I recently attended a retirement lunch for a mental health Clinical Director colleague and naturally we talked about the challenges ahead at a time where we have the GM Health and Social Care Strategic Plan, a GM mental health strategy and a national mental health strategy all emerging. We shared a sense of great optimism, whilst recognising the challenges ahead will be, well, challenging.
It struck me that moving forward, we still need to look back and learn from our achievements but if ever there was a time to grasp the nettle, it’s in 2016.
If 2015 was all about strategic development then 2016 should be about implementation. This year will also be about partnerships and new ways of working together across health and social care.
If we are to change to address the challenges set out in the Strategic Plan, what are the key things we need to do differently in 2016 and beyond?
Pennine Care launched its whole person care strategy in 2014 and I’m pleased to say that it remains relevant today and reassures me that our ambitions based around partnerships were the right ones.
When thinking about partnerships, I look back and can see we knew then it was important that we changed the organisation and started to deliver through place and people, not through Pennine Care the ‘Trust’. We have still some way to go but it does mean that over the years we have been on this journey, we are comfortable working in places, with partners and developing local care organisations.
Partnerships in practice
For instance in Oldham, we have worked with primary care, social care and voluntary partners to establish an independently chaired Care Consortium. It was important to bring agencies together to promote innovation and I believe we have delivered some real change. We are currently undertaking an evaluation of the work and will publish this over the coming weeks.
In Stockport, we have worked with commissioners and Stockport NHS Foundation Trust to set up a new ground breaking facility, called Saffron Ward. Saffron provides intermediate care for older people with delirium, who often don’t get the care they need when in hospital. This ward brings people from the acute hospital setting and provides an integrated care pathway, to provide treatment and care. We have found patients and their families really value this bespoke care, the outcomes are better, older people retain more independence and it has significant financial benefits over the costs to run the service.
Through these examples I hope I have shown that partnership working has many faces, and this principle of co-production will be key to our future success.
Putting people first
The most significant shift in how we plan, deliver and operate care will be through the partnerships we develop with patients, carers and wider communities. Changing the way we deliver health and social care, will only work if we can change the way people use services and how they look after their own health.
I am very optimistic we can and the work Pennine Care has done through My Health My Community has seen a substantial step change in our approach to care. At its heart MHMC is a living well academy, a self-care resource and a movement towards self-management at scale. Importantly, the self-care resources we have developed to date and the carers support programmes we have in place are all entirely co-produced from ideas, through to development and delivery.
The NHS has a long standing history of great care, I am proud to be a part of it and my 31 years as a nurse, a leader and now a Chief Executive. However, we have to move away from ‘doing to’ patients and start working with people and their communities.
New models of care and mental health
The examples I have outlined show how we are developing an alternative narrative to hospital care. Hospitals do great work, but they are busy and under pressure. Local care provider arrangements have to build better and alternative care models to the offer we currently provide. But we can’t just say it needs to happen, we have to make the case for it and demonstrate propositions that we can confidently invest in, knowing it will help reduce hospital pressures and keep people out of hospital-based care.
We must be able to measure, demonstrate and show the benefit over cost of the new care systems we are building and so health economic modelling, such as that undertaken by Pennine Care, is increasingly an integral part of how we plan and implement care.
With new models of care, I still think we underestimate the importance of mental health and how good mental health care can have far reaching benefits. In 2016 we are in a much better place than when I started my psychiatric nurse training in 1984. Back then ‘psychiatric patients’ were viewed negatively, a significant amount of care was provided through large asylums, the media often portrayed people with mental illness as dangerous and talking about your mental health problem was largely still a taboo.
Today, the vast majority of care is provided in community-based settings, most often in people’s own homes. Many patients prefer to be described as service users and have far greater involvement in planning services and their own care than ever before. I would never try to say we have arrived, we still have a long way to go, but we have travelled an incredibly long distance in the right direction.
I believe education on mental health is at the core of further reducing stigma, I think it’s at the core of delivering better health services overall. So education is key and specifically we must ensure we are acting on the evidence that demonstrates good mental health care leads to better health overall.
The new Greater Manchester strategy also draws together the known benefits of good mental health care improving physical health and the need for good physical care for those with a severe and enduring mental illness. The body of evidence is substantial yet the investment in and integration of good mental health care in all care, remains patchy at best.
This is a good time for Greater Manchester. There is a shared view on what the right things are that need to be done. We must now select the two or three most important things (that will deliver the most impact) to start with in 2016 and build from there as we work towards 2021.
I’m looking forward to being a part of it and hope you are too…
Pennine Care NHS Foundation Trust
Pennine Care is a provider of community and mental health services within Greater Manchester, serving a 1.3million population and employing 6,000 staff.
This blog has been taken from a version published by Pennine Care NHS Foundation Trust.