Update from Director of Operations, Mental Health, Cardiff and Vale UHB Apr 28, 2020 8:59:00 GMT
Post by Helen on Apr 28, 2020 8:59:00 GMT
Psychology and Psychological Therapies Directorate - The directorate commissioned a team senior pracs to review the evidence base around effective remote therapies which has guided the decision making in terms service models. A focus on supporting GP sustainability
· Primary Care Liaison Services (GP Services) depleted but intact – the team does not now have access to the GP practices for obvious reasons – so they have withdrawn and centralised to a single point of referral at Global Link – the service is via telephone and enhanced with visual digital link if possible through skype etc. They initially saw a reduction in referrals but now as anticipated this is rising again but still within capacity currently.
· Primary Care Mental Health Support Service (PMHSS Part 1MHM) and the Primary Care Counselling Services – again depleted but intact - neither of these services have access to GP practices so now have amalgamated into a single point of referral to ease GP referral confusion. Again saw a reduction in referrals which is now increasing again and may be a significant increase in the weeks to come. The team awaiting national guidance on adaptations to PMHSS to allow direct referrals from the public. All patients on the PCCS waiting list are being RAG rated and prioritised for urgency. There are 100s on this waiting list - Clinically the patients being contacted are worried about the circulating virus in addition to the original referral problem with some being redirected to PMHSS for that reason
· For specialist teams – EDSOTT/SHED (Eating Disorders) merged to deal with highest risk clients, low risk patients to be supported by phone. Emotional Regulation patient groups adjusting better than expected for the time being with psychology assistants supporting this group. Veterans service users are also adjusting well currently with alternative therapy offered. MH Psychology is offering support from psychology trained staff (counsellors and CBT therapists) into the Employee Wellbeing Service for staff as an additional resource for staff support.
Focus on maintaining all services, albeit depleted. All efforts on supporting people for as long as possible within MH to avoid overburdening general hospital services but also maintaining pathways with medicine where required. All service referral points remain open and managing to meet demand currently.
· PINE ward emptied as the only adult MH elective ward for the admission of positively tested patients for covid in HYC. Ward equipped for acute care – training and medical pathways completed to allow MH to provide a level of medical support pre agreed with medicine. Several brief admissions to date but no patient from HYC yet reported positive. We have another HYC cohort area for those patients who are symptomatic but not tested positive on Alder Ward (5 Beds) – this is now equipped and ready for use.
· Changes to CMHTs in progress – emergency referrals to transfer to HYC crisis teams from today – urgent referrals from locality bases at Barry in the Vale, Gabalfa in the North and Links in the South of Cardiff – all remaining cmhts taking routine referrals and managing non-urgent caseload work which has been RAG rated for urgency. Integrated Managers working hard to identify levels of complexity of caseload service users to allow prioritisation of community resources as this situation becomes more challenging. Initially again referrals into CMHTs seen to drop but numbers now returning to normal with surges in emergency and urgent referrals – this is anticipated to continue to rise.
· Specialist teams such Cynnwys /First Episode Psychosis to relocate to cmhts for critical mass and support reasons. Crisis Recovery Unit staff at Monmouth House on the UHW campus have seen a reduction in demand and have been temporarily redeployed elsewhere as a result. All liaison services busy but intact and meeting demand from the general hospital and police. Cynnwys service users being supported and the team is partly helping crisis work.
Mental Health Services For Older Peoples Directorate – Similar to adult services – both trying to meet demand into the cmhts and within the hospital services whilst maintaining a pathway relationship with the hospital site arrangements
· East 10 and 12 are the covid cohorting wards – east 10 was emptied 10 days ago to allow time to prepare the ward with equipment and training. The ward was emptied by increasing bed numbers on other wards to allow staff cover. These wards are amalgamated into one for staffing and leadership purposes. Again the ward can support patients to a level of medical complexity pre-agreed with medicine.
· Community services such as the CMHT, Crisis Team (REACT) and care home liaison are all intact but flexibly working across each-others responsibilities where required as services become depleted and recover etc.
· MHSOP Liaison continues to work into DGH wards fully to support the care of people with confusion/dementia where required. High demand on this service currently who are organising themselves to reduce virus spread.
Mental Health Act
· All rights under the mental health act being delivered – coronavirus bill being reviewed for impact
· Restraint of patients presenting significant challenges – bespoke equipment solutions being considered in MH to protect staff and patients