Managing transitions, access and
Our single point of access and FIND models have been highly successful in improving our ability to assess, admit and ultimately discharge patients. In contrast there are still system level barriers to accommodating patients with short term assessment needs, as well as those who would benefit from transitional packages of care prior to discharge.
We know we can improve our responsiveness to changing patient and partner organisation needs in transitions, access and shared care.
Our patients can experience their highest levels of uncertainty, and consequentially a risk of escalating symptoms, at times of transition. Recognising this, we need to make sure our models of care are adaptable and responsive to their needs which may mean novel working practices and additional non-forensic managed accommodation.
What is happening now?
Timely admission of accepted patients is impacted by a systemic under provision of de-escalation, seclusion and long-term segregation facilities. Capital grants have been allocated to this key priority area with likely wider investment requirements.
Consideration to piloting a virtual prison assessment ward within a secure mental heal accommodation is underway. The development of a clinical specification / tariff forms part of this work.
A cross sector working group focused on younger persons service model is being established.
What will come next?
We anticipate significant increase in supportive rehabilitation step down capacity. This will mean at least 10 transitional beds/accommodation solutions to maximise chances of successful discharge.
To allow for improved time between acceptance and admission, we are working towards a maximum 90% occupancy model.
A forensic advice and guidance service will be established. Scope to admit virtual patients for review, or enter a shared care agreement with community teams, will be explored.
In the longer term
Looking further ahead, supervised residential discharge / step down facility options will be delivered. In addition, CAMHS/Adolescent transitional supervised accommodation will be commissioned, along with a Prisons Assessment/Admissions ward with capped 16 week stay.