Transforming mental health: a plan of action for London

The government’s mandate for achieving parity of esteem between physical and mental health has put the spotlight on mental health provision. In London, meeting the mental health needs of the large and diverse population poses major challenges, and the London Health Board has identified improving the mental wellbeing of Londoners as a priority. But so far, there has been little consideration of what is required to meet the future mental health needs of London’s population and how this can be achieved.

This report describes a vision for the future of mental health provision in London, generated through a process of engagement with key stakeholders in the capital. The vision is based on a collaborative, integrated approach towards mental health that is relevant in London and elsewhere.

Key findings

A number of key steps have been identified to support systemic implementation of this vision:

• developing a process of collaborative commissioning to facilitate change

• driving change through collective systems leadership

• ensuring that service users and clinicians are at the core of provision

• using contracting systems to support integration

• building a public health approach to mental wellbeing

• developing pan-London solutions to increase impact

• improving the availability of meaningful outcomes data

• utilising London’s academic infrastructure to disseminate best practice

• creating a new narrative for mental health.

These steps reflect the strengths of individual stakeholder groups but also the importance of working collaboratively and adopting a shared agenda. Commissioners and providers are at the heart of this process, drawing together key organisations around the voice of service users, carers and clinicians in order to deliver improved outcomes. Other organisations have an important role to play in creating the infrastructure to do this, including Public Health England, NHS England, academic health science networks and centres, Collaborations for Leadership in Applied Health Research and Care and strategic clinical networks.

Policy implications

Achieving this vision will require the many and diverse stakeholders working on improving mental health in London to adopt new ways of working. The main stakeholders need to take the lead in bringing different groups together to develop a shared agenda and plan of action. They will need to address and overcome barriers to collaborative working, including different political and historical agendas, and unconstructive communication.

On the ground, certain approaches can support better integration of care and better outcomes. These include adopting collaborative leadership strategies, supporting and strengthening commissioning, and using contracting tools to facilitate integration. The strategic dissemination of evidence and development of data and outcomes can help ensure that change is systemic.