This page provides details of some of the work we have undertaken to improve services, taking into account what local people have told us.
Some of this activity is specific to the Darlington and Teesside area and local people. Some work may have been undertaken jointly with other Clinical Commissioning Groups in the region as we work together to look at ways to learn from patient experience and use this to improve the services for the future.
Single Point of Access Multi-Disciplinary Team in Middlesbrough and Redcar and Cleveland
What local people told us
Care home residents and patients often have to repeat their story or share their medical history with multiple organisations. They find this frustrating and also tiring at a time when they are unwell.
What we did
We implemented a ‘single point of access’ multi-disciplinary team for health and social care professionals so that they can refer any patients who need an urgent assessment, non-urgent nursing or therapy services.
This brings together a team of professionals including community nurses; mental health services health; social care services and community therapies.
This way of working will ensure patients get the right services in a timely manner without health and social care professionals having to navigate a number of different referral processes. A skilled and experienced team of clinical professionals can then assess people and refer them to the relevant services. These services can then enable people to remain in their own home with the additional support that they need.
Review of community skin services in Teesside including referral management for dermatology and plastic surgery
What local people told us
Patient feedback from surveys told us most people were happy with the waiting time between referral and their appointment. They were also happy with the quality of care that they received and would recommend the services to others. We wanted to ensure we maintain these positive experiences
What we did
In reviewing the services we identified that there was a lack of real patient choice in terms of who would provide the skin service they needed. We also found that patients were not always accessing the right service for them first time. There was also a lack of understanding by some professionals of how to refer people into the different services.
We revised the referral form for skin services and agreed clear criteria for what should and should not be referred for each service to help professionals when making a referral. We established a Clinical Assessment Service (CAS) to centralise receipt and triage of referrals for dermatology and plastic surgery services. We also set up a ‘see and treat’ dermatology service for people needing to be seen urgently, within two weeks.
Patients now have more choice in who provides their treatment and can be referred to the right provider of services first time. Local GPs have received training in identifying, treating and managing the top 30 skin conditions, and they have been provided with access to desk-top guidance which is more beneficial to patients. Fewer unnecessary lesion removal procedures are also taking place.
Improving the Physical Health of People with Mental Illness
What local people told us
Work has continued to improve the physical health of local people with a mental illness or learning disability, following engagement with service users and carers at an event in January 2020.
What we did
Engagement at the event led to priorities and actions being identified which have been carried through into the ICS Priority Group 3 – Parity of Esteem. These high-level priorities were defined as:
- Health Checks for people with mental health issues / primary care interface
- Addressing post-Covid-19 impact and potential increased mental and physical health comorbidity
- Embed ‘Making Every Contact Count (MECC)’
- Access to National Screening Programmes
- Reduce variation (learning from the best CCGs)
- Reasonable adjustments in Acute Hospitals’ access points
- Workforce training and education
- Information Sharing
- Social movement/Communication
Throughout the year, the CCG has continued with monitoring of achievement of SMI and Learning Disability Health checks as well as learning from high achieving areas across the country to share and disseminate examples of good practice. The CCG has also ensured that it is embedded in the development of the Royal College of Public Health’s national MECC for Mental Health programme.
Tees Valley remains one of the highest achieving CCG areas in the North East region, which continues to be the highest performing region, nationally, for the delivery of severe mental illness (SMI) Health Checks. The CCG has also invested further in supporting Primary Care Social Prescribing Link workers in increasing access to health checks going in to 2021/22. This work has helped to remove barriers to accessing health checks and promoting good practice for making reasonable adjustments to facilitate health checks.
Roll-out of Mental Health Support Teams in Schools
What local people told us
A task group with Local Authority representatives has been formed from engagement with children and young people and parents. The task group was formed to design workshops and engagement materials which will help to inform an upcoming Trailblazer bid, which is scheduled for Spring 2021. It will also inform the wider child and adolescent mental health services (CAMHS) transformation model development work.
What we did
An identified priority from this work is the roll-out of Mental Health Support Teams in schools. Consultation with children and young people and their parents identified that waits for treatment and support can be too long, schools need support to meet their pupils’ emotional wellbeing needs, young people like to have a choice in support delivery (such as virtual, face-to-face, in-school support and community-based support), group work can be beneficial in reducing stigma and that families are sometimes unsure of where to get support.
The CCG utilised this feedback to develop work and plans with commissioning and provider networks. A Covid-19 recovery offer was developed and delivered for schools that re-opened in September 2020. Children and Young People IAPT Providers ad CAMHS are now co-ordinating on a whole-system approach and developing a single point of contact.
This work has led to increased choice for patients, better experiences, and a more efficient mental health system to meet the needs of the population.
Needs-led Neurodevelopmental Pathway – Hartlepool and Stockton-on-Tees
A needs-led neurodevelopmental pathway was launched in Hartlepool and Stockton-on-Tees in September 2020, following consultation with parent carers.
What people told us
The journey began with parent carers giving feedback on the old Autism diagnostic pathway. There was much criticism over the long waits, lack of support whilst they were waiting and an uncoordinated system between health, social care, and education.
What we did
Work began with the Parent Carer Forums and the Local Authorities from Stockton and Hartlepool to look at how we could move to a pathway which supported the needs of children regardless of whether they had a diagnosis. We worked with the forums to develop a service specification for a Family Support Service to support and upskill families.
We also built a Neurodevelopmental webpage which was developed with the Parent Carers.
Changes to the diagnostic process, including the introduction of a referral form, were discussed with Parent Carer Forums, and adjusted accordingly based on their feedback. Ongoing dialogue is in place between Tees, Esk & Wear Valleys NHS Foundation Trust (service provider), the CCG and the Parent Carer Forums to ensure the tone of all letters, communications and statements are appropriate.
Initial feedback has been positive and building on the learning in Hartlepool and Stockton, the needs led pathway was implemented in Darlington for the over 5’s in April 2021 and there are plans to develop similar models in Middlesbrough and Redcar and Cleveland from September 2021. Continuous engagement with parents and carers is taking place to ensure satisfaction with the offer provided.