Strategy
The NHS in North Central London (NCL) spends £580 million each year providing Community and Mental Health services in Barnet, Camden, Enfield, Haringey and Islington. Every month, these services provide care to over 65,000 people from around 90 service areas. These range from district nursing and physiotherapy to counselling and psychiatric inpatient care.
For NCL residents, the borough you live in affects the services you are able to access, how long you wait for treatment and the outcomes you can expect. Concerns over this postcode lottery led to the NHS responsible for NCL launching a review.
CF were commissioned to undertake this work, to be delivered in partnership with the client team and via engagement of frontline staff and patients as well as interested parties. These included the 5 Local Authorities, 6 Mental Health NHS Trusts, 6 Community NHS Trusts, 4 Acute NHS Trusts, 185 GP practices and numerous voluntary sector organisations.
Over 12 months from February 2021, CF supported the client to develop a strategy for the future.
During the first 3 months, CF engaged with 60 leaders of health and care services and 440 front-line staff to hear their views on the strengths, weaknesses, opportunities and challenges for Community and Mental Health Services. We combined an evidence-based approach with their lived experience to produce an agreed case for change that helped them to articulate their vision for the future.
In response, the client wanted to design a new offer for Community Health and Mental Health services, which would be consistent across NCL and would tackle inequalities and inequities. We held 8 workshops in 3 months, bringing together around 70 service users, clinicians and service leads each time. We facilitated discussions between participants, thinking ambitiously about the requirements of residents and best practice, rather than the status quo. The result is a bespoke core offer which describes the services that should be available to all NCL residents.
We then supported the client to understand potential impact and benefits. For example: the core offer will shift the dial towards more proactive and preventative care, helping people stay well and avoid hospital admission. The NHS in NCL also needed to know whether this was affordable. Our analysis set out potential costs and savings and therefore how long it would take to implement the core offer.
Finally, CF helped the client team to map out the key next steps to delivering the strategy.
There were three main outcomes of CF’s support to NCL. Stakeholders from the organisations responsible for Community and Mental Health services aligned around the problems with current services. Secondly, they co-designed and agreed a solution. Thirdly, they committed to working together to deliver the strategy over the next 3 years. They have also agreed the core financial principle that investment should be made in Community and Mental Health services.
As a result of CF’s support, the NCL strategy for Community and Mental Health services will deliver a new, equitable and transformational service offer for residents.
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