Whole People Whole Systems & how to get there

2. Whole People Whole Systems & how to get there

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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.

13. 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

14. 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 ofmental health determinants and promote/ sustain recovery

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

16. 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

17. 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?

18. 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

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

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

21. 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?

22. Where to now? • The agenda you suggested today • Keeping in touch… • … and keeping the network going