Thames Valley Strategic Clinical Network Perinatal Mental ... · New to MH services 31% 69%...
Transcript of Thames Valley Strategic Clinical Network Perinatal Mental ... · New to MH services 31% 69%...
Raising standards through sharing excellence
Thames Valley Strategic Clinical
Network – Perinatal Mental Health
Network
Wednesday 9th March 2016
Zoë Page, Project Manager
Bespoke Data Collection • Commissioned by NHS England to assist Perinatal ERG/NHS England's work
programme on perinatal MH
• Data specification scoped with NHSE Perinatal Working Group to cover:-
Mother and Baby Units:-
Patient level data extract – all women discharged from MBU during 2014/15
Service metrics – staffing, quality, activity, finance
Mother and Baby community teams:-
Patient level data extract – all women seen by Mother and Baby CMHT during 2014/15 or sample
Service metrics – staffing, quality, activity, finance
Any other perinatal mental health provision
• Data collection process with all 58 English MH Trusts during June 2015
• Data collection period covers either 2014/15 outturn or census data as at 31.3.15
• Validated positions presented
Bespoke Data Collection - overview 57 submissions received (from 58 Trusts)
• National position reported
• No Mother and Baby units in TV SCN area – nearest Winchester
• Only Oxford Health NHSFT have a community mother and baby team (IPPS)
Inpatient and/or
community
perinatal service
49%
Raising standards through sharing excellence
Mother and baby units
2015
• 115 MBU beds provided across the 15 units (as at 31st March 2015)
• MBUs are geographically spread – 3 units in London area
• Number of beds in MBUs range from 4 to 13
• 4 Trusts only have beds • 11 Trusts have beds and a
community team
Mother and baby units
Location of MBUs
2015
Women from Thames Valley
requiring an MBU bed Distances travelled for a bed using GP practice as base
NB nearest MBU is Winchester (10 beds)
CCG No of patients
Admitted to MBU in: Average distance travelled (km)
NHS Aylesbury Vale CCG 1 South Staffordshire and Shropshire 182
NHS Bracknell and Ascot CCG 2 Royal Hampshire 71
NHS Chiltern CCG 1 Royal Hampshire 129
NHS Milton Keynes 2 1 – CNWL
1 - Hertfordshire 78
NHS Newbury and District CCG 1 Royal Hampshire 53
NHS Oxfordshire CCG 3 1 – CNWL
2 - Royal Hampshire 105
NHS Slough CCG 4 Royal Hampshire 95
NHS South Reading CCG 2 Royal Hampshire 69
NHS Wokingham CCG 4 Royal Hampshire 61
2015
Map
Blue = Home GP
Red = MBU Admitted to
2015
Map
Admission density is greater
in regions with a unit
Where specialist units do
not exist, women may also
be admitted to local general
services (adult acute /
PICU) – the scale of this
activity is unknown
2015
Length of time on MBU
88% stay < 3 months
NB:
12% stay less than 1 week,
12% stay more than 3 months
Mother & baby units
30
years old
White British
Any other White
Backgro…
Other Known to MH services
New to MH services
31%
69%
Inpatient Typical Profile
NO substance misuse code (=82%) NO history of prior maltreatment code (=90%)
2015
Mother & baby units
Patient demographics
Accommodation status of
patients on MBU
Employment status of patients
on MBU
Rented accommodation (private landlord
or housing association), 60%
Owner Occupier, 30%
Staying with family /friends
Shelteredaccommodation
Homeless / shelter /hostel / sofa surfing
Raising standards through sharing excellence
Community mother and baby teams
2015
Of the 43% of Trusts having a Community Mother and Baby Team, the following
services are provided (as an example):-
Community mother and baby teams Service model
• 71% offer pre-conception counselling
• 90% offer care during first trimester (100% 2nd & 3rd trimester, and care and advice
following delivery)
• 14% provide advice and support OOHs
• 52% provide advice and support to women with LD
• 25% have a rapid response medicines advice line
• 76% offer NICE/SCIE fully concordant care – of these 52% perform an annual audit
of compliance with NICE/SCIE concordant care
2015
• Average wait for
routine
appointment is 5
weeks (median is
4 weeks)
• Some Trusts
reporting high
maximum waits at
16 weeks
Community mother and baby teams
Access
0
2
4
6
8
10
12
14
16
18
Average waiting times for routine appointment in 2014/15 (weeks)
2015
Community mother and baby teams
Activity
• Measure of
intensity of input
• Report very wide
variation from 25 to
4 contacts per
service user
• Mean contacts per
service user = 13
• Median = 13
.0
5.0
10.0
15.0
20.0
25.0
30.0
Total contacts 2014/15 per patient on the caseload
2015
Community mother and baby teams
Workforce
AfC skill mix
• Band 5 = 4.5%
• Band 6 = 29.6%
• Band 7 = 15%
• Consultant psychiatrists =
11.7%
Richer skill mix than MBUs
(consistent with skill mix in
CAMHS)
Total staff vacancy rate = 15%
Staff sickness/absence rate = 4%
Staff turnover = 16%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%Band 1
Band 2
Band 3
Band 4
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
ConsultantPsychiatrist
Other Medical
Community Staff Metrics Data
All Participants P044
2015
Community mother and baby teams
Finance
• Unit cost per patient
on the caseload
mean = £2,454
• Median = £2,097
• Wide variation
apparent
• Cost per contact
(F2F + non-F2F) =
£208 mean
• median £207
£
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
Total Costs of service in 2014/15 (including corporate costs and overheads) per patient on the caseload
£
£100
£200
£300
£400
£500
Total Costs of service in 2014/15 (including corporate costs and overheads) per Contact
30
years old
Known to MH services
New to MH services
39%
61%
Community Typical Profile
White British
Any other White
Background
Other
2015
Community mother and baby team
Accommodation status of
patients on community
caseload
Employment status of patients
on community caseload
2015
Community mother and baby team
Length of time on
community team
caseload
85% stay < 1 year
NB: Over 400 patients had
0 -1 day LOS on caseload
www.nhsbenchmarking.nhs.uk
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