Is it an emergency?This is an executive summary of the ICB’s Adult Mental Health, Learning Disability and Autism Inpatient Services Quality Transformation Strategy 2024 – 2027.
Please contact us if you would like to receive a copy of the full strategy.
Introduction
This strategy explains how Suffolk and North East Essex Integrated Care Board (ICB) will improve mental health, learning disability and autism inpatient services for adults by 2027. A separate inpatient strategy will be developed for children and young people.
To do this the ICB will work with:
- mental health providers
- GPs and hospitals
- Local councils
- Community and voluntary sector organisations
- The Integrated Care Boards in Norfolk and Waveney, Mid and South Essex, and Hertfordshire and West Essex
The overall aim is to create better inpatient services that connect local mental health services, urgent and emergency health, and other organisation that people in local communities.
The development of the strategy has been guided by:
- The Suffolk and North East Essex Integrated Care Board Joint Forward Plan 2024 – 2029
- NHS England inpatient services quality improvement guidance
- The healthcare improvement programs at Norfolk and Suffolk Foundation Trust (NSFT) and Essex Partnership University Trust (EPUT) who provide mental health services in SNEE.
- Feedback from our communities, inpatient service users, and their families and/or carers.
NHS England plans to improve inpatient services
The key goals of the NHS inpatient improvement guidance for mental health, learning disabilities and autism services is to make sure that:
- People are admitted to hospital because they need help and admissions happen quickly.
- Care in inpatient services is therapeutic, keeps people safe and helps them to get better.
- People are discharged at the right time with personalised support for them in their community.
To make these changes in inpatient services, the work of the ICB and our partners will follow these four principles:
- Patients are involved in decisions about the care they need.
- Services and staff understand and can respond to trauma.
- Services will work together to support patients and their families.
- That everyone should have access to appropriate mental healthcare.
The health and mental health of people in Suffolk and north east Essex
Suffolk and north east Essex is a mix of towns, villages, rural and coastal areas. The graphic shows a map of Suffolk and North East Essex integrated care system (ICS). The system is divided into three areas, these are west Suffolk, Ipswich and east Suffolk and north east Essex.
The integrated care system provides services to improve the physical health and mental health of the local population. All the different partners who are part of the integrated care system also try to reduce the difficulties that make people ill. The difficulties are called health inequalities.
Some people have more health inequalities than others. For example, when people live in poverty this can increase health problems including mental health difficulties.
There are people living in poverty in places across Suffolk and north east Essex. Some of the places which are the most deprived are in Tendring and Ipswich. There is also a deprived area in Bury St Edmunds.
Our integrated care system is area which has more older people than many other places in the country, and often when people become older, they develop more than one health problem including mental ill-health.
To improve the physical and mental health of our local population we must understand more about the groups of people who have poor mental health because of health inequalities.
That is why the integrated care system has targets from government to improve the health of people who have poor mental health because of health inequalities. The targets are for: people who have a serious mental illness, people who have a learning disability, autistic people, and autistic people who have a learning disability.
The government also wants the different organisations who are part of the ICS to work together to prevent suicide and support people who are in crisis.
The Suffolk and north east Essex inpatient strategy outlines how the ICS will use information and data about our communities and mental health services to improve the physical and mental health of the local population.
Who is currently accessing our inpatient services?
Mental health services and hospitals in Suffolk and north east Essex are provided by Norfolk and Suffolk Foundation Trust and Essex University Partnership Trust. The integrated care board (ICB) is responsible for the management of NHS mental health services in the ICS – this includes inpatient beds for adults and older adults and specialist beds for people with learning disabilities and/or autism.
The inpatient beds are for people experiencing severe mental health difficulties who need intensive therapeutic help, and to be kept safe until they recover and can return to home.
There are many different circumstances why people are admitted to or have accessed inpatient services. As part of the inpatient strategy the ICB is working with the mental health trusts to improve the quality of the patient data to understand the reasons why people are going into hospital.
The strategy also explains how the ICB and the mental health trusts are involving people and their families and carers, who have been admitted to inpatient services, and asking current patients about their experiences.
This includes listening to feedback from people who have been admitted to inpatient services away from their homes – called an out of area placement. When people are placed at great distance from home this can have a negative impact on their mental health recovery and place a strain on families and carers.
The ICB is working with the mental health trusts and other organisations to meet the government target to reduce to zero by March 2025 all out of area placements which are not providing appropriate therapeutic care.
By engaging with people and having better information the ICB can make changes to inpatient services and can show evidence of what has improved for patients.
Community mental health and crisis care support
Improving the mental and physical health of people with severe mental illness, keeping them safe in the community, and having appropriate crisis services when people need them, are key objectives in the NHS Long Term Plan.
The ICB inpatient strategy outlines the importance of community mental health and voluntary services that prevent people being admitted in to inpatient services because they have access to local services that are therapeutic and help them to remain well. These services need to be accessible to everyone including people with dementia, people with learning disabilities and autistic people.
Engagement and co-production
Listening to the experiences of patients, families and carers and people with lived experience is a key principle of the ICB inpatient strategy, and the inpatient improvement plans for all the regional mental health providers.
The mental health providers are also taking part in the NHS Culture of Care Programme. This is an NHS England learning and improvement programme which emphasises the importance of engagement with patients and staff.
By working together through co-production, the goal of the Culture of Care programme is to develop inpatient services that are safe, help people to get better, provide access for adults and young people who need care, and make inpatient wards fulfilling places to work.
The inpatient strategy explains the different ways in Suffolk and north east Essex that the ICB will listen to existing groups and provide opportunities for new people to become involved with the work to improve inpatient mental health, learning disability and autism services.
Mental health workforce – inpatient services
The integrated care board and the mental health providers recognise that patients must be looked after by staff who are well trained and have the skills and experience to understand the individual needs of people with mental health difficulties.
The inpatient strategy outlines the national and local plans to:
- increase the number of staff working in NHS mental health services
- support the training and cultural knowledge of the workforce so that they can provide high quality mental care for everyone including autistic people, elderly people and people from minority ethnic communities.
Further areas of work
The ICB inpatient strategy is the result of information, data and feedback from many different sources including mental health providers, mental health staff, people with lived experience, the voluntary and community sector and local councils.
The inpatient strategy that the ICB submitted to NHS England is the beginning of work that will take place over the next three years. There are still some questions about specific groups and their experience of inpatient services that the ICB needs more time to understand.
The ICB will do this by working with partner organisations, patients and health professionals who have the knowledge and relationships with these groups.
These groups include people with complicated mental health and emotional needs; autistic people; people who are addicted to drugs or alcohol, people with dementia, and people who are LGBTQ (lesbian, gay, bisexual, transgender or questioning).
Mental health provider plans overview
The ICB has worked with its mental health providers and other mental health care providers to agree the priorities and action plans for year one 2024-25 of the inpatient strategy.
The plans are based on actions that respond to the following questions:
- What are we going to do (objectives)?
- How are we going to do it?
- When are we going to do this?
- How will we know we are achieving our objectives?
All the providers want to make the quality of inpatient care in mental health, learning disability and autism inpatient services even better. Below is a short summary of the action plans for the different inpatient mental health care providers in SNEE.
NSFT (NHS Norfolk and Suffolk Foundation Trust)
NSFT is already working to improve all the inpatient services that it provides in Suffolk because it is implementing a clinical improvement system called ‘Models of Care’ based on a personalised care approach.
SNEE ICB and Norfolk and Waveney ICB worked together as mental health commissioners, to jointly agree with NSFT the objectives outlined in the trust’s inpatient action plan.
The improvement programme and the inpatient action plan has been developed with the involvement of people with lived experience, current inpatients, their families and carers.
The actions in the inpatient plan will make sure that mental health, learning disability and autism services are based on treatments and quality of care that is evidence-based, meaning care that is proven to work for patients. Every admission will result in positive benefits that are felt by the patient.
The trust will create environments in its wards that encourage patients to get better, supported by well-trained staff who keep them safe and support them through to their agreed discharge from hospital.
EPUT (NHS Essex Partnership University Foundation Trust)
The actions included in the SNEE ICB inpatient strategy are part of two improvements programmes that the trust is delivering across the entire county of Essex – in west Essex, mid and south Essex and north east Essex.
The three Essex ICBs have worked together with EPUT to agree the general objectives outlined in the trust’s inpatient action plan.
The ‘Time to Care’ improvement programme is focussed on having the well trained and qualified staff with appropriate skills in all inpatient services.
The ‘Therapeutic Acute Inpatient model’ improvement programme follows the principles in the NHS inpatient guidance and other internationally recognised improvement schemes for mental health services.
The trust has also listened to feedback from patients, and engaged with partner organisations and people with lived experience to make sure that the results of improvement programmes will be high quality, caring, and safe inpatient mental health services.
Essex Learning Disability Partnership and NHS Hertfordshire Foundation Partnership Trust
Essex Learning Disability Partnership and NHS Hertfordshire Foundation Partnership Trust provide specialist treatment, community mental health support and inpatient services in north east Essex.
Specialist inpatient services are for adults with a learning disability and, or autistic adults who have a mental health difficulty that cannot be treated in community mental health services or general inpatient services. People access these services because they need additional support from mental health staff who are trained to care for people with complex learning disabilities and/or autism.
The providers’ plans highlight what needs to be improved in their services. This includes:
- New ways to help people get better and stay safe in their communities instead of being admitted to inpatient services.
- The importance of mental health providers, social care services, housing associations, and voluntary and community organisations working together to support people with learning disabilities and/or autism when they leave hospital.
- More specialist training for mental health staff to support the needs of patients with mild learning disabilities or autism who are admitted to general mental health inpatient services.
Feedback from current patients and people with lived experience has helped the providers agree which improvements are the most important for people with learning disabilities, autistic people, and their families and carers. And the providers will use co-production to make sure that services do improve and help people to live healthier and longer lives.
Next steps
Over the next three years the ICB will continue to work with mental health services, care organisations, and the integrated care boards in Norfolk and Waveney, Mid and South Essex, and Hertfordshire and West Essex to ensure that:
- the objectives outlined in the action plans for NSFT and EPUT result in better health for people who access inpatient services.
- people are supported to stay mentally healthy in their local communities because they have access to the right support for them and their families and/or carers.
- mental health services and crisis support services are made more accessible.
All the mental health providers have started to make changes to improve the quality of inpatient care and support in mental health, learning disability and autism services. SNEE ICB supported by the NHS Regional Mental Health Team and our neighbouring ICBs will monitor their progress.