Tag: Mental Health

SMI & Physical Health Webinar

Photo from Umit Bulut
Running on Thursday 17 February, from 13.00 - 14.30

Since last summer, BNSSG-based GP practices have provided physical health checks to an increasing number of patients on the serious mental illness (SMI) register, up from 11% to 31%. This represents very positive progress, but there’s still some way to go to reach (and exceed) the 60% national target.

This informative webinar is open to all primary care staff, and it is hoped all practices will send a representative — whether it be a GP, practice manager, GPN, etc. Attendees will be able to take useful ideas back to their practices, to continue and further embed physical health checks for SMI patients.

This event’s aims are as follows:

  • Better understand the health inequality and put the physical health checks into the context of of health improvement
  • Give participants a range of information about SMI physical health improvement and ideas to take away for use in their own practices
  • Hear from a GP practice about their success in providing physical health checks and health improvement interventions
  • Hear the patient’s view and from the peer support pilot project
  • Understand the importance of drawing cancer screening into the physical health check
  • Share good practice in the practical management and administration of physical health checks, the engagement of patients and use of EMIS

Alison Bolam (Mental Health Clinical Lead, BNSSG CCG) will be chairing this webinar, and there will be a chance to share your questions with the speakers.

To register your interest in joining, please click the button below to access the sign-up form.

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          Mental Health Support Workers

          Questions?

          If you have any questions relating to mental health support workers, please send your queries to [email protected]

          Mental Health Support Workers

          "Working with other PCN-based roles, MHPs can address the potential range of biopsychosocial needs of patients with mental health problems, as part of a multi-disciplinary team."

          Source: NHS Confederation's recruiting mental health practitioners through ARRS guide

          previous arrowprevious arrow
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          Slider

          What are they?

          What benefits can they bring?

          What is their scope of practice?

          Is funding available for them?

          Any case studies?

          What characteristics, training / qualifications, and competencies should they have?

          Are there any requirements to receive ARRS funding?

          Any example job descriptions?

          Any sample interview questions?

          What employment models are there?

          What clinical supervision do they need?

          What are mental health support workers?

          Mental health support workers (MHSWs) are healthcare practitioners trained to support patients (both adults and children) with their mental health, as fully-embedded members of the PCN multidisciplinary team (MDT).

          MHSWs work in a ‘first contact’ role, typically seeing patients referred to them by their GP colleagues. Specifically, MHSWs work with patients to support shared decision making about self-management, enable access to treatment services, and – where appropriate – conduct brief psychological interventions. As part of their role, MHSWs work closely with other members of the MDT to address a range of biopsychosocial needs.

          While MHSWs are deployed by the PCN, and operate as part of their workforce, they should be employed and provided by the local community mental health service provider. A local service agreement will confirm this arrangement.

          This role can be undertaken by any registered clinician working at Band 5 or above, such as:

          • Community psychiatric nurses
          • Clinical psychologists
          • Mental health occupational therapists

          This should be agreed between the PCN and community mental health service provider.

          For more information:

          Network Contract DES contract specification 2021 / 22

          Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

          To read it, please click here.

          NHS Confederation's MHSW guide

          Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

          To read it, please click here.

          What can a Mental Health Support Worker do?

          The Specialist Mental Health Practitioner role will help people over 18 years old, who are accessing support through primary care, to define achievable goals and access local community resources.  Areas of focus will include:

          • Those with mental health needs that do not meet the access criteria for IAPT (Improving Access to Psychological Therapies provided through Vita Health) and do not meet the access criteria for secondary care.
          • People with serious or significant mental illness (SMI) who are supported within recovery services and relatively stable in secondary care mental health services, who could be cared for within primary care.
          • Those diagnosed with, or presenting with traits of, personality disorder who will benefit from being signposted to services who can best meet their needs
          • Younger adults with SMI (17-25years) particularly those transitioning between children’s and adult services
          • Older adults with complex presenting issues
          • First contact with primary care

          MH Job description Outline Doc

          The above information was sourced from the following:

           

          Band 6 Mental Health Practitioner (ARRS BNSSG) AGREED 04.08.21

          What is their scope of practice?

          While the exact scope of the role and job description should be agreed between the mental health support worker and their PCN, broadly speaking, the role is qualified to:

          • Engage in shared decision making and support patients to make decisions about self-management
          • Support patients in accessing treatment services
          • Provide brief evidence-based psychological interventions for patients ineligible for IAPT, where such interventions can be safely offered outside of a multidisciplinary mental health team
          • Work closely with other PCN-based roles to address wider patient needs (e.g., PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support)
          • Operate without the need for formal referral from GPs (including accepting direct bookings where appropriate, subject to agreement on volume and booking mechanism between the practitioner and PCN)
          • Fulfil a consultation, advice, triage, and liaison function, backed by the local community mental health provider through robust clinical governance structures, maintaining quality and safety standards

          As stated above, this should not be considered an exhaustive list.

          For more information on the scope of practice of this profession, please consult AWP’s job description below:

          AWP's Job Description

          Provided by AWP, this job description offers a role summary, lists the role’s duties, and provides a template person specification.

          To read it, please click here.

          What are the benefits of a mental health support worker?

          Mental health support workers can bring a wide range of benefits to both their PCN and patients, as follows (sourced from NHS Confederation):

          • Benefits for PCNs:
            • No formal referral processes required
            • Practitioner works as part of the PCN MDT
            • Provides a bridge between primary care and specialist mental health providers
            • Can draw on a range of provider mental health services
            • Reduces employment burden
            • Improved integration between primary care and mental health
          • Benefits for patients:
            • Integrated pathway for patients
            • Access to specialist mental health support services
            • Reduced waiting times
            • Prevention of referral into secondary care
            • Positive patient experience

          For more information:

          NHS Confederation's MHSW guide

          Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

          To read it, please click here.

          Is funding available for them?

          From April 2021 onward, mental health support workers can be employed through the Additional Roles Reimbursement Scheme (ARRS). 50% of the funding will be provided by the local provider of community mental health services, and 50% by the PCN itself (this amount can be reimbursed through the ARRS, however).

          The maximum reimbursable amount is still to be decided, however. We hope to have more information over the coming months.

          For more information:

          BMA's Supporting General Practices in 2021 / 22 update

          Hosted by the British Medical Association (BMA), this document from January 2021 provides an update on expansions to the Additional Roles Reimbursement Scheme (ARRS), including the provision of mental health support workers.

          To read it, please click here.

          What characteristics, training / qualifications, and competencies should they have?

          Please find information on what you should look out for when employing a mental health support worker below:

          Personal Characteristics

          The Avon and Wiltshire Mental Health Partnership (AWP) suggests that mental health practitioners should have the following personal characteristics:

          • Ability to diplomatically challenge inaccurate assumptions and perceptions
          • Comprehensive experience in educating and training the mainstream workforce, particularly non-specialist mental health workers
          • Effective active listening skills, enabling the reframing and testing of understanding
          • Effective verbal communication skills, which can be put to use with people at all levels (even when an assertive approach is needed)
          • Effective written communication skills, with experience of compiling and sorting notes and reports, establishing statistical data, and analysing information
          • In-depth working knowledge of secondary specialist mental health services, the wider health and social care community, and the third sector
          • Possesses a detailed understanding of the relevant legal frameworks / legislation, including CPA process, the Mental Health Act, the Mental Capacity Act, and safeguarding
          • Substantial experience in assessing risk and producing risk management strategies
          • Well-versed with Microsoft Office, and willing to embrace new technology and processes
          • Well-versed with national drivers and policies, and with legislation affecting patients and service users

          Please note: this information is drawn from AWP’s job description for a Band 6 mental health practitioner — it should, therefore, not be considered an exhaustive list, for all situations.

          Training and Qualifications

          The Avon and Wiltshire Mental Health Partnership (AWP) suggests that mental health practitioners should have the following training and educational qualifications:

          • A professional qualification in mental health, equivalent to a registered RMN (mental health nurse), registered social worker, or registered therapist.
          • In-depth working knowledge of secondary specialist mental health services and the wider health and social care community, as well as the third sector.
          • Comprehensive experience in educating and training the mainstream workforce, particularly non-specialist mental health workers.
          • Substantial experience with assessing risk and producing risk management strategies.
          • Current registration with a professional body, and a commitment to CPD
          Competencies

          This is an emerging role — we hope to have more information here in due course.

          Are there any requirements to receive ARRS funding?

          As noted under ‘Is funding available for them?‘, mental health support workers (MHSWs) can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that MHSWs must adhere to.

          For instance, as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:

          • B14.2. Where a PCN engages one or more Mental Health Practitioners under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Mental Health Practitioner has the following key responsibilities, in delivering health services:
            • provide a combined consultation, advice, triage and liaison function, supported by the local community mental health provider;
            • work with patients to:
              i. support shared decision-making about self-management;
              ii. facilitate onward access to treatment services; and
              iii. provide brief psychological interventions, where qualified to do so and
              where appropriate;
            • work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. This will include the PCN’s MDT, including, for example, PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support; and
            • may operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider.

          For more information:

          Network Contract DES contract specification 2021 / 22

          Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

          To read it, please click here.

          Any example job descriptions?

          Avon and Wiltshire Mental Health Partnership (AWP) have a job description appropriate to this role, featuring a role summary and description of its duties, in addition to an example person specification.

          For more information:

          AWP's Job Description

          Provided by AWP, this job description offers a role summary, lists the role’s duties, and provides a template person specification.

          To read it, please click here.

          Any case studies?

          Pulse Intelligence can provide a case study on the impact of implementing a mental health support worker (MHSW), written by Dr. Sophie Kilmartin in 2019 and relating to a practice based in South Gloucestershire. Please consult the full case study below, but the summary reads as follows:

          “Our mental health practitioner is a key member of our clinical team. She provides an important service to our patients and we plan to carry on the role in the future. It is easy to forget how much she has eased our workload, but we get a glimpse of that when she is on annual leave and the clinics go back to how they used to be.”

          Source:

          Pulse Intelligence MHSW case study

          Published by Pulse Intelligence, this case study was written by Dr. Sophie Kilmartin in 2019 and relates to the implementation of a mental health support worker (MHSW) in a practice in South Gloucestershire.

          To read it, please click here.

          Any sample interview questions?

          Below is a set of sample interview questions:

          • “What are you able to bring to this post?”
          • “Can you recall a stressful experience you’ve had in the workplace — how did you resolve it?”
          • “What are your strengths and weaknesses?”
          • “How would you assess a patient’s needs?”
          • “How would you monitor a patient’s well-being?”
          • “How would you develop a patient’s treatment plan?”
          • “How do you go about defining professional boundaries between yourself and patients, and how do you maintain them?”
          • “How do you minimise risks to your clients and to yourself?”
          What employment models are there?

          As of April 2021mental health support workers (MHSWs) are included in the additional roles reimbursement scheme (ARRS), owing to a wider transformation of community mental health services for adults and older adults that seeks to bridge the gap between primary and secondary mental health care / physical and mental health services. The full list of measures included in this transformation can be found in the source document below.

          But against this backdrop, all PCNs are now entitled to a fully-embedded mental health support worker, employed and provided by the local community mental health service provider. The PCN will be responsible for 50% of the MHSW’s salary and of other costs associated with the role, while the remaining costs are paid for by the community mental health provider. The PCN contribution will be reimbursable via the ARRS, however, up to the maximum reimbursable amount associated with the banding of this role.

          This model provides the following benefits for PCNs:

          • PCNs need only fund 50% of the role, while getting the full capacity benefit
          • PCNs do not need to manage the recruitment process, the community mental health service provider does; as such, the MHSW can be deployed more swiftly
          • The role itself if flexible and can be developed based on local needs and circumstances
          • The role will be embedded within the PCN as a shared resource, working across both the PCN core team and their local mental health provider so as to support access to a wider range of community mental health services. This is intended to eliminate current barriers to accessing services and support a genuinely integrated approach across the system.

          For more information:

          Innovative Employment Models for PCNs

          Provided by NHSE / I, this document outlines the different employment models open to primary care networks (PCNs), including for mental health support workers (MHSWs).

          To read it, please click here.

          What clinical supervision do they need?

          There is not yet any detailed guidance on or requirements for clinical supervision for mental health support workers (MHSWs).

          But as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:

          • B14.3. A PCN must ensure that the postholder is supported through the local
            community mental health services provider by robust clinical governance
            structures to maintain quality and safety, including supervision where
            appropriate.”

          Please stand by until more information becomes available.

          Source:

          Network Contract DES contract specification 2021 / 22

          Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

          To read it, please click here.

          What ongoing support is available for MHSWs?

          Currently, mental health support workers (MHSWs) can receive ongoing support from: ???

          Finance & DES-supported roles

          Overview of the role

          • AfC TBC 2021/22
          • TBC 2021/22

          Mental Health Practitioners – including Improving Access to Psychological Therapy (IAPT) – to be included in the scheme from April 2021 – Awaiting further advice and guidance.

          E-learning for health link

          The above info on financing of the MHSW role can be found on the e-learning for health website:

          https://www.e-lfh.org.uk/programmes/new-roles-in-primary-care/

          The DES Role Descriptors

          The following information concerns the DES role requirements for Mental Health Support Workers, and full details can be found in the Network Contract DES link below.

           

          B.14. Mental Health Practitioners
          B14.1. The mental health practitioner role may be undertaken by any registered
          clinical role operating at Agenda for Change Band 5 or above including, but
          not limited to, a Community Psychiatric Nurse, Clinical Psychologist, Mental
          Health Occupational Therapist or other clinical registered role, as agreed
          between the PCN and community mental health service provider.

          B14.2. Where a PCN engages one or more Mental Health Practitioners under the
          Additional Roles Reimbursement Scheme, the PCN must ensure that each
          Mental Health Practitioner has the following key responsibilities, in delivering
          health services:
          a. provide a combined consultation, advice, triage and liaison function,
          supported by the local community mental health provider;
          b. work with patients to:
          i. support shared decision-making about self-management;
          ii. facilitate onward access to treatment services; and
          iii. provide brief psychological interventions, where qualified to do so and
          where appropriate;
          c. work closely with other PCN-based roles to help address the potential
          range of biopsychosocial needs of patients with mental health problems.
          This will include the PCN’s MDT, including, for example, PCN clinical
          pharmacists for medication reviews, and social prescribing link workers for
          access to community-based support; and
          d. may operate without the need for formal referral from GPs, including
          accepting some direct bookings where appropriate, subject to agreement
          on volumes and the mechanism of booking between the PCN and the
          provider.
          B14.3. A PCN must ensure that the postholder is supported through the local
          community mental health services provider by robust clinical governance
          structures to maintain quality and safety, including supervision where
          appropriate

          Network Contract DES document

          More can be read on the MHSW role des on page 93 of the following document:

          B0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

          Literature
          AWP's Job Description

          Provided by AWP, this job description offers a role summary, lists the role’s duties, and provides a template person specification.

          To read it, please click here.

          BMA's Supporting General Practices in 2021 / 22 update

          Hosted by the British Medical Association (BMA), this document from January 2021 provides an update on expansions to the Additional Roles Reimbursement Scheme (ARRS), including the provision of mental health support workers.

          To read it, please click here.

          Innovative Employment Models for PCNs

          Provided by NHSE / I, this document outlines the different employment models open to primary care networks (PCNs), including for mental health support workers (MHSWs).

          To read it, please click here.

          Network Contract DES contract specification 2021 / 22

          Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

          To read it, please click here.

          NHS Confederation's MHSW guide

          Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

          To read it, please click here.

          Pulse Intelligence MHSW case study

          Published by Pulse Intelligence, this case study was written by Dr. Sophie Kilmartin in 2019 and relates to the implementation of a mental health support worker (MHSW) in a practice in South Gloucestershire.

          To read it, please click here.

          A / V resources

          There is nothing here yet. Please check back later.

          INTERACT study

          Photo by Tim Mossholder
          A new way of delivering CBT
          For patients with depression

          The University of Bristol’s Centre for Academic Primary Care and Centre for Academic Mental Health are developing a new way to deliver cognitive behavioural therapy (CBT) for patients with depression, called INTERACT, which blends high-intensity therapy with new applications for technology.

          A trial programme for it will begin recruiting patients in the next few weeks, with the goal being to recruit over 400 in the next two years, from GP practices in Bristol, London, and York. GPs can refer patients, with potential participants being identified during consultations or from patient records. Participants will randomly receive either usual care or usual care plus the INTERACT CBT intervention.

          Participants receiving the intervention will be offered nine sessions of therapy; the first will be delivered face-to-face or by video call, and subsequent sessions will be delivered using instant messaging. Participants will also be able to access the study website and CBT materials at any time, as working outside the therapeutic session is an important ingredient in the effectiveness of CBT.

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