4 March 2021 – Mental Health Network – governance during the COVID-19 pandemic webinar

Last week’s webinar featured a discussion about the role of clinical leadership in systems, service design and planning and providers collaboratives.

Overheard during last Thursday’s webinar:

“When the money starts to crystalise and flow, it will show clearly if money is ringfenced for mental health. We are hearing from our system that mental health is the next wave of Covid so it is getting attention, and it feels like there is a move towards all parts of the system understanding the different parts and where the pressures are.”

“What strikes me is putting acutes at the heart of integrated care is treating the system upside down. Mental health services operate across an entire pathway, and work closely with social care, emergency departments, psychiatric liaison, community services and provide direct support to primary care etc. Mental health and community trusts would be the logical organisation to be at the heart of an integrated care system, with acutes providers in some ways more like tertiary providers. The ones who are both upstream and downstream providers are the ones which need to be at the centre.”

There was a comparison of how chairs are getting on forming mental health alliances, to help form one voice and make the most effective use of resources. Some examples shared were the following:

• In Bradford, they have the Provider Collaborative for mental health, learning disability and autism for West Yorkshire & Harrogate established over 2 years which is helping to talk with one voice and have assurance and shared risk on service transformations. But also helps to influence the rest of the system (acutes and councils) on improving learning disability services.
• In Sussex, they have a Mental Health Collaborative in Sussex. Their CEO, Sam Allen, is chairing an event on this with GGI next week.
• In West London, they are part of two provider collaboratives: for CAMHS with CNWL, and for forensic with CNWL and BEH.
• In Kent, they have a MH Improvement Board with 6 workstreams and a MH collective that informs it. The improvement board is multi-agency and we have agreed to hold a ‘shadow budget’. JC is really excited that if they can make it work, it will solve a number of the collaborative pathway problems.
• In Surrey, they have established a Mental Health Partnership Board within the ICS to try and get a whole system understanding and ownership of mental health and the implications for all agencies (including education, police, housing, acute, primary care and VCSE). They have also used the ICS escalation system to highlight the pressures on mental health and the need for greater investment.

Reflecting on provider collaboratives, one guest said: “A huge amount of what is happening is less focused on achieving integration, and more on innovation taking place in the hands of boards of directors. A large frustration is about where deckchairs are located and this seems to be focused on developing intermediate layers around hospitals and increases the distance from the accountable board and people delivering services on the frontline. The true test will be when it feels integrated from the patients perspective, and I’m not sure the discussions around governance will help achieve and maintain this line of sight between deliverers of service and those accountable.”

These meetings are by invitation only. For further details, visit our website https://www.good-governance.org.uk/events/

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk