out across London.