Understanding Regional Mental Health Management. Identifying Regional Ability for Systems Reform Unlocking the Value

Transcription

1 Understing Mental Health Identifying Ability for Systems Reform Unlocking the Value ANNUAL ACTIVITY WORK PLAN -

2 Version Control Version Date Prepared by Comments Susan Barron- Hamilton Distribution Name Title Function* Ivan Frkovic Aftercare National Operations Manager Lead Agency Representative WMO PIR WMO PIR WMO PIR Program Governance Approvals Endorsements Senior Director Name: Ivan Frkovic Date: Signature: Position: Aftercare National Operations Manager Chair (CMC) Branch/Division: QLD 2

3 Contents Version Control... 2 Distribution... 2 Approvals Endorsements... 2 ANNUAL ACTIVITY WORK PLAN Purpose... 7 Background... 8 A Strategic Plan for System Reform... 9 Activity Work Plan for - realising the vision... 9 Success Criteria Related initiatives / policies / documents Deliverables Milestones Resources Governance Risk Post Implementation Review Appendix 1 - Understing Mental Health : Driving the Desire for Change Appendix 2 Understing Mental Health : the Face of Disruptive Innovation 3

4 ANNUAL ACTIVITY WORK PLAN - Year covered by Annual Activity Work Plan: - PIRO ID: Medicare Local Region: West Moreton-Oxley Name of Lead Agency: Aftercare State/Territory: Queensl Activities / Tasks Start date End date Who is responsible? Who else will be involved? Risks Mitigations Outcome Measure 1 Service systems are Codesigned coproduced. commit to prototypes which are trialled scaled up across the region. Lead Agency Commenced facilitating hips in codesign coproduction. KPIs agreed evaluation processes in place. 2 Establish a community governance structure in collaboration with with clear roles responsibilities reporting pathways for systems review Networks that work Lead Agency Established community governance structure Networks that work. 4

5 3 Facilitate the construction of a Mental Health Model of Service for Living Well Lead Agency Commenced facilitating the construction of a Mental Health Model of Service for Living Well. are working together in a cohesive way to connect their operations on a client continuum which supports living well. 4 Establishing Mental Health navigator positions for trial Lead Agency Mental Health navigator positions are trialled. 5 Developing pathways to Living Well Lead Agency New services developed via codesign coproduction has commenced. Prototypes are implemented, trialled. Evaluation processes in place. 6 Building the capacity of the region in mental health awareness, practice prevention. Lead Agency Capacity building initiatives have taken place. 7 Changing consultation practices developing avenues for Living Well - More than medicine. Lead Agency Initiatives resulting in changing consultation practices are developed implementation has commenced. 5

6 8 Constructing an infrastructure for Social Prescribing Lead Agency Social prescribing infrastructure, training, tools resources are developed implementation has commenced. 9 Collaborating on the development of New Services Lead Agency New Services are codesigned, coproduced established. 10 Deliverables in the WMO PIR Engagement Strategy Communication Plan PIR Marketing Communications Officer Deliverables Met. 6

7 Purpose The ultimate objective of this paper is to set out a plan to improve the system response to outcomes for people living in the West Moreton-Oxley (WMO) Partners In Recovery (PIR) region who live with severe persistent mental illness by: Facilitating better coordination of clinical other supports services to achieve wrap around care, individually tailored to the person s needs; Strengthening hips building better links between various clinical community support organisations responsible for delivering services to the PIR target group; Improving referral pathways that facilitate access to the range of services supports needed by the PIR target group; Promoting a community based recovery model to underpin all clinical community support services delivered to people experiencing severe persistent mental illness with complex needs. The key focus for PIR are issues which arise as a result of gaps barriers in current services, policy funding arrangements which require systemic change, rather than changes or improvements in the case end of the spectrum. Changes to case processes are considered quality improvement activities as distinct from system reform activities. System reform initiatives will focus on issues which are known to affect more than one client will require both short longer term strategies to bring about systems change. The Vision 1 Health social care systems mobilise people recognise their assets, personal strengths abilities as well as family, friends, communities peer networks that can work alongside healthcare professionals, the community voluntary sector to support patients to live well with long term conditions; Ability to live well with long term conditions is powered by a redefined relationship, a hip of equals between people healthcare professionals. These relationships 1 Nesta Innovation Unit People Powered Health: health for people, by people with people: making the case for system wide change, foreword by the King s Fund: UK with_people.pdf

8 are trusting, purposeful oriented to the needs of the individual not the system; The health care system organises care around the patient in ways that blur the multiple boundaries within between health, public health social care; with community voluntary organisations; the boundaries between formal informal support. We are at a new frontier in mental health service delivery in WMO. Whether we seek it or not, a transition from past traditional service delivery models, to innovative creative models has arrived. In the future we can embrace the opportunities be part of the solution. There is evidence this approach is working well in Europe where changes to health service delivery has been driven by fiscal restraint. In Engl Scotl there is robust evidence for health budget savings of 7% with further evidence of an additional 20% savings. Given the increasing fiscal policy pressures, growing dem on clinical nonclinical services, it is counterproductive to clients services to continue in the present modus operi. This document will be submitted to the Department of Health as part of the Activity Work Plan for performance reporting requirements. Background This document is a summary of activities the WMO Partners in Recovery (PIR) (CMC) have approved for progressing supports the PIR Activity Work Plan for. This paper will form part of the fourth paper in a series of five documents the WMO PIR Program Team are preparing in line with the ADKAR 2 change model. This paper identifies priority projects, provides a summary of the tasks, identifies the key deliverables for the next 12 months. It also structures a response to the gaps barriers identified in the first paper Understing Mental Health - Raising Awareness: A Discussion Paper, the second third papers Driving the Desire for Change (appendix 1), Building Knowledge: the Face of Disruptive Innovation (appendix 2). Of key importance for WMO PIR success, its ability to leave a legacy in the region, is the CMC role in establishing a roadmap for systemic change which enables all stakeholders to play a part work towards a common goal. This paper supports our efforts to do so. 2 Awareness, Desire, Knowledge, Ability, Reinforcing 10

9 A Strategic Plan for System Reform West Moreton-Oxley Partners In Recovery System Reform Implementation Strategy West Moreton-Oxley Partners in Recovery IMPLEMENTATION PEOPLE GETTING CONNECTED AND STAYING CONNECTED BALANCING HEALTH PROVISION FOR PEOPLE, ACTIVE HEALTH MANAGEMENT BY PEOPLE, AND MUTUAL SUPPORT WITH PEOPLE OUR GOALS GOAL 1 CHANGING CONSULTATION GOAL 2 COMMISSIONING NEW SERVICES GOAL 3 CODESIGNING PATHWAYS STRATEGIES - Collaborative consultations - Flexible - Group individual - Client Focused STRATEGIES - More than Medicine - Improve wellbeing - Build social network of support - Service codesign around service user need STRATEGIES - Focus on long term outcomes - Recovery - Prevention - Includes service from a range of providers including volunteers community Initiatives - Self support & care planning - Shared decision-making - Social Prescribing - Signposting - System Navigators Initiatives - Peer support advice - Platforms time banking to exchange skills - Coaching, Mentoring Buddying from professionals or peers Initiatives - Integrating care through collaborative hips that join the dots - Self directed support - $ to choose - Collaborative commissioning Commission Design Delivery - Outcome Orientated - Prototyping STRUCTURAL BARRIERS - What we measure value - How we commission pay for services - Dominant culture of the mental health workforce Activity Work Plan for - realising the vision 3

10 The issues to be addressed by the WMO PIR Program during 2016 include: Change the way services are commissioned: to ensure the commissioning process reflects the lived experience of users, leads hips collaborations, supports market making (promoting efficiency by keeping markets liquid); Make the most of new structures: to involve consumers in commissioning; develop effective health wellbeing boards; foster a diverse range of providers including the voluntary sector; Encourage patients to take part in systems reform: by creating a social movement for change, including leadership from consumers organisations to create grassroots dem; Mobilise clinical leadership: from the Universities schools, as well as individual clinicians, rewarding new enhanced clinical behaviours incorporating principles into professional stards; Change what gets measured: to encourage recovery over treatment incentivise dem reduction; focus on wellbeing include consumer set goals; Shift investment in technology: towards technologies that enable collaboration, self effective communication; to codesigned technologies developed for, with by consumers; Transform organisational workforce culture: by making a clear case for change, developing staff motivation, embedding incentives throughout, making the culture real normal; Create a cadre of system leaders: who focus on the overall vision of the system, distribute leadership opportunities act in the interests of the wider system; Strengthen the business case: by testing, adapting iterating new innovative approaches, generating evidence addressing user dem strengthening networks of evidence makers. These approaches are not only designed to enable consumers to become more confident better able to manage their conditions, they also aim to address the root causes of mental illness, shift long term behaviors support social networks to improve mental health. The prize is the potential to improve health outcomes reduce costs for the health system. 3 NESTA People Powered Health A Business Case for Change Scotl: UK 11

11 Implementing all the above elements across the whole regional mental health system is not possible in the 2 years remaining. What is possible is to support work initiated with by regional champions of innovative change, facilitate new services systems, set up the infrastructure for supporting system reform processes moving forward; after PIR has gone. Success Criteria The key performance indicators against which the plan will be assessed include: PIR Program Objectives are addressed; Innovation activities are operational ($ s delegated); Partnerships in codesign coproduction are established; Established community governance structure Networks that work; Pathways are prototyped, implemented evaluated; Capacity building initiatives have taken place; Initiatives resulting in changing consultation practices are developed implementation has commenced; Social Prescribing infrastructure, tools resources are established; Services are codesigned/redesigned; Commenced facilitating the construction of a Model of Service for Living Well; Mental Health navigator positions are trialled; Timeframes are being met; Formal authorisation is received. Related initiatives / policies / documents This document is to be read interpreted in conjunction with: Understing Mental Health - Raising Awareness: A Discussion Paper ; Understing Mental Health - Driving the Desire for Change ; Understing Mental Health - Building Knowledge: the Face of Disruptive Innovation ; PIR Operational Guidelines; West Moreton-Oxley Partners in Recovery Department of Health Ageing Stard Funding Agreement; WMO PIR Partnership Engagement Strategy Communication Plan 2013; WMO PIR Flexible Funding Guidelines 2013; Support Facilitator System Coordinator Position Descriptions; National Stards for Mental Health Services 2010; National Stards for the Mental Health Workforce 2013; National Quality Safety Stards 2011; 12

12 Carer Recognition Policy 2013; Carer Recognition Act (Qld) 2008;. Consumer Carer Participation Policy - A Framework for the Mental Health Sector 2004 Deliverables Milestones No. Deliverable / Milestone Date 1 Partnerships in codesign coproduction are established. 2 Established community governance structure Networks that work. 3 Commenced facilitating the construction of a Model of Service for Living Well. 4 Mental Health navigator positions are trialed. 5 Pathways are prototyped, implemented evaluated. 6 Capacity building initiatives have taken place. 7 Initiatives resulting in changing consultation practices are developed implementation has commenced. 8 Social prescribing infrastructure, tools resources are established. 9 New services are codesigned. 10 WMO PIR Engagement Communication Strategy Plan implemented Resources In addition to the CMC, there is a PIR Program Team, a team of field workers including Support Facilitators (SFs) System Coordinators (SCs) located in partner organisations in the region. The human resource component of the funding structure changes over the next three years with SFs numbers increasing while SCs roles decrease. The PIR Program Team has formed a hip with Evocca College to place up to four community development students for the duration of their practice placement. These students are key to progressing innovative work within the region. PIR are continually looking for new with the expectation of additional resources being identified throughout the reform process. Furthermore, WMO PIR s intent is for consumer carer participation representation to be incorporated at all levels of program development reform activities. 13

13 From a regional resource perspective, WMO is fortunate to contain a rich varied, albeit complex, web of mental health services community organisations. We have levels of expertise in this region to be proud of. The task for PIR is to support the health community in the codesign coproduction of new innovative ways of working. As in all change processes, some of this work may cause a period of disruption in the short term but the benefits for the long term will be worth it. We are asking organisations agencies to step away for a moment from running individual operations work together to drive the changes required for supporting people with mental illness to map their own recovery journey; rather than travel the road we, as service providers, construct for them. The importance of these resources cannot be underestimated. PIR reform strategies plans are meaningless without the human resource element at the operational grass roots level to implement them. The activities identified in this paper will be funded via: Partner contributions commitment of resources; PIR Innovation Funding; PIR Program Resources; Additional resource funding acquisition efforts. Governance Community Governance 14

14 Risk CURRENT RISK ASSESSMENT Risk Consequence Likelihood Adverse event Negligible: Minor adjustment to operational routines Unlikely Mitigation Approach Outline possible mitigation approach if known at this stage. Working in hip to codesign, coproduce build a prototype for each reform strategy keeps the process visible manages risk, quality expectations. Damage to reputation Negligible: Minimal harm Rare Promotion marketing of the benefits are the key messages. Disruption to established routines Moderate: Some disruption to established routines with possible flow on to other areas Possible Build relationships, hips, gain trust buy-in. Partners will assess organisational operational risk mitigation strategies. Keep the work visible, maintain a relationship of trust. Clear, concise regular communication. Identify the problem areas address them early on. Staff morale Minor: Alteration to routine practices required Possible Clear, concise regular communication start early do it often Build the capacity of the workforce involved in trialing the reform strategies. Work place health safety Negligible: No illness / injury, no time lost, minor adjustments to operational routine Rare Working in hip to maintain quality practice throughout the reform implementation process. Workforce issues (capacity / capability) Minor: some effect on specific services or program alterations to routine practices Likely Regular consultation communication, community engagement community governance, working in collaboration to plan, codesign coproduction of prototypes for trial evaluation. Good regular marketing 15

15 CURRENT RISK ASSESSMENT Risk Consequence Likelihood Operational Finance required Moderate: Moderate to long term impact on wider operations Minor: CMC review on a broader basis Likely Unlikely Mitigation Approach Outline possible mitigation approach if known at this stage. communication keeps all informed Regular consultation communication with the Operational Group (OMG), community engagement community governance, working in collaboration to plan, codesign coproduction of prototypes for trial evaluation. Good regular marketing communication keeps all informed manages risk expectations. Program staff supervised operationally for quality practice. PIR Program Team maintains close working relationship with operational field staff. Good governance structures in place: CMC Quarterly meetings, Monthly Operational Group (OMG) Innovation Meetings, regular reporting to Department of Health mitigate risk. Community governance structures under development. Negligible risk Rare PIR Activities funded via: Partner contributions commitment of resources; PIR Innovation funding; Additional resource funding acquisition efforts; PIR Program Resources 16

16 Post Implementation Review Post Implementation Review will be undertaken in against the following assessment criteria: Timeframes met; Key deliverables met as Identified in the Annual Activity Work Plan on page 4; Issues identified during development have been addressed; Processes (simplicity, organisational ownership); Formal authorization; Partner, consumer satisfaction; ADKAR evaluation; Partner participation; Others as developed at time of post-implementation review. 17