NHS Foundation Trust
Mental Healthcare in Northumberland
Understanding and improving mental health patient flows for Northumberland
Northumberland NHS Trust is publically funded and is charged with the provision of high quality services to improve the health and well-being of people who live in Northumberland. Since Northumberland is a rural area with many small population centres, these services are provided in many different locations and some of these centres are quite small. In cooperation with other health and social care agencies, the Trust provides community-based healthcare, which includes mental health and care for people with learning disabilities. This project is concerned with the care and treatment of people with mental health problems.
The cost of mental ill health in England was estimated at about £105 billion in 2010 (Centre for Mental Health, 2010) and its social consequences are even more serious. Similar costs and consequences occur everywhere in the world. Because of these high financial and social costs, the UK Government introduced its Improving Access to Psychological Therapies (IAPT) programme in 2005. This aims to provide quicker and more equitable access to effective psychological therapies for common mental health problems such as depression and anxiety disorders.
Northumberland is part of the second wave of NHS Trusts implementing IAPT, through its First Step programme, which aims to implement the National Institute for Health and Clinical Excellence (NICE) guidelines. NICE is an independent body established by the UK Government to help health and social care professionals deliver the best possible care based on the best available evidence and to offer the best value for money. NICE guidelines summarise the treatments and care that are most cost-effective based on the available evidence. However, it is left to local NHS Trusts to determine how best to do this.
Mental healthcare in Northumberland is provided across a range of locations in Northumberland, with the aim of providing high quality care as close to people’s homes as possible. As people progress through the mental health services offered by the Trust, their progress is monitored via standardised data collection procedures. A process map of the mental healthcare interventions and actions forms is available.
The Medical Director (Dr Christine Betterton) and Clinical Director (Prof Dave Leggett) would like to increase their understanding of patient flows in First Step. The eventual aim is to provide an evidence base for better mental healthcare in Northumberland by making changes that will lead to improvement of Patient Flows. Ultimately, we wish to provide quicker and more equitable access to effective psychological therapies for common mental health problems such as depression and anxiety disorders
It seems likely that this project will have the following stages.
1. Initial familiarisation with UK mental healthcare and service provided in Northumberland.
2. Estimation of patient flows through the various routes within the system, possibly leading to a transition matrix showing the probabilities of flows from one point to another.
3. Consideration, design and possible implementation of a dynamic model that simulates patient flows, enabling experimentation with different service configurations.
4. Consultation with Stakeholders, including patients and Decision Makers
5. Report recommending improvements
We expect it will be necessary to make frequent trips to the sites and service offered by the Trust. The Trust will make anonymised information available, as collected by their data systems. Since mental healthcare is a sensitive topic, analysts engaged in this work will need to show discretion.
If this project is successful it may lead to further cooperation with the Trust across the set of services provided by the Trust.
Centre for Mental Health (2010) The economic and social costs of mental health problems in 2009/10. Centre for Mental Health, London. www.centreformentalhealth.org.uk