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Update on Update on
standards for ICPs standards for ICPs
for mental healthfor mental health
Name
Summary of FeedbackSummary of Feedback
IT systems & extra resources needed
Too medical
Difficult to read / navigate through document
Dividing into 5 ICPs not helpful
Concern over being too prescriptive on outcome tools
What about when diagnosis takes a long time
Response to FeedbackResponse to Feedback
A more generic approach taken
Removed duplication and inconsistencies
Removed requirement for specific outcome measures
Acknowledged that resources are needed
Removed some medical jargon
Initial FocusInitial Focus
A gradual implementation of ICPs is recommended
Initial focus on secondary care mental health services (except for depression)
A small number of variance points
In the longer term, ICP care to be expanded to whole journey of care (NHS and partner agencies)
ICP StandardsICP Standards
Process standards (how ICPs are developed)
generic condition specific
Care standards (content of ICPs)
Service standards (how ICPs are implemented)
Generic ICP StandardsGeneric ICP StandardsProcess standards Care standards Service standards
1. named leads 10. integrated assessment38. reviewing & acting on variances
2. stakeholder involvement 11. risk assessment39. staff and service user feedback
3. process mapping 12. risk assessment for women
4. links to care governance 13. physical health check
5. training needs assessment 14. recording diagnosis
6. diagnostic information 15. suitability for psychological therapies
7. recording & sharing of information 16. person centred care
8. recording & analysing variances 17. single care plan
9. referral systems 18. medication decisions
19. treatment of substance misuse
20. admission & discharge
21. needs assessment & outcome tool
Process StandardsProcess Standards
1. named leads
2. stakeholder involvement
3. process mapping
4. links to care governance
5. training needs assessment
6. diagnostic information
7. recording & sharing of information
8. recording & analysing variances
9. referral systems
Generic ICP Care StandardsGeneric ICP Care StandardsGeneric:
10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
Service StandardsService Standards
38. reviewing & acting on variances
39. staff and service user feedback
Generic ICP StandardsGeneric ICP StandardsProcess standards Care standards Service standards
1. named leads 10. integrated assessment38. reviewing & acting on variances
2. stakeholder involvement 11. risk assessment39. staff and service user feedback
3. process mapping 12. risk assessment for women
4. links to care governance 13. physical health check
5. training needs assessment 14. recording diagnosis
6. diagnostic information 15. suitability for psychological therapies
7. recording & sharing of information 16. person centred care
8. recording & analysing variances 17. single care plan
9. referral systems 18. medication decisions
19. treatment of substance misuse
20. admission & discharge
21. needs assessment & outcome tool
Bipolar Disorder ICP Care StandardsBipolar Disorder ICP Care Standards 10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
22 management of acute mania
23 management of bipolar depression
24 keeping well and recovery
25 monitoring medication
BPD ICP Care StandardsBPD ICP Care Standards
10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
26 medication guidance
Dementia ICP Care StandardsDementia ICP Care Standards
10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
27 treatment for cognitive impairment
28 interventions for behavioural symptoms
29 end of life care
Schizophrenia ICP Care StandardsSchizophrenia ICP Care Standards 10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
30 early intervention
31 psychological therapies
32 medication
Depression ICP Care StandardsDepression ICP Care StandardsFor people who meet criteria for referral into mental health services:
10 integrated assessment
11 risk assessment
12 risk assessment for women
13 physical health check
14 recording diagnosis
15 suitability for psychological therapies
16 person centred care
17 single care plan
18 medication decisions
19 treatment of substance misuse
20 admission & discharge
21 needs assessment & outcome tool
37 specialist assessment & treatment available
For people who do not meet criteria for referral into mental health services:
33 objective measure
34 assessment of need leading to self-help and signposting
35 psychological therapies within 6 weeks
36 therapy after measure of severity
What Next?What Next?
TimescaleTimescale
1. NHS QIS publish ICP standardsLate ‘07
2. Initial baseline assessmentEarly ‘08
3. Local action plans
4. NHS boards invited to apply for accreditation
Mid ‘08
5. Assessment of ICP standardsLate ‘08
2009 on 6. Accreditation of whole ICP including care & service stands.
Developing
Implementing
Getting Accredited
Baseline Assessment QuestionsBaseline Assessment Questions1. Do you have a project plan for developing ICPs
for mental health (please forward us a copy if you do)?
2. Have you appointed ICP leads and facilitators for the 5 conditions and who are they?
3. What plans do you have in place for involving stakeholders?
4. How is the ICP development process linked to your care/clinical governance structures?
5. What resources (human and financial) have been put in place to support ICP development?
6. Will your local information system support ICP data collection and sharing (only a small number of variance points are going to be required initially for accreditation)? If not, what plans have you got to address these issues?
7. Are there any specific obstacles or concerns you have about being able to develop and implement ICPs in the timescale?
AccreditationAccreditation
Accreditation PrinciplesAccreditation Principles
Incremental
Facilitative and supportive approach
Based on standards for ICPs
Emphasis on recovery, outcome measures and
variance tracking
Linked to Clinical Governance and Risk
Management standards
Delivering togetherDelivering together
NHS Education Scotland
NHS QIS National ICP Co-ordinators
ICP pack
SEHDSocial Work
Improvement Support Team Service users and carers
National
Regional
Local
Voluntary sector Workforces
Main issuesMain issues
1. Early focus: Process standards or Generic ICP
2. Adaptability to local circumstances
3. Opportunity to link with Clinical Governance & Risk Management standards
4. Opportunity to link with other reviewers / inspectorates
Local ICP
Process
Standards
Service standards
information
info
rmat
ion
Management of variance /
decision making
Care
standards
Assessment
Care Planning
Outcomes
Care Delivery
Mechanism for tracking
variations from plan
Level 1: varianceleading to individual
care redesign
Level 2: Local management
teams
Level 3:NHS Board and LA
PerformanceManagement & Governance
Level 4:National
GenericB
ipo
lar
BP
D
Dem
entia
Dep
ression
Sch
izop
hren
iaAssessment
Care Planning
Care Delivery
Outcomes
Care StandardsCare Standards
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