Consultant Psychiatrist. Tower Hamlets Home Treatment Team, ELFT Honorary Senior Clinical Lecturer, Bart & The London School of Medicine

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Joel Johnston
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1 Altrnatv to optal Amon n Mntal alth Cr- Th Towr amlt Exprnc Rahul Bhattacharya Conultant Pychatrt. Towr amlt om Tratmnt Tam, ELFT onorary Snor Clncal Lcturr, Bart & Th Lonon School of Mcn Improvng Mntal alth Cr Car, althcar Confrnc UK, 8 th July 2014

2 Cr ou Th currnt tuaton In 2006, 40 Cr ou rvc wr opratng n Englan, offrng a rang of rvc mol Thy ar typcally mallr than npatnt war, wth no mor than 10 b (Johnon t al 2009) Cr hou ar not tanar acro Englan or UK Nthr ar thy tanar Dal ou n L- non-rual cr rvc workng 6pm- 2am

3 Cr ou Rang of Mol of Car Btwn two xtrm: TT Cr ou A Mntal alth Srvc Prov by NS 1. Rponblty: Cr ou rvc omtm amt patnt unr multpl tam (CRT an AOS) or act compltly npnntly ba on lf-rfrral Cr ou B 3 r Sctor No ntgraton of carpathway Mntal alth Srvc Prov by NS TT 2. Thy may or may-not b wll ntgrat wth TT 3. May b run by NS or voluntary ctor

4 Cr ou Evnc Ba Dpt a long htory atng back at lat to th 1960, rlatvly lttl rarch ha xamn uch altrnatv. Srvc ur atfacton gratr (than acut pychatrc npatnt war) -rvw of promnantly US tu (Llyo- Evan t al, 2009) UK: Srvc ur xprnc of a womn cr hou - cr hou taff ar n a mor (compar to nghbourng hoptal) nformal, approachabl an thought to hav mor tm than hoptal (Johnon t al 2004)

5 Cr ou Emrgng vnc Rcnt unpublh rarch (2012, NIR fun) comparng 4x Cr ou (TAS tuy) an nghbourng npatnt war (PET tuy) patnt. T Cr ou wa on of th rcrutmnt t for th TAS tuy Improv Patnt Satfacton at Cr ou wa u to mprov: - thraputc allanc - rvc atfacton - pr upport at cr hou Patnt at cr hou xprnc fwr ngatv vnt. Thr wa No gnfcant ffrnc n lf-rat rcovry btwn war an cr hou

6 TT Stratg an Polc Mntal halth Cr Concorant- publh 18 th Fbruary 2014 Dpnng on local crcumtanc an th vnc n JSNA, halth an wllbng boar mght choo to rvw:. Whthr uffcnt rourc ar avalabl wthn th cr car pathway to nur patnt afty, nabl rvc ur an patnt choc an to mak ur nvual can b trat a clo to hom whrvr pobl. RCPych - Guanc for commonr of- acut car npatnt an cr hom tratmnt (2013) Commonr houl common a rang of rvc n th acut pathway nclung npatnt b, pychatrc ntnv car unt b, cr roluton an hom tratmnt tam an rntal altrnatv to npatnt amon. (ACCESS to CRT/ TT) local npatnt an CMT, an lf-rfrral ar normally accpt from patnt an carr alray known to th tam. Whthr othr ky agnc uch a GP, ocal rvc, thr ctor provr an th polc houl b abl to rfr rctly to th CRT tll bat. RCPych accrtaton tanar n rlaton to TAS CORE tuy bt practc guanc tanar, PIG guln rlat to NSF for TT

7 Cr ou Srvc Ur Fback Total C amon ovr th 1 t 27 month- 148 Total C rvc ur gvn urvy 118 (30 or 17% unplann charg, nclung mrgncy amon to mntal or acut hoptal ttng/ ngagmnt tc.) Fback form rcv 75 (63.5% rpon rat)

8 Rult Thmatc Analy Cutomr rvc, taff upport an rvc ur nvolvmnt

9 Rult Thmatc Analy-2 Complant

10 Rult Thmatc Analy- 3 Ovrall Commnt

11 Inpatnt Occupancy a a markr of ffctvn of provng a tru altrnatv 99.6% 99.8% 88.1% 84.9% 90.7% 76.3% 85.0% 0% 20% 40% 60% 80% 100% TOWER AMLETS YTD OCCUPANCY YTD TARGET C M T r n f o r c / S P A C R o u x p a n C R o u O p n R - t r u c t u r T T T C M T r n f o r c / S P A C R o u x p a n C R o u O p n Rf: Do th rght thng: how to jug a goo war RCPych OP79 (2011)

12 What Do th all man? B Managmnt complx an multfactoral W foun that followng th r-tructurng of T TT an th opnng of th Cr ou thr wa a ructon n npatnt b ay uag (Occupancy) Avrag lngth of tay ruc from 56 (2008-9) to 36 ay ( ) to 29.5 ay at prnt (Aprl 2014) Bttr war nvronmnt; ruc volnc on th war; bttr taff moral

13 Can all th b omthng l? CMT wr r-tructur wth front n conultant lvr GP facng rvc wth ngl pont of ntry Contnuty of car btwn communty an npatnt unt (not functonalzaton) Thr wa alo mor proactv managmnt of placmnt an npatnt lay charg by a cat r-ttlmnt tam. Towr amlt alo ha a pr-xtng parat local pycho-ocal rvc (not offr at hom) th Cr Intrvnton Srvc Tam.

ou's WoRLD CELEBRA11NG Written by Pamela Kennedy with Douglas Kennedy Illustrated by Amy Wummer ~-~- Worthx kidr ide.als" Nashville, Tennessee

ou's WoRLD CELEBRA11NG Written by Pamela Kennedy with Douglas Kennedy Illustrated by Amy Wummer ~-~- Worthx kidr ide.als Nashville, Tennessee My P>is P>ook ot!3-lv1in1t6 JBvotions ous WoRLD CELEBRA11NG G Writtn by Pala Knndy with Douglas Knndy llustratd by Ay Wur - ) _,,-- L-,} -- Worthx kidr idals" Nashvill, Tnnss / This prsntation of copyrightd