Integrated Specialist Adult Services

What was the issue you were addressing or working on?

In 2011 the CHCP set out its intention to have an integrated specialist adult service planning mental health, addictions and homelessness. This integrated arrangement is in place in ICHCP, including inpatient mental health services.  A paper describing this is available here.

Achieving integration and modernisation of services for adults with mental health issues, addictions and/or who were homeless – forming a one stop response for people with these commonly linked issues. Modernisation of specialist services in our locality to bring about the full close of Ravenscraig Hospital and greater partnership working with the third sector and other partners such as Registered Social Landlords.

What you did?

Full integration across all specialist adult services into one management team – Community and Inpatient mental health, addictions services and homelessness services (including homelessness health service).

Management team have formed; with annual development days 2011-2013. The day in 2013 used the Aston Team development inventory to reflect on team performance which was used to identify cross cutting themes, and priorities to focus work around for the forthcoming year.

Within monthly management meetings there are quarterly performance reviews of all services within this group, and shared consideration of issues these identify, and where they cross cut the service areas within the group, and those which are impacted on, and by other services within CHCP to enable these to be taken wider within CHCP work.

What were the outcomes - benefits or otherwise?

Within mental health, the following specific outcomes to date:

  • All inpatient services are now managed within CHCP. This has enabled workforce management to ensure safe effective service in this area; and appropriate use of inpatient beds according to service user need eg older person with functional mental illness with consequent challenges to management nursed within IPCU or “adult” inpatient ward. This has also been enabled by the mental health acute beds being relocated back into refurbished inpatient accomodation on Inverclyde Royal Hospital (IRH) site, and adjacent to older peoples inpatient service on same site.
  • Development of the integrated response and out of hours service is still in final stages of implementation. Out of hours assessment by nurse and Doctor via joint assessment, and transfer of care direct to community follow up in place.
  • Single point of access to mental health services is implemented, with linkage between primary care and secondary care services managed internally to the service.
  • Services focussing on older people are now within an integrated single system, with a single point of access. The elements of service are memory assessment linked with post diagnsotic support for dementia, fast track assessment , liaison services into acute service at IRH and care homes; and ongoing care management. Planning implementation of step up; step down support to people currently seen and followed up by consultant led outpatient clinics, with introduction of nurse led follow up clinic.
  • Work to streamline pathways has been developed in tandem with wider GG&C clincial service review to inform standards required and based on developed clinical care pathways. Review of detailed pathways in service has been supported by QuEST team and use of performance information to identify areas for improvement.

Contacts - to find out more

Susanna McCorry-Rice, Head of Mental Health Addictions and Homelessness ICHCP ( )