Sunday, 19 July 2026

Looking back over a quality week

Last week was a good one, and a busy one too. Matilda came into our lives following the untimely and unexpected death of our ragdoll cat Willow, 6 weeks ago. I had my first flying lesson, including taking controls of a Cessna plane at 2000 feet. A fabulous experience for sure. We also went to the Great Eccleston Agricultural Show yesterday, always interesting, although the price of food and drink seems to go up exponentially every year. Note to self, next year take a picnic! Everyone looked hot, including the animals, but it was great to see so many families out in the sunshine and clearly having a great time.

Work was also good, and there were two things from last week to note. One was visiting colleagues in one of our community older adult services. Always wonderful to meet colleagues and to hear about both their achievements and challenges. They did not disappoint!

The second was having a first read of the NHS Quality Strategy published last week. I wasn’t particularly inspired. However, there is nothing in the guidance that anyone would want to argue with. It provides a bit more of the detail, as to how the NHS 10 Year Health Plan might be best taken forward. I was left with a feeling there were lots of things promised for the future, with even more detail to be worked through. That said, there is much we can do in interpreting the guidance to ensure the decisions we take are ones we own. I have set aside time tomorrow to have a second and more purposeful read.

One of the things that caught my eye was the desire to develop and publish a Modern Service Framework (MSF) for Mental Health. The 10 Year Health Plan sets out the notion of MSFs being the means for improving outcomes associated with serious health conditions where there are high rates of avoidable deaths and ill health. In the first instance, these will include a MSF for cardiovascular disease, frailty, dementia and mental health.

It’s said that each MSF will set out an ambitious long-term outcome goal (a so called ‘moonshot goal’) for the particular service MSF. Take a look at the current cardiovascular disease MSF which, whilst having 12 immediate priorities, sets out a much bigger ambition for the future. I thought the scale of ambition was truly impressive. 

In our Trust, we are not sitting back waiting for the Mental Health MSF. We know our immediate focus has to be on continuing to reduce out of area placements (something we are already succeeding in), improving timely access to support for children and young people (we are not doing so well at) strengthening the continuity of care, and ensuring folk receive the right support at the right time (for us this means particularly upping the pace of our community transformation programme). All of which we are focused upon.   

I think one of the reasons my interest was piqued by the mention of a new Mental Health MSF was, actually, I have been here before. It was way back when I first started my academic career. Through my PhD supervisor Professor Joel Richman’s generosity, I was able to stand on his shoulders to see the world from many different perspectives. For that I will be forever grateful. He was a great PhD supervisor, but Joel wasn’t the only one to help me on my academic journey. The late David Skidmore was a steadfast guide, and Ian Stronach and Sheila Stark became the best mentors anyone could want.

In my earliest days, both were more than generous in allowing me to be a named author on what I think was one of my most favourite papers. The paper was tilted ‘Towards an Uncertain Politics of Professionalism: Teacher and Nurse Identities in Flux’. Hopefully, you can read it here. It became an enormously well-cited paper, and in my day, to become a professor, one had to write good quality papers for refereed journals, be an active researcher, secure research funding and successfully supervise PhD students to get their doctorate. It’s sometimes very different these days.

Our paper referred to the original Mental Health MSF, published in 1999. Frank Dobson was the Secretary of State for Health back then, and the world was a very different place. To be honest, I didn’t think much of that MSF. Did it improve mental health care? I think probably not. Will the forthcoming MSF improve mental health care? Well, I think the ‘improvement momentum’ is with us, and so I’m confident it will.