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Birmingham and Solihull Mental health NHS Foundation Trust
Better Together
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Reach Out News 

Important changes to NHS Specialised Commissioning for Adult Secure Care Services

From 1 October 2021, the responsibility for the commissioning of Adult Secure Care services in our region is transferring from NHSE Specialised Commissioning to the West Midlands Provider Collaborative – known as Reach Out.

The Provider Collaborative

Birmingham and Solihull Mental Health NHS Foundation Trust is the lead provider of the West Midlands Provider Collaborative. This transfer of commissioning responsibly is in line with national policy and underpins delivery of the ambitions set out in the Long-Term Plan for the NHS. The move to regional Provider Collaboratives sees the planning, quality assurance and delivery of Adult Secure Services, including Mental Health, Learning Disability and Autism, devolved to partnerships of local providers.

The Reach Out Partnership, originally between the three forensic mental health providers; Birmingham and Solihull Mental Health NHS Foundation Trust, Midlands Partnership Foundation Trust and St Andrew’s Healthcare; has recently been expanded to include secure inpatient learning disability and autism services and joined by Coventry and Warwickshire Partnership NHS Trust and Black Country Healthcare NHS Foundation Trust. Coventry and Warwickshire Partnership Trust is the Lead Partner for learning disability and autism services, working in Collaboration with other providers and supporting the Lead Provider to fulfil its commissioning responsibilities. 

Achievements from the Wave 1 New Care Pilots

Since working together on the new care model for adult secure mental health services prior to going live as a commissioning Provider Collaborative, the collaboration has made significant improvements in the care and experience of our mental health service users:

Reduced Inpatient population

Reduced Inpatient population from 555 patients to 471 patients by August 2021 - a total of 15% reduction.

Reduced number of patients

Reduced number of patients receiving care outside West Midlands by 60% and increased investment in Forensic Services to support patients in the community improving their life and reducing re-admissions.

Increased the number of patients

Increased the number of patients receiving support in the community by 89% from 111 to 210 as at August 2021. 

Enhanced collaboration

Enhanced collaboration between clinical teams via Central Bed Management function resulted in optimum utilisation of local bed capacity, the need for out-of-area placements and care being delivered closer to home. 

Aims of the Collaborative

The formation of the Reach Out Provider Collaborative will enable providers to work together and use the collective expertise to improve patient care and outcomes across the region. 

The aim is to ensure that people with a serious mental illness, learning disabilities or autism requiring secure services experience high quality, specialist care, as close to home as appropriately possible. This specialist care will also be connected with their local teams and support networks.

A new model of care has been developed that puts the patients at the centre of everything we do, having them and their families and carers fully engaged and co-producing the Collaborative’s plans and services. We aim to have our patients feel they are understood, accepted, and supported in a safe and inclusive environment - whatever their needs and characteristics.

Quality

This model will provide the foundation for how services are transformed by:

Reducing inequalities and improving patient experience and outcomes:

  • Reduced waiting times for assessment and admission
  • Increased person-centred care and peer support
  • Improved recovery and life opportunities
  • More responsive and inclusive services
  • Improved patient journey and reduced transitions
  • Creating improved patient journeys through:
  • Providing alternatives to admissions and ensuring clinically appropriate admissions, 
  • Reducing length of time people need to stay in secure services
  • Improving quality of services 
  • Reducing out of area placements to keep care close to home and investing into community pathways and services

 

Learning Disabilities and Autism

This is a very exciting time for us in Learning Disabilities and Autism services as we are becoming part of the Provider Collaborative and working across our partners to continue to improve our services and pathways for our patients. We have set up working groups which will ensure all actions that clinicians, families and patients have told us we need to get better at are fulfilled in a co-produced fashion. The main actions we will focus on are:

  • Ensure we all use similar assessment documentation and discharge plans
  • Ensure we improve our communication about our services and our communication is person centred
  • Ensure we keep people as close to home as possible- we have set up a weekly bed management meeting which ensure we use our local beds to the best of our ability
  • Hold each other to account for the quality of the services- we have set up a safety and quality group whose job it is to do this.

 

Over the next six months we will be keeping in contacts with our patients, their families and clinical teams to ensure we progress our actions and that all change is coproduced.


The Commissioning of Provider Collaboratives

The delegation of commissioning from NHS England to Lead Provider Collaborative require clear and robust governance arrangements within the Provider Collaborative that acts as the commissioning function which needs to be separate from the service provider function. In order to fulfil this requirement and to avoid conflict of interest, Birmingham and Solihull Mental Health Trust (lead provider) has delegated some of its responsibilities to a ‘Commissioning Function’. The key purposes of the function are:

  • Case management to provide oversight of clinical pathways for patients in secure services, both in and out of area placements 
  • Quality assurance and improvement of services
  • Improving health outcomes and reducing inequalities
  • Commissioning and contracting
  • Financial planning and management of care budgets
  • Performance monitoring of providers
  • Facilitation and co-ordination of service transformation & redesign