Last week I was at the NHS North
West System Leaders meeting. This was part of an NHS England Board regional
tour. They are currently visiting each of the seven regions across England. All
the Chief Executives and Chairs were invited to join the national team in
exploring progress, ambitions, challenges and so on. It was also a chance for
each of the three Integrated Care Systems in the North West to showcase how
they were delivering the three ‘left shifts’ outlined in the NHS 10 Year
Health Plan. In particular, how was ‘neighbourhood health care’ beginning
to be developed and delivered.
I have to say the presentations from
the national team were, for once, positive, congratulatory, and at times humorous.
Unusually, there was an early nod towards mental health services. My colleague
Anthony H from Pennine Care FT presented the work we had done together to eliminate
‘out of area placements’ over the past 18 months.
Out of area placements are used where
service users requiring inpatient care can’t get this in Greater Manchester, as
there are no available beds. They are then placed in services often many miles away
from their home and family. It is a failure on our part that we used such
placements. Eliminating these placements was a tremendous achievement on the part
of my colleagues, and it was great to see their story being shared with
colleagues from across the region and beyond.
Then, as is so often the case,
the conversations returned to urgent and emergency care, and reducing waiting
lists and waiting times. Mental health was put back in its box. Saying that,
the local service presentations were interesting. The use of new technologies
in transforming services was impressive, and the use of data to develop population
health initiatives was encouraging, and in particular appeared to be really making
a difference to preventing ill health and reducing the need for expensive hospital
care.
But throughout the presentations there
was no other mention of mental health. I wondered why - there is no health
without mental health. One of the people who had been part of the Greater
Manchester presentation was a GP called Claire. I grabbed her before she could
leave and talked to her about when she thought her data programme might include
mental health services. Her answer both surprised me and excited me.
She told me they are already
looking at the related mental health problems that might result from the
physical conditions their data had focused on. Anxiety, depression, generalised
stress were all factors that they were now beginning to build into their data programme.
Likewise, employment status, housing conditions, family and community,
relationships were also increasingly recognised as being important health determinants
and were now being incorporated into the data base.
Claire hadn’t mentioned any of
these developments, and to be honest, I should have ‘heard’ what she
didn’t say. But then, perhaps others wouldn’t have thought about the mental
health and wellbeing consequences of Cardio Vascular Disease, Diabetes, Asthma
and Chronic Kidney Disease either. Folk are probably more familiar with the physical
consequences of such health problems. It was a lesson for me in terms of
helping people think about mental health differently.
Travelling home on the train, I
wondered what Joel would have made of my day. He sadly died on a plane, on his
way back from a three-month speaking tour in Hong Kong in 2008. Health care,
and how services are provided have changed out of all recognition since then. Thankfully,
as was evident at the meeting last week, health care continues to transform, and
hopefully for the better.
*Joel once kept his Dean of
Faculty a prisoner in his office as a protest at the termination of his
contract. The police were called and he was arrested. After the Jewish
Chronicle published his story, he was reinstated and carried on working for a
number of years before his death in 2008.