Mental Health – Providing a primary care mental health service for adults in Leeds

Lead: Citywide

Period: 29th Jun 2018 - 30th Sep 2018

Primary care mental health services (PCMHS) are services usually provided through your GP practice. You might be referred into primary care mental health services if you are feeling low, vulnerable or anxious.

Brief summary of the project

In Leeds there are three different primary care mental health services available: 

  • Improving Access to Psychological Therapies (IAPT) provided psychological support to people with common mental health problems, such as depression and anxiety disorders. In Leeds, the IAPT service is provided by Leeds Community Healthcare (LCH) NHS Trust, Community Links, Northpoint Wellbeing and Touchstone. You can find out more about IAPT by accessing this link: https://www.england.nhs.uk/mental-health/adults/iapt/
  • There is also a Primary Care Mental Health Liaison Service for people whose needs cannot be met by the IAPT service. This is only provided at some GP practice in Leeds and is delivered by NHS Leeds and York Partnership Foundation Trust (LYPFT) and Northpoint Wellbeing.
  • There is also some support available to women in the perinatal period from conception to one year of birth. This service is provided by the Women’s Counselling and Therapy Service and Homestart.

In April 2018 the three local Clinical Commissioning Groups (Leeds West, Leeds North and Leeds South and East) merged into NHS Leeds CCG. As one CCG, we intend to commission a single Primary Care Mental Health service for Leeds from 1st October 2019. We think this will make services easier to understand and access.

Who did we speak to?

1105 people responded to our survey. We spoke to current and previous service users of primary care mental services in Leeds, carers, staff working in primary care mental health services, the wider public and other stakeholders.

What did we ask?

We want to know what people in Leeds think about primary care mental health services in Leeds. We asked them about their satisfaction with current services, and for their needs and preferences when accessing primary care mental health services.

How did we ask?

We used surveys, drop-ins and focus groups to gather people’s thoughts and experiences. The survey has been shared widely, including with service users, people at public events, GP practices in Leeds, partner organisations and via social media. We organised focus groups seldom heard communities and held 4 drop-ins in deprived areas of the city.

What did people tell us?

We received responses from a good range of different groups. People had mixed views about the service they received.

People identified a number of key areas that need to improve:

  • Information – some people wanted more information about general mental health, mental health services available in Leeds and how to access services. 
  • Access – most people told us that they needed to be seen much more quickly. They also told us that the referral process and criteria where unclear and confusing. Some communities told us that more could be done to create inclusive services.
  • Quality – while many people were happy with the service they received, others told us that services needed to be more consistent, patient centred and have more trained and experienced staff.

What did we do?

The recommendations and feedback from this engagement have been shared with the commissioning team. One of our CCG volunteers is working with the commissioning team to help design and plan the future service. We will update this webpage with details of how the commissioning manager has responded to each of the recommendations made in the report as soon as we can.

You said (Recommendations)

We did (What did the commissioners do?)

Information Support local and national campaigns to raise awareness of mental ill health. Information to be provided in May 2019
Work with other local organisations to develop information about:

  • how to access mental health services in the city.
  • what services are available (in particular perinatal services, carers and partners)

This information should be available in a variety of formats.

Information to be provided in May 2019
Accessibility

 

Waiting times

  • Develop ways to reduce waiting times for mental health services in the city. This should include:
    • Waiting for initial assessment
    • Waiting for interventions, such as CBT and counselling
  • Develop ways to enable service users to ‘track’ their waiting times
  • Explore ways to stay in touch with service users and referrers while they wait for assessment and interventions.
Information to be provided in May 2019
Referral process

  • Develop a single point of access to services which can be used directly by patients or by a variety of different organisations.
  • Provide a variety of different ways people can refer into the service. This might include:
    • Face-to-face referrals
    • Online referrals
    • Telephone referrals
Information to be provided in May 2019
Criteria for accessing service

  • Simplify the criteria for accessing the service. This might include providing clear information to patients, referrers and wider stakeholders about who is suitable for the service.
Information to be provided in May 2019
Communication between services

  • Improve communication and collaboration between the services that provide PCMHS.
Information to be provided in May 2019
Location and opening times

  • Provide local services that are available outside of traditional working hours.
Information to be provided in May 2019
Quality of service Person centred care plan

  • Work with service users to create a person centred care plan that considers missed appointments and sets out a clear plan of action.
  • Improve the service flexibility around the number of sessions available through PCMHS
Information to be provided in May 2019
Treatment

  • Provide a range of treatment options for patients and working with patients to understand the most suitable course of treatment for them.
Information to be provided in May 2019
Discharge

  • Work with service users to develop clear discharge care plans. These care plans might consider crisis management and fast track back into treatment
  • Work in partnership with voluntary sector organisations when developing discharge plans. Be mindful of resource implications for voluntary sector organisations and identify additional funding when appropriate.
Information to be provided in May 2019
Staff

  • Provide adequate training and supervision of staff.
  • Provide services users and carers an opportunity to evaluate the service being provided to them.
  • Ensure continuity of care.
Information to be provided in May 2019
Equality of access – improving access and providing services for people with diverse needs Develop services that are accessible to groups with protected characteristics. In particular consider:

  • Age specific interventions for older people and younger people
  • Managing the transfer of care for people moving out of area
  • Providing information that is relevant and accessible to all people from all communities in Leeds, especially people;
    • With sensory impairments
    • From BAME backgrounds
    • From Gypsy & Traveller community
    • Who are male
  • Providing services that are accessible to people from all communities, in particular people:
    • with sensory impairments
    • from BAME groups
    • from Gypsy & Traveller community
    • with young children
    • from LGB+ community
    • who have a gender identity different from the one they were assumed to be at birth
    • who are asylum seekers or refugees.
Information to be provided in May 2019
Equality monitoring

We recommend that the PCMHS routinely gathers equality monitoring data and the experience of service users, their carers and wider stakeholders. This should be used to develop the service.

Information to be provided in May 2019

 

Please see below the engagement report which outlines the engagement in more detail and highlights the findings and recommendations.

If you have any questions about this engagement please contact Chris Bridle, chris.bridle@nhs.net

Downloads:

Primary Care Mental Health Services – Engagement Plan  (890KB)

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Primary Care Mental Health Services – Engagement_Report (2,049KB)

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CCG Volunteer Report (301KB)

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Primary Care Mental Health – Survey (529KB)

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Primary Care Mental Health – Survey – Easy read (990KB)

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Primary Care Mental Health – Engagement Poster (98KB)