A few years ago, Denis and his colleagues from across health and social care in Lambeth realised that despite the big efforts and money going into mental healthcare they still weren’t getting great health outcomes. They wanted to change things, moving the system from being crisis-dominated to one focused on prevention, early intervention and enablement.
Together, they set up the Lambeth Living Well Collaborative, which brings together a wide range people to radically improve the way mental health services work. This includes people who use services as well as clinicians, carers, secondary mental health services, voluntary sector providers, primary care practices, public health and commissioners.
They created new initiatives like more empowered Community Mental Health Teams, a structured programme of peer support, timebanking, a Community Options Team and networks between GPs, social care and mental health primary care.
Denis, Assistant Director for Integrated Commissioning of Mental Health Services in Lambeth, and the team’s work in Lambeth has transformed outcomes – they are now supporting up to 500 people a month, well before they reach crisis point, and there’s been a 43 per cent reduction in referrals to secondary care, which has led to a reduction in waiting times.
There has been a deeper change too – a shift towards an ethos of collaborative working and a collective reframing of what the challenges are. What’s been the key element of this success? Regular breakfasts. In their breakfast meetings, everyone comes together and solves problems as a group.
‘You can develop as many whizzy new services or amend services that exist, but until you address how people work together you are never going to address the service change you want.’Denis, Assistant Director for Integrated Commissioning of Mental Health Services in Lambeth
The idea of co-producing with local citizens is still at the core of what Lambeth is doing locally. The way they’ve transformed mental health services has inspired the National Lottery to invest £3.4 million in new approaches to improving mental health.
This project part of the People Powered Health programme, run by Nesta and Innovation Unit. Between 2011 and 2013, Nesta supported innovations to test and scale collaborative approaches to supporting people with long-term conditions. The programme took innovations that had been developed over many years – from doctors prescribing exercise to expert patient groups – and asked what would happen if they became a normal part of life.
Nesta and various partners, including Innovation Unit, supported the six teams to develop their capacity in fields such as co-production, service design, business case development and commissioning. Nesta also worked with teams to establish a peer network to enable them to learn from one another as well as from external experts. The award-winning business case for implementing this approach across England indicated that it might be possible to save approximately £4.4 billion.
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