Workstreams

The Mental Health Clinical Network is aligned to the vision described in the NHS Long Term Plan. We view service users and carers as equal partners and seek to continuously increase delivery of co-produced solutions.

Programme delivery is based on:

• Co-production
• Tackling the stigma associated with mental health
• Networking
• Building relationships
• Programme and project management
• Clinical leads developing ‘at scale’ projects
• Learning and sharing – nationally, regionally, and locally
• Enabling and supporting our stakeholders.

The Clinical Network is integral to the success of the Mental Health workstream of the Integrated Care System (ICS) of North Cumbria, the North East and North Yorkshire. A number of the ICS workstream programmes are led by Clinical Network staff and clinicians.

As the ICS develops and matures, the nature and focus of the clinical network contribution evolves to match. Some examples are:

The network has been a leader in developing a Trauma Informed approach to care, from hosting a national conference on this to establish the work, the output from this is now impacting at a national level. There is a thriving community sharing knowledge and ideas online in the Future NHS platform.

There are a wide range of projects where the network provides leadership and support including those linked to physical health, such as the Passport for Health and Wellbeing aimed at helping people with both cancer and mental health diagnoses. Another example where we work with partners across the North East, is in continuing to work together to maintain benefits from ‘A Weight Off Your Mind’, an initiative utilised by local mental health Trusts to support people with serious mental illness and learning disabilities to access physical activity and weight management services.

The network has provided clinical leadership to the Persistent Physical Symptoms workstream of the ICS. Through this the Network has supported the development of a tiered service model and has facilitated input of IAPT providers into this model. The network involvement continued to develop and stay relevant particularly in the context of Long Covid and our response to that new healthcare need.

The network has a long history of supporting national and local ambitions on improving care for people with Dementia. We now lead the discussions on older people’s mental health on behalf of the Mental Health ICS, with much of the focus being to embed specific and appropriate provision for older people into all areas of work where they can be affected but are often underrepresented. We have maintained our online workspace and used it to curate and share relevant information to our network.

We have strengthened our links to frailty and Ageing Well programmes, sharing goals and work programmes for alignment. We are broadly agreed on the need for collaboration between these spaces and are looking to share and improve progress monitoring over time.We have continued our work to broaden and strengthen the representation from different sectors in our workstream. The rapid adoption of new technology has allowed us to continue to meet in virtual meetings, combining groups from across the ICS geography (and beyond) to leverage even better relationships and sharing of ideas. The result is more efficient and we are in a strong position to take advantage of further integration as the ICS develops. A good example of this cross fertilization is discovering excellent work such as (Eleanor’s Story, Unforgettable Experiences and many more) and being able to use our platform for sharing the lessons learned with a new audience.

The Dementia Diagnosis Rate (DDR) is a nationally recognised key metric. Across the whole of England the DDR has been significantly negatively affected by the pandemic, as a result of the closure of services during the early lockdown and the disproportionate number of deaths in the older population. We will continue to provide support to our local systems to understand their position and the options available to recover a DDR above the national ambition. We have been able to showcase the dementia friendly credentials of a variety of partners through producing our 2020 Cumbria Dementia Pathway, which was co-produced and is utilized across the county.

We have supported various other initiatives, including the Age UK “Your mind matters” campaign through promoting regionally via email, social media and word of mouth. We will continue to challenge the system to recognise the need in the older population for better support for common mental health conditions, while making sure that older people also benefit proportionally from programmes with specific funding such as the Community Mental Health Transformation. We will also continue to advocate for the inclusion of OPMH & Dementia in incentive schemes where the opportunity exists.

The Network contributes to the Suicide Prevention workstream of the ICS by providing programme support, facilitating delivery of the suicide prevention regional plan.

The Network supports the priorities of this workstream including real time data surveillance, system competency, and suicide safer communities. Further information on the regional programme of work can be found on North East and North Cumbria Suicide Prevention Network website www.stopsuicidenenc.org

The Clinical Network provides a forum for crisis and liaison mental health practitioners to meet as a peer group to discuss developments in crisis and liaison services and to share learning and insight.

This informal peer support function has been welcomed by those frontline practitioners who have been dealing with increased demand for their services in recent months, providing a safe space to share knowledge and experiences for the benefit of colleagues in other organisations, and fostering a spirit of collaboration between services. The Network continues to link with and support Crisis Care Concordat groups and the Suicide Prevention Network, providing a conduit for information sharing between local partnerships.

Psychological Therapies is a vital part of mental health with the clinical network delivering a number of forums to provide a conduit for information sharing and best practice. We work in partnership with colleagues across the North East and Yorkshire to provide a consistent approach to development of improved services.

The network will support the expansion of Talking Therapies within primary care and the increase in evidence based psychological therapies for Patients with serious mental health problems.

The psychological therapies pathways will be developed in conjunction with community mental health investment in transformation to provide a community based service for our local population.

Our shared vision is to transform children and young people’s (CYP) services, with a focus on integrating health and social care, to improve CYP’s mental health, physical health and wellbeing.

Partnership working, in particular engaging with service users and their carers meaningfully, is a key to our success. Our role is to demonstrate, develop and enable systems leadership which focuses service design on prevention, early detection and recovery along mental health Trust (referred to as Integrated Care Partnerships) and community geographies.

In 2018, we established the CYP Mental Health and Wellbeing ICS Partnership by bringing together partners from across the system of children’s services so that we can work toward integrating services better for the benefit of local families. This Partnership meets every 2 months, and has working groups focusing on different areas of work that are needed in order to transform children’s services, including this new role of integrating health and social care. Partners include, but are not limited to: young people, parent carers, Local Authorities, Public Health England, inpatient care, health and justice, CCGs, children’s service providers, voluntary and community organisations, Health Education England, CYP IAPT, schools, Academic Health Science Network, universities.

We have three top priorities that are indicators of our progress, which all seek to address complexity and complex cases:

1. Building resilience in families, communities and services
2. reducing crisis and use of crisis services
3. getting evidence into practice.

Our progress will be measured by the success of the working group ‘Scaling up integrated care along resilience, crisis and care pathways’, and improvement in clinical, social and education outcome measures for CYP and their families. We report to the Northern England Clinical Networks’ Mental Health Network and to the North East and North Cumbria Mental Health ICS Steering Group. We also work closely with the Mental Health ICS Evidence and Evaluation subgroup.

The Northern England Perinatal Mental Health Network was established in 2015 and works closely alongside the Maternity Clinical Network and Mental Health Network. The network has a dedicated Clinical Lead and a Network Delivery Lead along with administrative support.

Perinatal Mental Health Networks play an important role in supporting strategic planning and local delivery.

Networks perform a range of functions, including providing specialist advice to:

• Commissioners to support local decision-making on what a good service should look like
• Services, including maternity and mental health services (community and inpatient), for example on the development of materials to support preconception advice, including the use of medication
• Facilitating training, including general awareness, core professional training and specialist training
• Encourage research and supporting routine outcome monitoring, audit and evaluation of local services.

Key messages:

• Around one in four women experience mental health problems in pregnancy and during the 24 months after giving birth. Depression and anxiety disorders (such as generalised anxiety, social anxiety, obsessive-compulsive and post-traumatic stress disorders) are the most frequent, occurring in around 15% of women in the perinatal period.
• The consequences of not accessing high-quality perinatal mental health care are estimated to cost the UK £8.1 billion for each one-year cohort of births, 72% due to the longer term associated effects on child well-being. The annual cost to the NHS was estimated at £1.2 billion, whilst the annual extra cost to develop perinatal care pathways was estimated at £280 million (Bauer, Parsonage et al, 2014).
• Maternal mental illness is a leading cause of maternal death in the weeks and months after birth, with 1 in 8 women who died during pregnancy, or up to baby’s first birthday, died by suicide (Oates, 2003; Oates and Cantwell, 2011; Knight, 2018; Bunch et al, 2019).
• Serious mental illness requiring admission is much less common, with around two to three women per 1,000 births being admitted to a Mother and Baby Unit (MBU).
• It is imperative that these services continue to be prioritised, with a focus on equity of access, high-quality care available at the right time in the right place.
• Approximately 30,000 babies are born across the North East and North Cumbria (NENC) each year. Perinatal mental health services not only provide specialist support to mums, birthing parents, and families, but impact on the emotional wellbeing of the infant through robust pathways embedded within maternity and health visiting giving each child the best start in life (1001 Critical Days).
• The mental wellbeing of women and birthing people, and their families is as important as the physical wellbeing of the women and birthing person and developing baby – everyone has a role to play in this.

The pathway can be found HERE and the directory found HERE

A short video with the title ‘Looking after Mam’ can be viewed HERE

Contact: If you would like any more information regarding maternal emotional wellbeing please contact england.northernmaternity@nhs.net