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In the community for the community
Better mental health care for Barnet, Camden, Enfield, Haringey and Islington
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How lived experience is helping recovery in a pioneering pilot project
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People who have experience of mental health conditions are helping others on their journey to recovery, by accompanying them to appointments and offering support and reassurance.
In a pioneering pilot scheme, volunteer Peer Buddies have been recruited for the Hand-in-Hand project in Islington and have been given training in all aspects of peer support.
Each volunteer has committed to offer at least one day a week to helping service users who need support attending appointments, services, activities, green spaces and events.
They remind service users about where and when the appointments are, and accompany them, helping plan travel routes, offering reassurance about what they should expect on arrival and signposting people to other sources of community support
The lived experience of people with mental health conditions and recovery is an important resource that we are using to shape and inform our changes to mental health community services. Experts by Experience, Peer Support Workers and volunteers across North Central London are helping us understand the needs of service users and support them during recovery.
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Camden and Islington NHS Foundation Trust (C&I) is running the pilot scheme in partnership with Manor Garden’s Welfare Trust, Islington MIND, Islington Council, The SidebySide Network, Islington Borough Users Group and the Nubian Users Forum.
Cerdic Hall, Manager of the Choice and Control Peer Coaching Service at C&I, said: “One of the big problems for people with mental health conditions is actually getting to appointments, for many reasons. It could be because the nature of their condition means they feel overwhelmed, anxious or disorganised around getting to places.
“Peer Buddies will help them to get to appointments so that they get the help and connection they need. A lot of the volunteers do it because it is a good way of giving back and helping others. It also means that they get valuable training and experience, which could lead them into other roles in future.”
The Hand in Hand pilot is now running across Islington and if successful, will be extended to other areas.
To find out more, or if you think the Hand in Hand project could help you please contact: Stephen@manorgardenscentre.org
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The Experts by Experience helping to shape our services
People who have lived experience of mental health conditions and services are helping us to shape the changes we are making to community mental health services. Here, Jaime Buckingham, Interim Head of Service User Experience Engagement and Involvement at Barnet, Enfield and Haringey NHS Mental Health Trust (BEH) explains what the team are doing to develop this important area.
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The past few months have been really exciting as we have been developing our team and our strategies for increasing the involvement of people with lived experience. We have employed four Expert by Experience (EbE) coordinators to support us in driving forward our engagement and involvement work to increase the number of service users and carers on our register. We will be recruiting more EbE Coordinators to further support this work..
Our EbEs are coproducing their career pathways and we have introduced a system to capture their aspirations, their strengths and areas where they want to develop further. This information is helping to identify training and development opportunities, which may include shadowing or matching EbEs to roles that enable the individual to be involved in work across the organisation in a meaningful way.
Our EbEs attend meetings, committees, chair service user and carer forums, sit on interview panels and more. An EbE may develop to become a peer support worker or may wish to work in other services such as finance, nursing or governance or management, bringing important lived experience to all areas of our NHS workforce. Our ambition is to remove barriers so that EbEs can pursue their career aspirations without limits.
BEH is also working with Camden and Islington NHS Foundation to define and strengthen our peer support workforce, to ensure they become equal members of the multidisciplinary team. Developing this revolutionary role as a discipline in its own right will enable us to truly deliver person-centred care and break the stigma surrounding mental health.
We are working with the divisions, our Peer Support Workers and with our EbEs to strengthen BEH's Service User Forums. This includes training our EbEs to chair meetings and making sure we act on feedback and share the actions we have taken.
Peers and EbEs will also be offered training to strengthen their engagement and involvement in all Trust activities to enable coproduction to be at the heart of everything we do, including how we hear and respond to feedback effectively and compassionately.
Our team will re-brand and re-launch as the: “Your Experience Team” with the slogan: “Empowering, Engaging and Involving, driving change through Listening, Learning and Coproducing”. We want to get the voice of service users and carers heard and to showcase their contribution.
I joined the NHS because of my own service user and carer experience in both acute and mental health services, I have felt very grateful and privileged to be a part of such an amazing journey. This includes working with my small yet very passionate team and everyone I work with at every level of the organisation.
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Transformation in your community
Our Community Mental Health Transformation programme is nearing the end of its first year – a time to take stock and celebrate our achievements so far.
The programme is creating hundreds of new roles and changing the way we deliver care so that those with mental health conditions can be given help to resolve related issues such as problems with benefits, accommodation or physical health. Another key feature is that people are seen in their communities and given help to access local organisations and support networks.
The three-year, £25m transformation programme, across Barnet, Camden, Enfield, Haringey and Islington, began in the summer of 2021 and much of the early work involved building strong foundations for services. In recent months our service users have seen changes in their areas, including new members of staff.
Among those recruited are new community outreach specialists, occupational therapists, peer coaches, psychologists, psychiatrists, specialist nurses, as well as other new innovative roles. There will be capacity to help thousands more people across North Central London.
Below is a short summary outlining some of the work being done in each borough to achieve these aims.
Barnet - Clinical Project Lead, Angela Sobers
Mental health specialists have now started working within GP practices; providing holistic care close to where people live, with a focus on preventing people from developing mental health conditions, and early intervention to help them recover.
These Advanced Clinical Practitioners and Mental Health Practitioners play an important role in providing support, advice, knowledge and clinical time with GPs and patients in a primary care setting.
We have also recruited new Voluntary Care Sector staff, who are working with our core community teams helping to expand what we can offer to the community, enriching the multidisciplinary team by bringing new skills and specialist knowledge. They will support clients who are isolated and help them to connect with their communities. They will also support clients to continue their recovery in the community after time in hospital.
We have appointed a consultant psychiatrist who will start with the Linkworking and Wellbeing team in April. He will be supporting the teams and our Primary Care Networks with developing community services. We are introducing the new care planning tool DIALOG+, first to the Barnet North Core Community Team and then to the other community teams.
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,Camden - Project Manager, Charlene Nyanhemwa
Within the next few weeks we will start recruiting to new roles for the remaining Primary Care Networks in Camden this includes the new key worker roles who will be the point of contact for all stages of the client’s assessment and their care and support journey. Essentially they are the person who guides clients through the system and follows up with other professionals where necessary. In some cases they will coproduce the care plan in collaboration with other professionals involved in the service users’ care.
These roles will help the teams offer holistic care; service users will be given help to sort out issues related to their mental health, such as employment, benefits or housing. They will also be supported in accessing organisations within the community that can help them connect socially.
A Co-Location Learning Partner has been embedded within the core team; working for the charity Fulfilling Lives in Camden (FLIC), they will help us better understand how we can support service users who are experiencing multiple disadvantages. We held a workshop looking at this issue at the end of March; two more workshops are planned and, later in the year, they will publish a report with recommendations on how our services could adapt to meet the challenges of these often-complex cases.
We have been reviewing how we work alongside Voluntary Community Sector organisations and other stakeholders and are building in our learning as we plan the next two years of the programme, this includes expanding the employment support offer, embedding welfare rights workers within the core teams and further scoping of the community development worker role.
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Enfield - Clinical Project Lead, Sade Olutola
We have set up new Adult Core Community Mental Health teams aligned to GP Primary Care Networks, and allocated each case to a health care practitioner. We have been transferring cases in teams so that people can be seen closer to where they live.
Together with the local authority, and other significant stakeholders including the community voluntary sector and the service users’ group, we have produced a new model and structure for services to ensure easy access to mental health care and agreed new procedures and standards.
We have recruited additional staff and we are developing closer relationships with voluntary community services. Ten of the new recruits in the division are staff from the mental health charity MIND, who have been integrated into the core community mental health team.
We are piloting the new care planning tool DIALOG+ and a new online supervision tool called MaST that will help clinicians spot service users who are at risk of crisis.
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Haringey - Clinical Project Lead, John Londy
The new team of Mental Health Practitioners Team is up and running, based in GP practices, and is piloting the new care planning tool, DIALOG+.
We have set up new Core Community Mental Health teams aligned to GP Primary Care Networks; this includes the Intensive Complex Emotional Needs Service, and the specialist pathways of Personality Disorder (PD), Post Traumatic Stress Disorders (PTSD), and Mood and Personality disorders (MAPs).
We have circulated a new Standard Operating Procedure for the core teams, asking staff, service users and other stakeholders for feedback. This document will evolve as we engage with service users, changing to reflect practice and to help new staff and organisations understand how the core teams operate and work with other services such as GPs and specialist pathways.
Voluntary Community Sector workers have been recruited by Hestia, and have started working with clients within the pioneering East Core Community Mental Health Team and the Personality Disorder Pathway.
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Islington
We have agreed on a new recruitment plan for the expansion of our core teams during the next year, this includes voluntary sector and peer coaching roles. The teams will give wraparound support so that people with mental health conditions are given help to resolve problems with accommodation, benefits, employment or loneliness.
We are relaunching the Primrose A offer to GP practices within the borough to support those with a long term physical health condition getting annual health checks. Primrose A is a large scale study, led by researchers at University College London, aimed at addressing the higher risk of cardiovascular disease among people with severe mental health problems.
We are piloting a new process for the core teams to speed up screening and triage of referrals. This means that people with greatest need of urgent help will be seen quickly. If the trial is successful it will be expanded as we rollout the core teams in other Primary Care Networks.
Feedback is being collected from GPs and service users about their experiences of accessing the different core team services, such as peer coaching, social prescribing and support from Mental Health Practitioners, as well as psychological, clinical, population health or social care interventions. This information will be fed back to the Islington Core Team Delivery Group and used to support improvements in our referrals process.
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Find out more about the new care planning tool DIALOG+ being introduced across North Central London on the BEH website here or on the C&I website here.
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We are working alongside community partners to transform community mental health services. These agencies include Voluntary Community Sector organisations, local authorities, stakeholders and others.
Here, Philippa Russell, explains her work as Mental Health Partnerships Co-ordinator working with the Islington Mental Health Core Team and Healthwatch Islington.
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I joined the transformation programme at the beginning of the year, to improve links between the Islington Core Team and voluntary and community organisations in the borough. My first task was to meet the Core Team, to learn how it works, what makes it different, and what kind of support is provided by attending Multi-Disciplinary Team (MDT) meetings and other related services.
Following that, I have been meeting with many of our community organisations to let them know more about the Core Team, as well as explain my role and offer health checks from the Population Health Nurses. This programme will enable residents with mental health issues, family carers and other vulnerable people to access a health check in their community environment where they feel familiar and safe.
I have produced an online signposting tool, for our teams to learn about some of the key community support available in Islington, detailing referral pathways. This is a live tool, which I update regularly.
By talking to colleagues and voluntary groups, I am finding out more about the great resources and care available in Islington to link in people according to their needs, with an emphasis on the holistic needs of residents, where physical and mental wellbeing is interdependent. I am working with colleagues to consider some partnership plans between statutory and community care.
I have worked in the voluntary sector for two decades, and in Islington for the last 6 years with Centre 404 (an organisation supporting carers of people with learning disabilities and autism) and with Healthwatch Islington as Community Link Worker since 2019.
Healthwatch Islington is the independent champion for people who use health and social care services in Islington, listening to the experiences and concerns of people who use them and to speak out on their behalf. Healthwatch Islington is committed to reducing inequality and hearing the voice of the diverse population in Islington, particularly through the Diverse Communities Health Voice partnership, working with diverse groups in Islington.
If you want to know more or have any queries or suggestions, you are very welcome to contact me: Philippa.Russell@candi.nhs.uk
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Published by
Barnet, Enfield and Haringey Mental Health NHS Trust
St Ann's Hospital, St Ann's Road, London N15 3TH
Email: beh-tr.communications@nhs.net
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