Redbridge - Crisis Alternative

Description

This pre-procurement exercise will allow NELFT to engage directly and collaboratively with potential providers to:<br/>• Aid with procurement process design.<br/>• Determine the level of provider interest.<br/>• Help enable providers to participate in the process.<br/>• Inform development of service specification/s and collaborative service delivery options. <br/>• Help shape the commissioning and contracting process. Lot 1: This specification outlines the development of a Mental Health Crisis Alternative in Redbridge, a service providing non-clinical, community-based mental health support. The service will focus on supporting those experiencing a self-defined mental health crisis who do not require immediate medical attention. It will offer timely interventions aimed at preventing escalation to statutory services like psychiatric liaison or emergency departments. This initiative aligns with local needs, addressing the unique demographic and socio-economic factors of Redbridge.<br/><br/>Strategic Service and Population Needs<br/>The borough of Redbridge is home to a diverse population of approximately 310,260 people, with significant communities from White (34.86%), Asian (47.31%), Black (8.43%), Mixed (4.10%) and Other (5.35%) ethnicity backgrounds. The borough has a large South Asian community (Census 2023) and in the 17 neighbourhoods are amongst the 20% most income deprived in England with 1 in 4 adults and 1in 3 children in Redbridge living in poverty. (Annual Report 2023/24,Redbridge council). High levels of deprivation concentrated in the areas of IIford, Seven Kings.<br/>There is a growing population of older adults, many of whom face barriers in accessing mental health services, such as language difficulties and stigma. Redbridge has a lived history of underrepresentation from its Asian community in mental health service presentations, highlighting the need for culturally appropriate outreach. The mental health needs of the population include common disorders like anxiety and depression, which contribute to emergency department (ED) attendances and require community-based alternatives to prevent escalation.<br/>This service supports the objectives of the North East London Integrated Care Board (ICB) and aligns with the Redbridge Joint Strategic Needs Assessment (JSNA), which emphasizes mental health as a key priority. Please see the link below for the London Borough of Redbridge Joint Strategic Needs Assessment (JSNA) 2022:<br/>• Joint Strategic Needs Assessment<br/><br/>The NHS Long-Term Plan and the North East London Joint Forward Plan highlight the importance of non-clinical, community-based crisis services that reduce the pressure on statutory services, emergency departments, and inpatient facilities. The Crisis Alternative will serve as a critical component of Redbridge ’s mental health crisis.<br/><br/>NELFT have experienced significant increase in referrals and complexity of service user presentations; resulting in increases in waiting times and high caseloads with the number of discharges back into primary care not matching the increase in referrals. The impact on NELFT services means high caseload levels which impacts on the ability to provide high quality care in a timely manner. The expectation is that the crisis alternative reduces the pressure and demand on other services i.e. Emergency Departments, and supports those patients discharged back into primary care as part of the provision for patients not requiring clinical support in a crisis. <br/><br/>Service Aims<br/>The primary aims of the Redbridge Mental Health Crisis Alternative are to:<br/>• Provide immediate, non-clinical support for individuals experiencing a mental health crisis, preventing escalation to statutory services like emergency departments and psychiatric liaison teams<br/>• Reduce pressure on emergency services by offering a safe, non-medical alternative to hospital-based crisis interventions<br/>• Address mental health inequalities by providing targeted support to underserved and underrepresented groups in Redbridge including the homeless, LGBTQI+, older adults, black males and Asian/Asian British communities, utilising current peers support worker and volunteering resources<br/>• Promote early intervention and de-escalation through crisis listening, safety planning, and peer support, empowering individuals to manage their mental health and avoid future crises.<br/>• Enhance community resilience by offering practical support and linking individuals to appropriate local services, thereby reducing social isolation and promoting long-term mental wellbeing.<br/>• Collaborate with local VCSEs and statutory services to ensure an integrated care pathway, allowing smooth transitions between community and clinical services where needed.<br/>• Easy Access to provide a safe space that is easily accessible to all adults and older adults during the operating hours via self-referral, third party referral and walk-ins.<br/><br/>Service Model<br/>Access and Referral Pathways<br/>• Self-Referral and Third-Party Referrals: The service will be accessible to anyone aged 18+ who is a resident and/or is registered to a GP in Redbridge, as well as referrals from family members, carers, VCSEs, and statutory services.<br/>• Hours of Operation: The Alternative will operate from 5:30 PM to 10:30 PM, seven days a week, providing out-of-hours support to residents.<br/>• Locations: The service will be delivered at accessible community venues. <br/>Service Delivery<br/>• Crisis Support: The service will provide a safe, non-stigmatising environment for immediate emotional support. The core interventions include:<br/>o Crisis listening and de-escalation: One-to-one sessions to help individuals manage their distress and reduce the intensity of their crisis.<br/>o Safety Planning: Development of personalized crisis management plans, including practical coping strategies and signposting to other services.<br/>o Peer Support: Trained individuals with lived experience will offer non-clinical, empathetic support.<br/>o Outreach and Culturally Sensitive Support: Proactive in, ensuring communication in culturally appropriate ways through partnerships with local VCSEs, volunteers and peer support workers.<br/><br/>Budget: £150,000 PA <br/>Contract Term: 2 years + 2 optional 12 month extensions <br/> <br/>Staffing<br/>The Crisis Alternative will be staffed by a combination of:<br/>Peer Support Workers from diverse backgrounds, trained in crisis management.<br/>• Mental Health Practitioners for complex case management and oversight.<br/>• Volunteers, particularly from local communities, including those with multilingual capabilities to support non-English speakers.<br/><br/>Safeguarding and Risk Management<br/>• The service will implement robust safeguarding policies and risk assessment protocols to ensure the safety of staff and service users.<br/>• Strong partnerships with statutory services, including the NELFT psychiatric liaison at King George Hospital, Queens Hospital and Whipps Cross Hospital will facilitate smooth escalation for individuals requiring higher-level interventions.<br/><br/> Monitoring and Evaluation<br/>The service will be monitored using the following key performance indicators (KPIs):<br/>• Number of individuals accessing the Alternative on a daily/weekly/monthly basis and of this number, how any many are currently referred or have been previously known to NELFT services. <br/>• Demographic data, including ethnicity and language, to ensure diverse community engagement.<br/>• Rates of successful crisis de-escalation and referrals to statutory services and referrals to non-statutory services.<br/>• Reduction in ED presentations for mental health crises in Adult Social Care, Adult Mental Health Services, Housing, Talking Therapies, Urgent Care Centres and A&E.<br/>• User and carer feedback to assess service satisfaction and cultural appropriateness.<br/> Outcomes<br/><br/>Locally defined outcomes<br/>North East London ICB Joint Forward Plan refresh 24-25 Shared Outcomes are.<br/>• Tackling Health Inequalities <br/>• Prevent early death.<br/>• Improve people’s access to care.<br/>• Improve people’s experience of care.<br/>• Enhance people’s quality of life.<br/>• Reduce admission to acute services, reduce lengths of stay and improve where needed supported housing /residential care.<br/><br/>Value and benefits <br/>• Improving access to mental health support<br/>• Improve experience of people experiencing mental health challenges<br/>• Improve experience of carers supporting people with mental health challenges<br/>• Improve the outcomes for people who use the service.<br/>Ensure people receive the right care by the right service in the right place.<br/><br/>The service specific outcomes are:<br/>• Reduced demand on emergency services, particularly for anxiety and depression-related ED presentations.<br/>• Improved access to mental health services for underrepresented groups<br/>• Increased community resilience through empowerment and crisis prevention tools.<br/>• Enhanced collaboration between statutory and VCSE services in Redbridge.<br/><br/>The service specific outcomes are designed to ensure the crisis alternative achieves a positive impact on individuals’ quality of life and on the health and care systems. Outcome will require tracking of individuals’ use of the health and care systems when the service us set up. All outcomes should enable efficiency cost savings through a reduction in referrals to acute crisis mental health services and acute and emergency services.<br/><br/>Partnerships<br/>• The Crisis Alternative will work in close partnership with local VCSEs, as well as statutory services, to ensure integrated care pathways and effective referrals.<br/>• Outreach programs will be developed with services which may include local faith groups, community organizations, and language support services to engage populations in a trauma informed approach.