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09.06.17

Putting parity of esteem at the heart of GM plans

Source: NHE May/Jun 17

Jon Rouse, chief officer of the Greater Manchester Health & Social Care Partnership, explains how the city region aims to tackle parity of esteem between physical and mental.

In January, we published our Population Health Plan for Greater Manchester. We are a city region that has grappled with public health challenges for centuries – from food riots to cholera, from overcrowding to addiction – reflecting the stresses of change and development across our settlements, which are home today to some 2.8 million citizens. 

The plan is guided by a set of principles for how we can best support the population in maintaining and improving their health and wellbeing. They are: a preference for community-based models, an adherence to evidence-based interventions, a commitment to parity of esteem between physical and mental health, and belief in the merits of a life course approach. 

Greater Manchester is committed to the goal of parity of esteem between physical and mental health, and that includes our preventative programmes. It is at the heart of everything we plan to do. For example, we will adopt a holistic approach to our early years programme, working across universal and targeted services to influence the physical, mental, emotional and cognitive development of young children. And under our ‘Live Well’ theme, we will introduce an expanded Work and Health Programme that provides rapid access to both physical and mental health services to enable people who are struggling to stay in work or get back into work quickly.

Tackling unwarranted variation 

We had a difficult starting position, with quite a lot of unwarranted variation and we were not as joined-up as we would have liked. The first thing we had to do was to admit that. Data was important in working that out; the Centre for Mental Health is still working on identifying any gaps. And there were areas of good, even outstanding, practices and services – it just was not uniform. 

Governance was then put into place. There was a board established which developed a single strategy but also sought views on what was meant by mental health and what needed to change. Our strategy document has gone well beyond just a clinical response and recognises there is a palette of other factors that influence mental health, including health, social services, education and housing, and they all have a potential role in improving it. We also have an implementation board with an independent chair; it’s important we are able to hold people to account for delivery, otherwise implementation plans just sit on the shelf. Although we can’t hand-hold every one, individual areas will have to work towards set standards and outcomes that are the same for the whole of Greater Manchester. 

There are a number of key priorities outlined in our plan, including suicide prevention, eating disorders, crisis intervention, children and young people’s services, and ADHD. These were all felt to be important for the local community. For example, ADHD is not often a priority but early diagnosis and interventions can keep pupils in mainstream schools and reduce the impact on their lives and those of their family. 

We also want to become the best place in the world to live with dementia. We need to support people through early dementia and prepare them for what lies ahead. Social care is key in this plan so we need to make sure that we keep hold of, and improve, our services and providers. 

We are currently working through many of these changes by using our Transformation Fund, a pot of money that will help us transform health and social care, but the timescales are tight. We need to be implementing and delivering our plans by 2020 and the savings need to be flowing. In five years, I want to be seeing holistic approaches to mental health both in prevention and treatment with GPs able to treat or refer patients to a number of local options. The timescales are tight, but from what I’ve seen so far it is eminently doable.

FOR MORE INFORMATION

W: www.gmhsc.org.uk

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