1.Introduction
The following information outlines the context, aims, and scope of the National Mental Health Development Unit's (NMHDU's) Personalisation in Mental health programme. This emerging programme, currently in set-up and development phase, is an increasing priority for the NMHDU and is likely to form a core part of the NMHDU's work plan in 010/11. The programme is being led by Kevin Lewis (Kevin.lewis@nmhdu.org.uk).
Kevin Lewis, National Mental Health Development Unit's Personalisation in Mental Health Programme Lead. www.nmhdu.org.uk. video and film production by www.filmsgb.com
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2. Policy and Practice Context
2i) Policy drivers:
Personalisation is a key strand in current and emerging health and social care policy. Personal health budgets can be seen as part of a wider drive to personalise public services, which dates back to the 1970s and the campaign by disability groups for people to be allowed to control their own funding. A pilot involving around half the primary care trusts in England is currently underway, testing out personal health budgets in the NHS.
2ii) Issues in practice
The evidence from implementing related policy areas such as self directed support (direct payments, individual budgets etc.) demonstrates that mental health service users, carers and providers face a distinct set of real or perceived barriers when implementing a more personalised basis of care. However, there have been successes to build on and the message from early adopter providers and service users is that personalisation is cost effective and changes lives. While third sector and local government champions have been quicker to realise the benefits of personalisation, understanding and awareness at PCT and mental health provider trust level remains patchy and under-developed. As well as a broader cultural and organisational shift in attitude and behaviour, practical issues impeding progress include lack of transparency around item of service tariffs and pricing levels, which can hamper the release of funds from block contract based services.
3. Programme governance
As an emerging programme, formal governance arrangements are currently being developed. Discussions are currently taking place with the Department of Health, Association of Directors of Adult Social Services (ADASS) and the NHS Confederation regarding the aims, membership and terms of reference of this group. It is proposed that this new national reference group will formally sit under the Putting People First governance structure. The intention is that a "light touch" authoritative body will engender the focus and cohesion required to aid the acceleration of the development of personalisation in mental health. It is hoped that details will be agreed by the autumn.
4. Programme aims
- To provide a strong national voice, point of connection and focus to drive personalisation in mental health from policy to practice.
- To support the roll out of the personal health budget national pilots that are mental health focussed and trail-blaze early adopter PCTs and other providers, enabling peer groups to share learning and experience of implementation.
- To provide practical guidance to commissioners and providers of mental health services, in particular those from PCT, Foundation Trust and other mental health providers, enabling them to locally commission and provide personalised service provision that is cost effective and transforms lives.
5. Stakeholder engagement and key partners
The programme follows the principles of co-production and has already engendered strong partnerships with the NHS Confederation (via Mental Health Network) and ADASS. The NMHDU works collaboratively with the Personal Health Budgets Pilot Programme and the Putting People First teams within the Department of Health.
Other areas of stakeholder engagement to be further developed include third sector alliances and multi-agency perspectives (including housing employment, leisure etc.).
6. Key developments and planned activity
The 09/10 first quarter has been dominated by detailed discussions with organisations from every sector, to ensure the programme's aims and emerging activity focus on the right areas. These early fact finding and relationship establishing sessions have drawn out a number of consistent themes, which are reflected in the programme aims and issues analysis in section 2. These initial findings are directing the next phase of work. Currently, the development activity falls into two broad areas:
6a. Making the case for personalised mental health care
6a i) Commissioned research
While personalisation is an essentially simple concept, it is one that is proving challenging to embed in organisatinos and systems. From the initial scoping of the task with key partners, it's clear that there is a need to make a high profile and high level case for personalisation in mental health, to embed a working knowledge and undertanding of the agenda. To that end, qualitative research has been jointly commissioned by the NMHDU, NHS Confederation and ADASS, involving interviews with CEOs of PCTs, Foundation Trusts, third sector, independent providers and Directors of Adult Services. A report, based on the findings, will be published in the autumn, highlighting common themes and outlining urgent actions.
6a ii) Information and profiling
The programme team take advantage of tactical and strategic opportunities to raise the profile of personalisation in mental health, at conferences, seminars etc. Different organisations are at very different levels of experience and understanding, but often the combination of information giving, fostering positive contacts and partnerships and the potency of an external view can help move local economies forward. The message is being put out wherever the opportunity arises: personalisation is simple, cost effective and changes lives. The current economic climate and drive to make efficiencies offers real opportunities to make system change happen more quickly and local economies need to be assisted in taking the necessary steps.
6a iii) Bespoke support to local economies
The Unit is also working to bring together partners in a variety of economies in order to overcome barriers to change. There have been early successes. The programme team is currently working directly with a number of pilot and early adopter sites to advise on local challenges and are open to approaches from local economies where general guidance on implementation challenges may be required.
6b. Supporting personal health budget pilot sites
The NMHDU and the personal health budgets team are working together to achieve shared goals. The Unit will lead in supporting the mental health themed pilot sites. The outline work programme was formally launched at the pilot launch event on16 July. An e-community will be developed to support progress and to identify blocks to progress, enabling problem solving and shared best practice. Specifically the NMHDU will:
- explore a pilot development programme for commissioners. This hybrid learning-set/themed workshop programme will be offered to pilots and if successful, be rolled out to any other early adopter PCTs.
- provide bespoke consultancy to individual pilot sites
7. Evaluation
The programme will be evaluated across a number of formal and informal measures and methods. A formal evaluation framework will be developed and agreed with the Reference Group at the earliest opportunity.
For further information on the programme please contact Kevin Lewis (kevin.lewis@nmhdu.org.uk)