Changing care through our community transformation programme
Our Community Mental Health Transformation Programme is changing the way we work across North Central London. Here we hear from some people delivering this new approach, and from some of those it has helped.
Carol Joseph, a project manager at Haringey Safe Haven, explains how the new DIALOG+ approach to co-developing mental health care helped her to get back on track:
I’m a mother with no living children. I’ve been on a journey for 13 years, battling major depression and despair to the point I contemplated suicide. My GP put me forward for the DIALOG+ trial.
At my first appointment, I was asked to complete a short app-based questionnaire rating 11 areas of life – my medication, psychological needs, practical needs, mental health, physical health, friendships and relationship with partner, personal safety, accommodation, job, and leisure.
My lowest scores were job situation, mental health and relationships including family who wanted me to pull myself together. While I wanted to, I didn’t have the emotional capacity to do so. I withdrew from family and friends which triggered a mental health crisis.
In my appointment, I talked about my challenging areas and I identified small actions to take before the next meeting. For example, I agreed to contact a local recruitment agency who could help me update my CV and prepare for job interviews.
This opened new doors. I was encouraged to apply for a job at Clarendon Recovery College as a co-tutor expert by experience. I applied and was successful. I later applied for a job as a project manager for Haringey Safe Haven, a crisis café, where I still work today.
My experience using DIALOG+ was brilliant and assisted a pathway to recovery. It empowered me to identify, for the first time, the specific areas of my life where I was stuck and needed help. By breaking my challenges into manageable parts, I was able to identify actions and potential solutions.
It has changed my life for the better.
Freddy Semanshia is an Expert by Experience (EbE) who has been working with the Patient Experience team at Barnet, Enfield and Haringey (BEH) to develop the service user forums and the Trust EbE infrastructure so that there is greater coproduction and engagement in our services. He is also an EbE coordinator and is on the MaST and DIALOG+ steering groups. He explains why he got involved:
I started my role as an EbE so I could make a difference and support others in a similar situation to myself. When I joined the BEH Patient Experience Team it was an amazing opportunity to have a bigger impact on service users.
I love my role as EbE Coordinator because I can use my skills and abilities to strategically allocate opportunities for individuals who I know will excel in a particular role. The most rewarding part of my work is engaging with service users and management and bridging the gap between the two.
Encouraging some EbEs to take part in certain roles can be challenging, and so can explaining NHS jargon to them. But the individuals who accept challenging roles really make my role worth doing.
Laurence Thomas, an associate mental health worker in the Barnet North community mental health team and has been involved in piloting the use of our new care-planning tool DIALOG+ at the Trust:
I have found DIALOG+ to be a useful way of getting to better understand an individual and what is important to them. I feel that ensuring DIALOG+ is used in a collaborative way, in which the service user can view the screen and complete the assessment with a clinician, is essential and provides a sense of agency in their care.
Although it initially takes a bit of time getting used to the software and identifying when it is appropriate to complete a DIALOG+ assessment, it allows both the service user and clinician to review their progress and develop a shared understanding of what is going to happen in the future, and what actions are going to be taken and by whom.
I feel DIALOG+ holds real potential to help support service users to have their views considered and for their care to become more person-centred.
Sade Olutola, Clinical Project Lead for Enfield:
I am very excited to be part of the transformation project team responsible for designing and shaping a new model that is transforming our community mental health services; multi-disciplinary teams of experts are working within the primary care networks and community services offering holistic care to our service users and the wider community.
Together with the local authority, and other stakeholders including community voluntary services and the service users’ group, we have produced a new model and structure for services to ensure easy access to mental health care and agreed new procedures and standard to benefit everyone who uses our services.
We expect more people to use our services and we have recruited additional staff and we are developing closer relationships with voluntary community services.
In line with the rest of the Trust, we are introducing the new care planning tool DIALOG+, which helps people identify areas of their life that they would like to improve and enables us to focus on those areas.
I am confident these new innovative and exciting changes will help people as they live with, or recover from, mental illness and will aid them to resolve other challenges they may face such as debt, housing, education, training or relationship problems.
John Londy, Clinical Project Lead for Haringey:
This has been an exciting opportunity for me to help innovate and transform community mental health services in Haringey and tailor them to the needs of the local community.
We have made great progress building the foundations of the new services and starting to adapt to a new way of working.
The new Primary Care Network (PCN) based Mental Health Practitioners Team is up and running and piloting the new care planning tool, DIALOG+.
We are setting up and putting into operation the New Core Community MH teams aligned to GP Primary Care Networks; this includes the Intensive Complex Emotional Needs Service, and the specialist pathways of Personality Disorder (PD), Post Traumatic Stress Disorders (PTSD), and Mood and Personality disorders (MAPs).
Voluntary Community Sector workers have started working with clients within the pioneering East Core Community mental health team and the Personality Disorder Pathway.
I’m pleased to be part of this programme which will be of great benefit to service users and the wider community. I’m looking forward to seeing how services develop in the months ahead.
Angela Sobers, the Clinical Project Lead for Barnet:
We are really pleased that mental health specialists have now started working within GP practices in Barnet; providing holistic care close to where people live, with a focus on preventing people from developing mental health conditions, and early intervention to help them recover.
These Advanced Clinical Practitioners (ACPs) and Mental Health Practitioners (MHP) play an important role in providing support, advice, knowledge and clinical time with GPs and patients in a primary care setting. I want to congratulate everyone in these new roles for the pioneering work they are doing; they are forging a new path and working hard to establish new working patterns, offering high quality care and support.
We have also recruiting 14 new Voluntary Care Sector (VCS) staff, 11 are now in post, with three more still to join. These new members of staff are working in our Core Community Teams helping to expand what we can offer to the community, enriching the multidisciplinary team by bringing new skills and specialist knowledge. They will support clients who are isolated and help them to connect with their communities. They will also support the “stepping down” of clients and act as a bridge between secondary and primary care.
We are rolling out training for our new care planning tool DIALOG, first to the Barnet North Core Community Team and then to the other community teams. This is an exciting time, as it will we move towards a new person-centred and holistic way of delivering care and support to people using our services. You can see more about DIALOG+ here.