Implementing Choose and Book for Mental Health Services

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Implementing Choose and Book for Mental Health
Services

• London SHA
• 30 January 2007

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1. Where we started2. The Focus Group and the
Expert Reference Panel3. The pilot - Processes
- Specialties and Clinic Types -
Evaluation4. Technical issues
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Where we started

• Difficulties with making CAB work so that it
  matches single point of access process model
• Version 6 Specialties and Clinic Types are not
  CAS friendly
• Specialties and Clinic Types funnel services by
  age
• Providers not sure how to manage safety aspects
  of referrals
• Non mental health providers not adequately
  described

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CAS models

• Review of referral CAS The CAS clinician simply
  adds their expertise to the assessment of the
  referral information provided by the GP and the
  patient is then referred on or advice returned to
  the GP
• Telephone CAS A telephone CAS operates by taking
  referral information and then using a telephone
  conversation with the patient to gain additional
  information for the assessment
• See Style CAS The patient is physically seen and
  assessed by a clinical specialist at an allotted
  time. The patient is then referred to another
  service or the advice sent back to the patients
  GP to assist with management
• See and Treat CAS The patient, upon assessment,
  may be treated by the clinicians or team that
  provide the assessment

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Next Steps in The Mental Health Pilot
Focus Group and Expert Reference Panel

• FOCUS GROUP
• Objective To produce a standardised process flow
  and service descriptions so that referrers can
  find relevant service easily regardless of where
  they are provided
• Agreed that it involved producing guidance for
  GPs
• Will enable the implementation of Choice
• Consists of 15 20 MH CAB leads who have worked
  through the process flows and agreed the pilot
  Specialties and Clinic Types
• Led by Wayne Eckersley, supported by Claire
  Dalton / Nicci Williams
• EXPERT REFERENCE PANEL
• Objective To provide sponsorship and support
  from MH policy CAB implementation teams (using
  the same model as for 2WW) - one meeting to date,
  two more planned
• Chaired by James Seward
• Other members include Simon Walford, Hugh
  Griffiths, North / South Essex MH leads, CfH
  technical lead, Wayne Eckersley

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Pilot Single point of access model

General Practice
Service User
CAB Referral
Non clinical staff
Referral made by GP to MH CAS via CAB CAS
appointment made at practice on behalf of patient
Attached referral letter extracted from CAB
E-mailed to appropriate CMHT Referral assessed,
outcome notified to CAS Outcome discussed with
patient and a suitable appointment(s) booked in
PAS (not via CAB), outcome noted in CAB
Clinical staff
Mental Health CAS
CMHT 1
CMHT 2
OUTPATIENT SERVICES
OUTPATIENT SERVICES
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Pilot Distributed access model

General Practice
Service User
Clinical Admin staff
CAB Referral
CMHT 1 (CAS)
CMHT 2 (CAS)
CMHT 3 (CAS)
OUTPATIENT SERVICES
OUTPATIENT SERVICES
OUTPATIENT SERVICES
Referral made by GP to appropriate commissioned
CMHT service via CAB based on geography and/or
GP Service appointment made at practice on behalf
of patient Referral assessed, outcome discussed
with patient Suitable appointment(s) are booked
in PAS (not via CAB), outcome noted in CAB
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MH Specialties and Clinic Types

• SPECIALTY is a coarse filter
• Pilot proposal consists of two
• CLINIC TYPE is a fine filter
• Need to be distinct
• Need to be intuitive to referrers
• Need to focus on either
• Conditions (preferable)
• Interventions