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West London CCG Whole Systems Long Term Mental Health Needs:
Community Living Well Service
Kensington & Chelsea Voluntary Organisations Forum
20th October 2015
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Aims of session
• To share the outline model for Community Living Well service
• To update on progress and timescales
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What is the whole systems mental health project about?
• Creating a vibrant network of support and services in the community for people with LTMHNs and their carers
• Maintaining mental, physical and social wellbeing
• Watchwords: Easy Access, Preventative, Pro-active, Self Efficacy: living well, not just ‘in recovery’.
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Previously…• Extensive co-production over last 15 months, with
people with LTMNs, carers, voluntary sector, GPs and other providers.
• Key messages- more information on what’s available- easy access to services- better co-ordination of support- time to listen- advice for GPs, including access to benefits, housing and employment support for their patients
Tier 2: Navigation in specialist non mental
health areas e.g. benefits, housing,
employment, debt.
Tier 1: Peer support, e.g. daily
living tasks, personal budgets.
Tier 0: Self help and community support
Increasing health and social care needs
“Community Living Well’: core features of model
Easy access, pro-active, 24/7 providing full range of bio-psycho-social assessment and services to support service users, their carers and GPs based on principles of empowerment and self care.
“A vibrant, resilient community-integrated network of pro-active care, support and treatment, matched to need and risk, that best secures the mental, physical and social health of those with long term mental health needs”
Home Community settings North / South Hubs CNWL & ASCGP practice
Peer supportService users and carers empowered to help themselves and each other; active ‘co-workers’ in living well.
Specialist navigatorsMental Health Specialists: CMI and Stable SMI in CLW; Complex /High Risk SMI in CNWL
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GPs are central to care, and receive specialist resource to deliver ‘Living Well Plan’ from CLW ‘Co-Workers’
Tier 3: Primary care mental health: case
management, psychiatry, psychology, counselling, diagnosis
Tier 4: Specialist
acute mental health: e.g. urgent care,
early intervention, in-patient.
3rd Sector
...Pe
ople
… P
lace
s
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Timescales
• Business case to WLCCG Governing Body meeting January 2016
• Phase 1 early 2016
• Phase 2 Autumn 2016
