Q & A 's

Date	Question	Answer
17/04/2012	What is our vision for our services?	The Board of Directors for the former Norfolk and Waveney trust approved a vision for services in August 2010 and I have recently asked our Radical Pathway Redesign (RPR) clinical leads in Norfolk and Suffolk to refresh that document - I don't expect it to change a great deal. The revised version will go to the Board of Directors in May 2012
17/04/2012	What is the Trust doing to streamline all of the different assessment processes?	Radical Pathway Redesign has re-emphasised the need for a streamlined assessment process and recording of that process. Streamlining these processes will help us to be more efficient - but it is also crucial for our implementation of the national project (IMROC) Implementing Recovery: A new framework for organisational change. The Trust is part of a Mental Health Single Assessment Project Group that includes Norfolk and Suffolk County Councils , commissioners in Norfolk and Suffolk and service users and carers. The aim is to create a single conversation (assessment ) between care coordinator and service user that will produce information required to deliver health and social care to people with mental health problems - Payment by Results (Clustering), CPA, Non CPA, Fair Access to Care, Financial Assessment, Personal Budget. For further information and to get involved - contact Ian Young (Associate Director of Operations)
17/04/2012	How can I get involved in Radical Pathway Redesign?	It is really important that all stakeholders internal and external are able to have their say to help shape the process and contribute their ideas. A series of events have been set up so you can take part and share your thoughts. These events will be your chance to hear what the plans are, contribute to the plans and to ask any questions you may have about RPR. For details of planned events click here. Or if you have a question please email radicalpathwayredesign@nsft.nhs.uk
17/04/2012	Isn't Radical Pathway Redesign just about saving money?	RPR is about providing services that compare with the best nationally both in terms of quality and efficiency. Being efficient means providing the best quality service possible for the funding available. Because of the economic down turn we are facing an estimated 20% drop in funding over the four years from April 2012. This assumes that the number of service users that we see remains the same - so we need to become more efficient at seeing the same number of people and providing higher quality services. We can increase our income (and hence create jobs) by seeing more service users - in the future we will paid for the number of people that we see - that is called 'Payment by Results'.
17/04/2012	Will RPR lead to acute bed closures?	We know that we need to plan for a 20% drop in funding over four years and this assumes that we see the same number of service users. Although only a small number of service users require inpatient admission, our acute assessment beds account for almost half of our costs. It is important to understand that commissioners purchase complete care pathways not beds - so if we spend more on beds we will have less to spend in the community. It is essential that we achieve the right balance between community and acute services. In Norfolk and Waveney, our clinical leads believe that, assuming no change in patient numbers, it could be possible to close about 20% of our beds. They have developed a range of community-based plans which, if put in place, could reduce the need for inpatient beds. The plans include: • A step down/crisis facility as part of the community pathway • Youth Service pilots for people aged 14 to 25 aimed at reducing admission and length of stay - building on the success of the Early Intervention for Psychosis model (these have already started) • A bed management and discharge team with a real-time picture of bed availability and delayed discharge and the ability to make best use of available beds and overcome blocks to discharge • A dedicated team to look at moving people from long-term residential care and creating capacity for short-term step down from the wards • Dementia Intensive Support Teams (DIST) to reduce pressure on dementia assessment beds • A specialist pathway for people with a personality disorder providing 'resource centres' alternatives to admission • Increasing the capacity of the Wellbeing Service so that it can see people with mild to moderate mental health problems - taking the pressure off recovery teams Ultimately, we must take the pressure off recovery teams so that these teams can really focus on social recovery including crisis prevention, in partnership with other agencies. Ultimately, we must take the pressure off recovery teams so that these teams can really focus on social recovery including crisis prevention, in partnership with other agencies. Of course we don't know which of these plans will work to reduce beds - and we will only continue with the initial pilots if they demonstrate the reduction in admission and length of stay. If we can reduce the pressure on beds then we know that we have facilities that need updating - for example in West Norfolk and Central Norfolk and we will take that opportunity to build smaller, modern units. During April and May we will consult with our Localities and Clinical Commissioning Groups - discussing the plans that apply to those areas To get involved sign up to come to The Future of Acute Services day-long event on 11 May at Dunston Hall in Norwich. This event is led by Dr Julian Beezhold, consultant psychiatrist, who with colleagues has been leading the acute care and stepdown pathway in Norfolk and Waveney. It will look at what an acute service should deliver for service users, ensuring discharge at the right time, gatekeeping and alternatives to admission. Click here to book online or contact Dr Julian Beezhold (RPR clinical lead for acute care pathway in Norfolk and Waveney) or Veno Sunghuttee (Chair, Acute Services Forum)
17/04/2012	What is the Trust doing about social recovery and Whole Life approaches?	Whole Life Care (Recovery) and Wellbeing are central to our strategy. The Trust has a national reputation for the former and a rapidly developing one for the latter. These are important markers that set us apart from most competitors and again they set us above competitors who base their offer solely on price. We are part of a national project (IMROC) Implementing Recovery: A new framework for organisational change and members of our IMROC project group are working with our Radical Pathway Redesign clinical leads to ensure recovery is at the heart of every pathway and development. Over the next few months Professor Geoff Shepherd, one of the co-authors of ‘Making Recovery a Reality’ written for the Sainsbury Centre for Mental Health, and his colleagues will work with our IMROC team, RPR clinical leads and partners to support the organisational change required to support our plans. To get involved contact Lyn Skipper (Service Manager, City Locality), Ruth Pillar (Service Manager, North Locality) or Dr Becky Horne (RPR clinical lead and Lead Clinician, City Locality)
17/04/2012	What is happening about RPR in Suffolk?	In Suffolk, the design process is at a much earlier stage than in Norfolk and Waveney and it is too early to provide information about the ideas coming out of the design process. The design process is due to complete at the end of June 2012 and so further information about the new pathways will be available from July. We plan to implement RPR in Suffolk from January 2013. The technical support developed for Norfolk and Waveney has been rolled out to Suffolk and weekly meetings covering human resources, finance, informatics etc are in place. For further information or to get involved: RPR Clinical Leads for Suffolk are Siri Robling (Consultant Clinical Psychologist), Heather Balleny (Consultant Clinical Psychologist), Anna Vizor (Consultant Clinical Psychiatrist), and Viv Peeler (Consultant Clinical Psychiatrist). The Project Manager is Chloe Abbott.
17/04/2012	Does the Trust plan to move away from a Locality structure or merge Localities? .	The Trust is committed to a Locality structure there are no plans to change that. The boundaries of Localities will eventually align with the boundaries of the new Clinical Commissioning Groups (CCGs). CCGs are replacing Primary Care Trusts in deciding what services should be provided, and therefore what services they wish to ‘buy’ from us on behalf of the population. In Norfolk and Waveney we need to wait for the CCG structure to settle before making any adjustments to Locality boundaries. Click here to see current Locality boundaries shown against current CCG boundaries. Our Locality Managers and Lead Clinicians in Norfolk and Waveney have spent the last year building strong relationships with family doctors (GPs) and CCGs and we will now build on this as we consult on our Radical Pathway Redesign plans. In Suffolk, there are two Localities and two CCGs and the structure seems more settled. For further information or to get involved in how we organise and structure the delivery of services contact Kathy Chapman (Director of Operations) or Kate Willis (Locality Operations Manager)
17/04/2012	Is the Trust Alcohol and Drugs Service (TADS) in Norfolk and Waveney included in the RPR Programme?	Yes, and we are at an advanced stage in the redesign process. As well as community support, In Norfolk we are also commissioned to provide six detox beds and these are provided across three acute wards in West Norfolk, Norwich and Yarmouth. One of the ideas from Radical Pathway Redesign is to bring the six beds together in one location to create a single detox unit. For further information or to get involved in design and delivery of Substance Misuse Services contact Ajay Wagle (RPR Clinical Lead), Denise Grimes (Service Manager) or Ian Young (Associate Director of Operations)
17/04/2012	Does the Trust support the idea of non-medical prescribers?	Yes absolutely, non-medical prescribers are one of a number of roles that are being built into the new workforce plans within RPR For further information and to get involved contact Michele Allott (Deputy Director of Nursing) or Beverley Hallpike (Nurse Consultant)
17/04/2012	Will the redesign of services include improved mental health liaison with acute trusts and district general hospitals?	For Norfolk and Waveney, this is looking likely. At the moment the discussions are taking place at Chief Executive level - involving all NHS organisations including the new GP-led Clinical Commissioning Groups. Every organisation needs to agree how the service will be organised and funded. If the discussions are successful the service will be put in place during 2012/13. For further information or to get involved: Our representation in these discussions is provided by Hadrian Ball (Medical Director), Kathy Chapman (Director of Operations) and Pauline Goffin (Associate Director of Operations).
17/04/2012	Will the redesign include the development of Dementia Intensive Support Teams (DIST)?	In Norfolk and Waveney, the design includes extending DIST across all of the Clinical Commissioning Group areas. We are still negotiating the final details with commissioners but the roll-out of DIST should take place during 2012/13. For further information or to get involved contact Neil Ashford (RPR Clinical Lead for dementia pathways in Norfolk and Waveney) or John White (Service Manager)
17/04/2012	How will RPR take account of equality and diversity?	Members of the Trust’s Equality and Diversity Group are working with RPR clinical leads and managers to conduct an Equality Assessment for each of the main RPR Pathways. The Equality Act (2010) requires that we consider equality and diversity issues at an early stage in our design process. For further information or to get involved contact Beverley Hallpike (Nurse Consultant) or Robert Nesbitt (Trust Secretary)
16/03/2012	Are the correct people in the staff engagement meetings?	Yes, however we need to recruit to more members across Norfolk and Waveney, if you would like to be involved please email radicalpathwayredesign@nsft.nhs.uk
16/03/2012	What is the Change Management strategy?	Radical Pathway Redesign is clinically-led. Clinicians lead the design, supported by Direct Cares Service (DCS) operational managers and Corporate Services (Finance and Informatics, Human Resources, Marketing and Communications) to implement the changes.
16/03/2012	Who set the quality and merger goals?	The RPR goals were set by the clinical leads and are available on the Hub. Please refer to the merger PMO office for details on the merger goals.
16/03/2012	What is the process for change?	For every proposed change there is a set process which involves engaging with (commissioners where appropriate), engaging with unions and a formal consultation period with affected staff to ensure staff have an opportunity to influence the proposals. Dependant on the change there may also be the need for public consultation.
16/03/2012	Are the proposals set in stone?	No, every proposal will need to be positioned with commissioners and Unions before it is launched as part of the formal consultation process, (normally 30 -90 days) allowing all impacted staff to have a say on the proposals. Some proposals will also require public consultation. Once this process is complete the final proposal will be released.
16/03/2012	How can I get involved?	email radicalpathwayredesign@nsft.nhs.uk

If you have any more questions please email radicalpathwayredesign@nsft.nhs.uk