We're recruiting for our new Admiral Nurse service

The NHS and Dementia UK are advertising for a senior dementia nurse to lead their new Admiral Nursing service in central Norfolk.

And the amount of money being invested into the service, to help local people live more positively with dementia, has risen by £100,000 to £700,000 a year.

New inpatient unit for new mums

New mothers with serious mental health problems will be able to receive specialist inpatient help closer to home when Norfolk and Suffolk NHS FT opens the region’s first dedicated mother and baby mental health unit.

The eight-bed unit - which will ensure mums and their newborns can stay together while the mother is receiving acute psychiatric care - will be based at Hellesdon Hospital, in Norwich. Due to open in 2018, it will take referrals from across Norfolk, Suffolk and Cambridgeshire, as well as other parts of the country.

The unit will cost around £3m to develop and is one of just three in the country commissioned by NHS England as part of their investment into improving access to specialist treatment for new mothers in regional areas with the most limited inpatient services.

NSFT’s unit will care for mothers with mental health illnesses such as postnatal depression, severe anxiety, as well as postpartum psychosis - a serious mental health condition which can occur in recently delivered mothers which causes hallucinations and delusions and can severely disrupt perception, thinking, emotions and behaviour.

GPs and health visitors, as well as mental health staff, will make the referrals to the unit, which will be staffed by a perinatal psychiatrist, specialist mental health nurses, nursery nurses, occupational therapist and social worker.

A range of therapeutic services will be available including medication, cognitive behavioural therapy, family therapy, along with help with attachment. Trained peer support workers – people who have personal experience of perinatal mental ill health – will also offer support and practical help.

The new unit will complement NSFT’s new Community Perinatal Mental Health Service, which launched in April and cares for pregnant women and new mothers with serious mental health difficulties, as well as providing support for the rest of the family.

Andy Goff, NSFT’s Children, Families and Young People’s services Locality Manager, explained that the bid for funding for the locally based unit was submitted by NSFT and supported by the NHS Clinical Commissioning Groups in Norfolk and Waveney.

“We also worked closely with the Norfolk and Norwich Universities Hospitals NHS Trust (NNUH) who run local midwifery services, and the support group Get Me Out These Four Walls, to develop our model which will ensure both mothers and babies receive responsive and effective care in a family-friendly unit which has been designed to meet the highest standards,” he said.

“And the staff there will carry out daily assessments to make sure the emotional and physical needs of mothers and their babies are safely met.”

NSFT’s Chief Executive Michael Scott said: “We are absolutely delighted that our bid to create a specialist mother and baby unit for our region has been successful. This is a vital and potentially life-changing service that for the first time we will be able to offer local families from across the region.

“We are extremely proud that NHSE has such confidence in our model of care and that we can now continue to work with local service users and staff to add the finishing touches to the development of the new service.”

The news of the new unit has been welcomed by Jessica Bannister from Norwich. She received mental health crisis treatment with NSFT when she suffered postpartum psychosis following the birth of her son, Albert, three years ago, but then had to travel to Hackney, in London, for specialist inpatient treatment as soon as it was safe to move them.

“The immediate care that I received from NSFT when I went into crisis was literally life-saving, offering an urgent short-term safe haven, and for that I will always be grateful. But there were no local facilities to treat my condition in a specialised environment,” said author and playwright, Jessica.

“The Hackney unit was a godsend for us – even with the distance involved, but if someone becomes ill, it’s much better if they don’t have to travel hundreds of miles for treatment as it’s essential that you’re near your family and friends so you can keep some kind of life going outside of the illness.

“These units are incredible places – the humanity, love and support you receive is phenomenal. The dedication of the staff to your recovery and wellness, along with the love they give to your child, is fantastic.”

Jessica returned home when Albert was around four months old, and continued to receive support from NSFT’s community mental health team. Now fully recovered, the family recently welcomed their new arrival, daughter Roxie, to the family on 25 January.

Keen to help raise awareness of mental ill health among other new mums and mums-to-be, Jessica has written a drama documentary for BBC Radio 4 called Mama Courage, due to be aired on Friday 12 May at 2.15pm, then available on the BBC Radio 4 iPlayer.


Get support

If you are concerned you or someone close to you is showing the signs of mental ill health either during pregnancy or after a birth contact your midwife, health visitor or GP immediately for further support and advice. Or if you have a pre-existing mental health condition you can also speak to your mental health adviser.

You can also get support from NSFT’s Wellbeing services at www.wellbeingnands.co.uk

Mental health acute capacity review

An independent report exploring initiatives aimed at relieving the pressure on local mental health beds has been published in full.

The independent review was jointly commissioned by Norfolk and Suffolk NHS FT (NSFT) and the NHS clinical commissioning groups in Norfolk and Waveney in response to increasing demands on mental health services. This has resulted in some patients needing to be sent for inpatient care out of the local area at times of high pressure.

NSFT has made it a priority to reduce the number of out of area placements of its patients but as demand for all Trust services has increased - in 2015-16, NSFT saw 22,000 more patients than in 2012-13 - OOAs have also increased.
In addition to opening more crisis assessment beds in 2015 and last year, NSFT and the CCGs recently appointed independent experts Mental Health Strategies (MHS) to look in detail at NSFT’s adult acute care pathway, including everything from crisis services, crisis assessment, inpatient beds, length of hospital stay, as well as community services.

The review was drawn up in consultation with frontline mental health staff, GPs, commissioners and stakeholders, and incorporates a wide variety of data, and it focused on:

  • Determining how many and where beds are needed to deliver day-to-day services in Norfolk and Suffolk while continuing to meet increasing demand
  • Where there may be hot spots or issues causing additional pressures in the system and on beds
  • To offer best practice advice on what has worked in other parts of the country in helping to manage the increasing demand on NHS mental health beds and services

The report concludes that if differences are addressed in the way referrals to inpatient beds are made in various parts of the Trust, and additional alternatives to hospital admission are introduced, the current number of NSFT beds could be sufficient to continue meeting demand.

A number of key alternatives have been suggested and will be developed under the remit of the Mental Health Sustainability and Transformation Plan (STP).

Michael Scott, Chief Executive, of NSFT said: “This month we have seen a number of days where we have achieved zero OOAs, and the last thing we want is for local people to have to travel elsewhere for their care and we fully understand the distress this can cause to some patients. We are determined to do whatever we can to bring down the number of OOA placements consistently.

“But it is important to stress that it is not just about the number of beds. Not all people in mental health crisis need to be, or should be, admitted to a bed, and the best outcomes are often achieved when they can remain in their own home, close to the people who care for or support them, with good community-based, mental health support in place.

“That is why our Trust and our commissioners have continued to extensively invest into community services and preventative services to keep people as well as possible for as long as possible.

“We all know there are finite resources in the NHS and so the emphasis of this has to be about identifying if we have the right type of beds in the right places to meet local needs, and how can we better manage all of our services to ensure that our beds are free to support the people who really need an inpatient stay.

“The independent reviewers are suggesting, for example, that crisis assessments beds may not provide any advantage over using normal, working age, crisis beds in reducing of OOAs.

“And the report has been extremely useful in outlining some differences in clinical practices in various parts of our Trust in regards to how we make use of our existing beds from service to service, and in different geographical areas.

“It is important for us to address these differences, as they can affect the length of time a person stays in one of our beds, whether people are admitted at all, or how they are supported in a community setting.”

Michael explained that an acute and community pathway of mental health services has many stops and checks where health professionals can ensure people are kept as well as possible and avoid the need to go into hospital. 
“If we are not using our existing beds and services efficiently for the best purpose and with the best outcomes then adding more beds can potentially add to the problem. You can get a revolving door scenario, where people are in and out of hospital rather than receiving more appropriate community support which better helps people to live their lives independently and well.

“For people with a personality disorder for example, unless they are severely unwell and need a prolonged specialist placement, being in a mental health unit can exacerbate their problems. And they can often be the patients who we see regularly coming in and out of beds and yet they may not be making much progress in their recovery as a result.”

The £58,000 cost of the review was shared between NSFT and Norfolk and Waveney CCGs, who jointly commissioned the project.
Antek Lejk, Chief Officer of NHS North Norfolk and NHS South Norfolk CCGs, said: “There are some really interesting initiatives which have proven to work very well in other parts of the country in keeping people well and out of hospital.

“We are working through the findings of the independent report with NSFT and frontline staff and after these discussions we will have a clearer picture on how we might develop local services and initiatives, which will be drawn up under the remit of the Mental Health Sustainability and Transformation Plan work.”

MHS’s findings include:

• Crisis cafes and step down beds would provide alternatives to admitting patients to acute inpatient units

NSFT is planning to open a crisis café in Norwich in 2017-18 to offer a safe, specialised, community setting where people with an escalating mental health condition can go for immediate professional support.

Work is also taking place to explore in greater detail the potential impact which step down beds, which are used when a person is no longer in a mental health crisis but is not yet ready to return home, could have on reducing admissions to acute units.

• The development of a community personality disorder service would provide a useful addition to existing services

NSFT already provide services to people with personality disorders, and is currently working on a Personality Disorder Strategy. The review further highlighted the need for a specific service PD service. An NSFT consultant is leading a project to create a community personality disorder service (from existing resources) which will offer high quality assessment and supervision, as well as a range of interventions such as active listening, psychotherapy and crisis response. Work is due for completion at the end of 2017-18.
• Learning and best practice should be shared across the Trust to address differences in referral and admission rates between community teams

The Trust is working with clinicians to develop a consistent approach to admitting and discharging, as well as criteria for admissions. Recommendations to standardise practice where appropriate are also being drawn up.

To read the full report log onto the Trust’s website at www.nsft.nhs.uk/our-priorities


Advice clinics at the doctor's

Cotman Senior Support at the Doctors Team 1People over the age of 60 in Norwich who would like a little extra help with housing issues or their benefits are being invited to use an advice service based in two GP surgeries.

Cotman Housing Association is running a pilot scheme called “Senior Support at the doctors” from both Lionwood Surgery and St Stephens Gate surgery. Trained advisors are running clinics that people can just ‘walk in’ and ask about, make an appointment or be referred by their GP or nurse.

The sort of things they can help with include housing, adaptations at home to make everyday living easier and safer, advice on getting help at home, benefits, care alarms and making new friends or finding new things to do for a fulfilling life. The overall aim is to help people keep independent at home and reduce loneliness.

Special event asks “what can you do?”

People from across Norfolk and Waveney will be encouraged to plan for their future, speak openly to their loved ones about death and make dying well a natural part of a good life at a special event next week.

Taking place at The Forum in Norwich on Tuesday 9 May, the drop-in event has been organised to tie in with national Dying Matters awareness week, which this year has the theme “what can you do?”