07.04.16
The future starts now
Source: NHE Mar/Apr 16
As NHE went to press, Forward Thinking Birmingham went live. Its managing director, Denise McLellan, explains the main changes and what benefits the new integrated mental health system will deliver.
Forward Thinking Birmingham, the city’s new integrated mental health system, is technically just a few days old: it went live on 1 April, at which point its drop-in centre, Pause, started taking referrals for children and young adults. While this has been a momentous landmark for the city’s healthcare history, the programme has been quietly taking shape since October last year, when local CCGs first began rolling out the reformed model.
The headline difference between this system and other mental health services nationwide is the age range: replacing the well-known CAMHS scheme, the programme will take referrals from anyone up to the age of 25. Denise McLellan, its managing director, said this is a big change from the former model that forced children to switch to adult providers in the city – namely Birmingham Solihull Mental Health Trust NHS FT – between the ages of 16 and 18.
She told NHE: “That’s a time of great volatility in a young person’s life. It’s also a time when young people’s mental health condition is least stable. By 25, their mental health condition is much more stable, so it makes sense to change healthcare provider at 25 rather than 18. That’s the single biggest new thing about the service.”
Operating as a system
Forward Thinking Birmingham will also operate as a system, something different to what the NHS is historically accustomed to. Pause, the one-stop shop for anyone needing help, stands as its shopfront, with a reformed system of referrals embedded within it. This is a major leap from the fragmented model it replaces, whereby GPs would refer patients to a range of different providers depending on whether they needed therapy, advice or treatment. “It’s now a single integrated service with a single integrated access point, one telephone number, and one electronic portal,” said McLellan.
Explaining Pause, which is effectively the first of its kind in the UK, she said “it’s a bit like a Costa café” in terms of atmosphere: “If you’re a young person, you can pop in, pick up leaflets, talk to a member of staff, talk to a user, join a young person’s group or, if a parent walks in, they can join a parent’s group. We’ll have significant online presence as well – Facebook, Twitter, Instagram – so people will interface with the service through that.”
Five-way partnership
In times of financial restraint, Forward Thinking Birmingham is only made possible by its five-way alliance. Birmingham Children’s Hospital is its lead partner, while Worcestershire Health and Care NHS Trust provides adult mental health expertise; Priory Group provides over-16 inpatient beds at Woodbourne Hospital; charity Children’s Society is opening the walk-in hub; and Beacon UK acts as a case management partner, supporting them with business intelligence and access and flow data.
Less formally, the project works closely with the city council, West Midlands Police, all local schools and acute hospitals, and a range of voluntary sector bodies.
The system, which covers around one million people, will cost the city £25m per year, which McLellan promises will be spent cost-efficiently: “We’re absolutely focused on making the best use of every public pound that’s available to us to improve mental health outcomes for young people.”
Replicating the model
Asked how the city has accomplished such a feat with the funding available, McLellan said it has been a long time coming, with people always claiming Birmingham could do more to make patients’ journeys smoother, more integrated and less difficult. When three CCGs set out to tackle this, Birmingham South Central CCG took children’s services as their priority. “They started off focusing on what you might call a traditional model, but they did a big process of consultation and the feedback from users was that it needed to go up to 25,” said McLellan.
But could the new system be replicated across the UK? “I absolutely think it could,” she argued, but added: “We need to evaluate it and learn about it first, and then I should be more confident in promoting it. Yet we’re absolutely committed to this being the right model.”
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