New funding to transform community mental health care

People in Surrey and North East Hampshire who have a severe mental illness are set to benefit from a ground-breaking new community mental health service designed to improve access to a wide range of specialist support.

Surrey and Borders Partnership NHS Foundation Trust is working with Frimley Health and Care Integrated Care System (ICS) and the neighbouring Surrey Heartlands Partnership - two of twelve ‘early implementer’ sites across England - to test a new community model of mental health care adults and older adults over two years.

The ICS has been awarded a share of £70m funding by NHS England and mental health services will lead on delivering new model, in partnership with Primary Care Networks (groups of GP practices working together).

Extended appointments with mental health experts from the NHS, social care and specialist third sector organisations, plus access to therapies, physical health checks and pharmacists, are just some of the wider expertise patients will be able to access in their local GP practice and in the community under new ways of working. Patients will be able to explore the situation affecting their wellbeing – whether that is an ongoing mental or physical health problem, loneliness, debt, or other issues. They can then be guided to appropriate resources that may help, including talking therapies, benefits advice, or an introduction to a local community group.

Around 50% of those with severe mental illnesses, such as bipolar disorder, or major depression, currently see their GP to manage the majority of their care and treatment. But, until now, multi-agency support has mostly only been available to those referred to a specialist community mental health team. 

The new funding will enable our Trust  to expand on field trials of this approach which have already been running in three Primary Care Networks in West Surrey over the past six months. This service, known locally as GPimhs (General Practice Integrated Mental Health Service), is to be scaled up and expanded on thanks to new funding, as follows: 

Fiona Edwards, Lead for the Frimley Health and Care Integrated Care System and Chief Executive of Surrey and Borders Partnership NHS Foundation Trust, said: “We’re really excited to have been chosen to pilot this new way of working, as it responds directly to what local GPs have been telling us would most help their patients. We heard from more than 80 GPs that some patients need a greater level of support than can be offered in a normal appointment but don’t meet the criteria for the local mental health services.”

Dr Claire Fuller, Senior Responsible Officer for the Surrey Heartlands Health and Care Partnership, said: “Some patients need a greater level support than can be offered in a normal appointment fall between the gaps of the support that’s on offer. This means that GPs feel like they are left to deal with a high level of complexity and need on their own while patients feel like they are struggling to access the help they need to get better and stay well.”

Health leaders estimate the changes will prevent up to 10,000 adults each year from needing frequent appointments. This will free-up around 5 to 7.5 hours, equating to 30-45 appointments of GP clinical time every week.

Katie*, from Guildford, who has accessed the GPimhs service, said: “Ten minutes with my GP isn’t enough, but the time spent with the GPimhs worker helped me to open up. There are so many things that I don’t tell the doctor because there’s not enough time. I now feel supported and feel that I can open up and explore issues.

"This service will help to address the long standing health inequalities faced by people with serious mental illness”, says Professor Helen Rostill, Chief Innovation Officer and Director of Therapies, said: “It is unacceptable that people with serious mental illness die around 20 years younger than average. This is often because of poor physical health and social factors, whilst smoking, drug or alcohol use, are also big influences.”

Professor Rostill added: “By providing expert advice and support to local GP practices, we hope to reach more people, free up clinical time and help reduce the risk of people relapsing when their care is transferred back to their GP. Ultimately, it is about intervening early to save lives and improve quality of life.” 

Susanna Yeoman, Divisional Director for Mental Health Services at Berkshire Healthcare NHS Foundation Trust, concludes: “This focus on high quality and accessible mental health services in local communities is a significant step towards improving care for people with mental health issues. The shift towards this integrated, preventative approach will begin to address health inequalities and ensure people can access timely support.” 

Where this approach has been explored in Surrey, third sector mental health providers Richmond Fellowship, Catalyst Support, Mary Frances Support, which work together as Community Connections to provide mental health support, have been part of this integrated service.

John Anderton, Senior Operations Manager at The Mary Frances Trust, said: “Community Connections, being integrated into GPimhs, has brought together a blending of different specialist skills and knowledge, from medical to social. This gives people needing support more options, and more time to discuss, and be guided in their recovery journey. By gaining a collaborative relationship with the person to make small steps forward in their day to day life, the Community Connections Link worker can provide a gateway from the surgery right through to Community based services”.

Sue Murphy, Chief Executive of Catalyst Support, said: “Being part of a multidisciplinary team has broadened the opportunity for personal development; learning new skills as well as working more closely with GPs and being able to have informal discussions about patient need and care. This has had the positive result as being seen as an equal. This opportune moment to have an open dialogue is not something that has happened before now in any other form other than a brief telephone conversation to discuss a referral. Creating a structure within which we can contribute and add to group case discussions is a crucial factor, allowing different perspectives to create more informed decisions, and has paved the way for collaborative working and the feeling that our opinions are valid.

“In a time of workforce challenges being able to offer staff flexible working opportunities within new ways presents Community Connections with the chance to upskill staff and boost morale, demonstrate value for money for the third sector and to be a part of a transformational and innovative approach to service delivery.”

Under the proposals, the service will help connect people with a wide range of local authority health and wellbeing support services from leisure facilities, clubs, groups, stop smoking advice to community transport. 

The plans also include expanding the specific support available for people with a personality disorder and developing more targeted approaches for young people aged 18–25 years old.

Services are expected to be up and running by the end of the financial year as part of a gradual roll-out and will include an extensive recruitment campaign. 

These developments reflect ambitions set out in the NHS Long Term Plan, published in January this year, to transform community mental health services for adults of all ages with moderate to severe mental illnesses.

The funding announcements were made at the beginning of the Conservative Party Conference and coincide with the publication of the national Community Mental Health Framework which sets out how the new approach for how mental health services will be provided in the community.

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