Whole People Whole Systems

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(No Transcript)
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Whole People Whole Systems how to get there
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Key themes

• The SPN - its reason for being
• Reflections further down the line
• The Next Phase- working with the grain of
  modernisation
• Building Critical Mass - planning, commissioning,
  delivering and supporting services

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Why the SPN?

• Historical low profile and low confidence of
  advocates of the social model
• Social models lost out in the medicalisation of
  mental health services and the lack of national
  emphasis on both primary and secondary prevention
• Concern about obliteration within integrated
  services

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Drilling down into concerns

• Concerns related to
• Integration - loss of home and support for
  social care staff and erosion of expertise
• policy neglect
• social care reductionism
• fragmentation of support to individuals
• no focus on needs on communities
• failure to reconcile values and lack of
  understanding across perspectives

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At the same time

• Modern mental health policy
• new understanding of the full range of
  determinants of mental health
• new focus of equity, health inequalities
• new language of social inclusion
• renewed legitimacy for community focused
  interventions
• language and structures for user and carer
  empowerment

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Emergent Ethos

• Recovery
• evidence based policy
• focuses new attention on systems, and structures-
  and the social and community dimensions of
  patient journeys
• Underpinning ideological root of the social model

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Circle Squaring

• The SPN position
• Exploit the policy opportunities and influence
  future policy directions
• Develop policy and practice across competing
  delivery systems (NHS/ Local Gvt. and Vol.
  Sector)
• Define and clarify how social perspectives enable
  and support whole systems approaches and support
  and promote recovery

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Where are we now?

• Integration-a done deal but still transitional
  -needs persistence.
• NSF implementation- a sound direction of travel
  (with some provisos)
• Social inclusion- new awareness across whole
  systems
• User and carer involvement- very powerful
  potentialities

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Future Possibilities

• Higher profile for mental health
• strong local commissioning involving all local
  stakeholders may force the pace for local, social
  solutions (user-led crisis houses, self help, new
  step-down day services etc)
• new opportunities for influence and development

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However.

• The language of modernisation may obstruct
• social perspectives are implicit and subordinate
  to clinical interpretations
• social care reductionism still the norm
• social care staff still on back foot in power
  structures within trusts
• user and carer involvement strategies immature

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The Big One

• Mental health still losing out in funding battles
• Historical deficits not overcome by new funding
• Establishing a mental health system that can
  respond to local population need cannot be
  achieved through service redesign alone
• Budgets need ring fencing for growth - so the
  cost benefits need to be clear.

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As Usual -Threats Possibilities

• Policy opportunities and new evidence, plus
  stronger user voice creates a fertile environment
  for the application of social perspectives
• The target driven culture and real resource
  constraints may mean that these opportunities are
  not exploited

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Where Next?

• Working with the grain of modernisation to apply
  the social model
• Will help in achievement of performance targets
• Users and carers demand local, non clinical
  solutions
• Enables joined up responses to address the full
  range of mental health determinants and promote/
  sustain recovery

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How?

• Champions for social perspectives at every level
• Getting smart about how to apply the perspective
  within
• planning
• commissioning
• delivering
• supporting

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Planning

• Director of Social Care at Board level within
  Trusts
• The workforce- strategies for ensuring that
  social models are explicit within multi
  disciplinary training
• Clarifying LITs relationship with other strategic
  planning bodies. i.e. LSPs
• Developing mature planning relationships with
  Patients Forums

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Commissioning

• Consider how Trust can address local need as well
  as national targets
• Initiate multi stakeholder commissioning
• Assess local capability for social care
  commissioning
• Commission against assessed local needs
• Commissioning for social inclusion, regeneration
  and challenging stigma- how?

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Delivering

• Social care PIs- what would these look like in
  various settings?
• User focused monitoring of Trust performance
• Identify opportunities for applying social
  perspectives within new service models
• Who delivers - not always the usual suspects

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Supporting

• Address the developmental needs of people who
  deliver services inc. users, carers, volunteers,
  vol. orgs
• Trust based/led learning networks for social
  perspectives

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Tentative Conclusion

• We are in better shape than we could have been -
  but the task is only just beginning!

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Workshop

• Remember partnership working skills
• What can each of us do include a social
  perspective?
• How will you as a team present this to the group?

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Where to now?

• The agenda you suggested today
• Keeping in touch
• and keeping the network going