H o m e T r e a t m e n t E x p e r i e n c e

C h o i c e & A l t e r n a t i v e

Kevin Heffernan

Nurse

11 years leading HT developments in Birmingham

Consultant for the World Health Organisation

National Institute Mental Health England (Regional Implementation … 5.5 million population …. 39 Home Treatment Teams, 27 Assertive Outreach Teams)

Research fellow Birmingham City University

West Midlands Strategic Health Authority (Service Development)

Community teams in BirminghamCaseload size and distribution in a

locality of 150,000 population

Distribution of Cases

CMHT’s20 staff

Rehab & recovery15 staff

Assertive Outreach12 staff

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600 Cases

Days Years

Intensity of support & Length of stay in the service

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370 Cases

123 cases

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Seri

ou

s M

en

tal Il

lness

Distribution of Cases

CMHT’s20 staff

Rehab & recovery15 staff

Assertive Outreach12 staff

*************************************************************************************************

600 Cases

Days Years

Intensity of support & Length of stay in the service

**********************************************************************

370 Cases

123 cases

**********************************************

***********************

Seri

ou

s M

en

tal Il

lness

Home Treatment

14 staff20 cases

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Characters represent

CRISIS

Characters represent

CRISISDanger/risk and Adversity

Characters represent

CRISISDanger/risk and Adversity

Opportunity forPersonal Growth

Fidelity principles

• Gatekeeper to all potential admissions

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix)

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix) • Rapid Response (1-4 hour variable)

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix) • Rapid Response (1-4 hour variable)

• 24 hour/7 day availability

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix)

• Rapid Response (1-4 hour variable)

• 24 hour/7 day availability

• Flexible visiting (duration/frequency/Intensity)

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix)

• Rapid Response (1-4 hour variable)

• 24 hour/7 day availability

• Flexible visiting (duration/frequency/Intensity)

• Clearly targeted Caseloads (acute)

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix)

• Rapid Response (1-4 hour variable)

• 24 hour/7 day availability

• Flexible visiting (duration/frequency/Intensity)

• Clearly targeted Caseloads (acute)

• Time limited (average length of stay)

Fidelity principles

• Gatekeeper to all potential admissions

• Operating a corporate caseload (utilising MDT skill mix) • Rapid Response (1-4 hour variable)

• 24 hour/7 day availability

• Flexible visiting (duration/frequency/Intensity)

• Clearly targeted Caseloads (acute)

• Time limited (average length of stay)

• Fully Integrated (not operating in isolation, whole system responsibility)

• Comprehensive Assessment

Fidelity principles

• Comprehensive Assessment

• Address social issues (in vivo)

Fidelity principles

• Comprehensive Assessment

• Address social issues (in vivo)

• Medical staff involved/available

Fidelity principles

• Comprehensive Assessment

• Address social issues (in vivo)

• Medical staff involved/available

• Mobile

• Practical problem solving approach

• Supervision and administration of medication

Fidelity principles

• Comprehensive Assessment

• Address social issues (in vivo)

• Medical staff involved/available

• Mobile

• Practical problem solving approach

• Supervision and administration of medication

• Advice, support for Carers

Fidelity principles

• Comprehensive Assessment

• Address social issues (in vivo)

• Medical staff involved/available

• Mobile

• Practical problem solving approach

• Supervision and administration of medication

• Advice, support for Carers

• Early Discharge (not becoming discharge team)

• Effective communication and planning

...continued in part 2

Fidelity principles