1. Mental Health Promotion: Develop and agree a mental health promotion strategy based on local needs. Build into the strategy action to reduce discrimination.

Promotion strategy completed.

• Link with suicide prevention strategy and suicide audit; integrate service governance procedures and effectively engage with Local Strategic Partnerships to develop performance monitoring arrangements.

• Further link with developments in strategies covering diversity and social inclusion.
• Develop and implement training on Human Rights and Race Relations Amendment Act 2000.

• Comedy festival to become an annual event with Exeter City Council.
• Ongoing involvement of service users and other members of the public in planning of services.
• Continued work of the Patients Advice and Liaison Service.

2. Primary Care implement strategy to promote employment of people with mental health problems within Health and Social Services. Multi-agency Human Resources (HR) group to be established to develop HR policies and practices that can support this.

• Continue to establish the practice of contracting for services staffed by mental health users.
• Implement HR strategy for the support of staff with mental health difficulties.
• Imaginatively use resources for staff needing a high level of support from the mental health services.
• Work with local employers to increase awareness of the needs of employees with mental health problems.

Support the development of registers in primary care.

Registers within primary care are still mainly manual systems. Further work is required to develop an IT system. (The newly formed Mental Health Information Board will deliver this as part of the wider development of IT systems.)

• Deliver the Connectivity Programme by getting all clinical teams connected to the internet.

Develop training in mental health for all primary care staff

The Workforce Development Group is co-ordinating this work in the region. Locally the Devon Partnership Trust will lead implementation.

Increase community mental health staff employed to work with general practitioners and primary care teams, with NHS Direct and with each A & E department.

Workforce Review completed. Pressures and priorities identified.

• Develop and deliver primary care graduate worker course with Plymouth and Exeter Universities.
• New Mental Health Worker to be introduced in 2004 using national Accelerated Development Programme.
• Training to improve management of Dual Diagnosis, (Substance misuse, Learning Disability, and Personality Disorder).
• Training on Human Rights and Race Relations Amendment Act 2000.

3. Workforce Planning: Review workforce to identify pressures and priorities, including the action needed to match workforce to local community.

Region to initiate setting up of a multi-agency forum to ensure implementation. An education, training and retention strategy should be in place.

Workforce Review completed. Pressures and priorities identified. Little progress made on matching workforce to local community. Local workforce development group has multi-agency sub-group with a workforce plan in place. Quarterly reports presented to the workforce confederation as part of the Human Resources (HR) performance monitoring process.

• There are targets in the workforce plan to meet identified gaps in roles i.e. Consultant Psychiatrists and Allied Health Professionals including Social Care Workers.
• A key priority is to become more focused on service user need. This will be achieved by developing a workforce plan from service plans and objectives by an integrated approach to workforce planning, introducing new roles, establishing close links with colleges and the smooth introduction of the Agenda for Change national job evaluation framework. This will also include workforce requirements to comply with the Race Relations Amendment Act 2000.

4. Care Programme Approach (CPA); Developing Pan-Devon CPA Policy and Procedures.

• Minority groups to be represented on CPA steering group.
• New CPA based on 'recovery principles', to be implemented early in 2004.
• Regular audit via teams.

• Standards will be audited across the Partnership Trust.

The Mental Health Information Board is developing an information strategy and implementation plan to accompany the CPA policy developments, with the aim of all service users who are on CPA having their assessment, care plan and contingency plans available electronically.

Exeter, East, North, South, Mid Devon and the Emergency Duty Team (EDT) all connected to electronic CPA.

• New investment in information technology across south and west Devon, with faster networks and computers across the Trust (Implementation of Protechnic EPEX system).
• Explore how to integrate Mental Health and Social Services management information in a joint project.
• Appointment of Data Quality Facilitator.

• The new structure for the Community Mental Health Teams is in place.
• Training for all the new Team Managers and National Service Framework for mental health implementation.
• Joint Training in Social Services in commissioning procedures and Human Resources.

• Supporting People programme utilised. Further supported accommodation projects to be identified.
• Homes and support need to be tailored to individual need.

5. Fair Access to Care

• Agreed Fair Access to Care policy is implemented with FACs paperwork completed and supported by Care Programme Approach assessment and care planning.

• Trust training department in conjunction with Social Services training have a continuing commitment to deliver multi-agency training to support social care model as a routine.

• Regular audit through the trust audit group.

6. Day opportunities

Develop a spectrum of services, with the aim of linking people into education and meaningful employment.

Review of Day Opportunities completed and Steering Group now implementing recommendations. Services being redesigned to integrate health and social care community opportunities. Integrated management structure in place to support this.

• Aim to increase choice by focusing on use of statutory, voluntary and mainstream resources. Improve access for black and minority ethnic persons.
• A day service conference has been held which launched a series of community network forums across Devon, these will provide a focus for community organisations.
• Forum being developed specifically for wider service user and carer issues.
• User / Carer evaluation of the services.

7. Secure Services

Up to 400 patients from high secure hospitals will move to more appropriate accommodation.

The Regional Peninsula Secure Services Group has been established. A business case is being developed for more local resources. This includes the development of community forensic services, as well as improved facilities on the current Langdon site. Specification agreed for the 1st phase of the low secure unit at Langdon.

Business case completed. New unit being commissioned on Langdon site.

• Work now to be done to identify recruit and train a mixed Health and Social Care staff group.

• Outline case to develop environmental improvements has been agreed by Strategic Health Authority.

Key actions:

• Provide open accommodation for people who are in medium secure accommodation but who could be in more suitable environments by 2004.
• Improvements of facilities and resources for borderline learning disabled people.
• 2 more full-time Social Care staff.

8. Mental Health Re-configuration

Agree proposals and timescales to deliver NSF targets including integration via the Pan-Devon Reconfiguration Steering Group and the review of Community Mental Health Teams.

Integrated management structure in place. Review of Community Mental Health Teams (CMHT) complete and recommendations being implemented

• Complete the partnership agreement.
• Provide further joint training for operational and managerial staff.

• Routinely audit integrated policies.
• Establish clear supervision arrangements for all staff including social care staff.
• Set up an integrated annual appraisal system (except for career grade assessment for social workers).

• Complete the partnership agreement fully utilising the Local Implementation Teams and Local Implementation Group (LIG) arrangements. (New Joint Executive arrangements will oversee the Partnership Agreement between the different agencies and manage the performance of the mental health services.)
• Ensure staff have an understanding of Black and Minority Ethnic (BME) issues.

9. Information about treatment and services is available for all people with mental health problems including information about access to local self help groups and support services such as housing and employment.

• Ensure that within the Care Programme Approach the principles of recovery housing, finance and employment are central to an individual care plan.

• Ensure that local directories are available and that these are reviewed.

• Agree a revised approach to the Charter resulting in publication of information on standards in 2004/5. Ensure that the Charter addresses Human Rights and Equalities legislation.

Every health authority and local council must have multi-agency protocols agreed and operational for the sharing of information relevant to reducing risk of serious harm to self or others.

Information sharing protocols have been developed.

Protocols relating to people with a mental disorder are about to be signed.

• A robust procedure will be developed by the Devon Partnership Trust to support implementation.
  
• The Policy and Procedure will be reviewed annually.

10. Serious mental illness

Plans established to implement crisis resolution services. These services will enable all people in contact with specialist mental health services to access crisis resolution services at any time.

Following the outcome of the Community Mental Health Team review in mid November 2001, service redesign plans have been developed with Local Implementation Groups (LIGs). These were implemented in 2003/4.

• Crisis Resolution service established in all localities. There will be a service user evaluation in 2004. Service improvements will follow as required. Ensure access to mainstream services for people from Black and Minority Ethnic (BME) groups.
• Emergency Duty Team support and back up the crisis service in parts of Devon.
• Further investment will enable more robust service delivery.

• Manager and team leader now appointed for the prison in reach team.
• Work to be done on appointing staff and establishing working relationships with prison staff. All prisoners with a mental health problem will have a through care plan. Strategic review of service provision will be completed early 2004. This will inform further service developments.
• Ensure staff are trained in cultural diversity, equalities legislation and human rights.

• Service co-ordinator appointed.
• Steering group has been convened. Ensure minority groups can participate.
• Need to build on the embryonic plans.
• Services will be in place by Spring 2004.

• Graduate Training programmes in each Primary Care Team area.
• Gateway posts being established in some areas to be rolled out.
• 'Stepped' access approach to managing mental health issues in place, from G.P consultation through to referral to secondary care.
• Development of link workers between Community Mental Health Teams (CMHTs) and Primary Care being implemented.