Clinical mental health lead Dr Gwyn Elias talks to Angela Sharda about the challenges of her role.
Q. Tell us about your role as clinical lead for mental health, dementia and learning disabilities.
A. Being creative, building relationships and collaborative working are important aspects of my role. At the moment, I am working on improving population-specific mental health needs by helping to develop new models of care.
Q. What are the biggest challenges you face in your clinical commissioning group (CCG)?
A. Balancing my passion for a sustainable future for the whole of the NHS and only being able to focus on one area at a time.
Q. What are you most proud of in your CCG?
A. My CCG is committed to quality of care for patients. Having a supportive senior management team has been crucial in developing innovative ways of working. Our member practices are working closely with local services towards improving population-specific outcomes for their areas.I have been working with the areas that have a mental health focus to link into ongoing improvement work on mental health in the city.
The CCG has commissioned the redesign of community-based mental health services, which has been co-produced with the people of Leeds. The emerging new models are working innovatively with other partners across the system, including our commissioned social prescribing service and exploring their skill mix to create meaningful outcomes, addressing the wider social determinants of health as well as improving the flow through the system.
Q. What do you think needs to be done about the lack of funding for mental health?
A. Several studies suggest that there is an overall underspend on the NHS in the UK, yet the Commonwealth Fund reported the NHS as providing the best healthcare in the world. I’m aware that there has been a shift in the position on support for mental health, which is a positive move, and with that has come the promise of increased resources. Having said that, any funding challenges need addressing at the most senior level.
Q. What changes do you want to see the Government make to the NHS and services for mental health, dementia and learning disabilities in particular?
A. The setting of targets drives services towards a tick-box approach, when really the focus should be on achieving outcomes for patients. Although it is important to evaluate effectiveness, the administrative time overall underspend on the NHS in the UK, yet we are also reported as providing the best standards of healthcare in the world taken to form-fill and box-tick eats into the time clinicians spend with patients, which impacts on waiting times for patients. It would be helpful to either have administrative support for administrative work or the development of innovative ways of effectively capturing the data. In Leeds, the redesign of community- based mental health services involved all stakeholders, including citizens.
We are very fortunate to have a strong third-sector presence and this offers the opportunity to truly co-produce services. Co-production in service redesign may offer the potential for services to truly meet the needs of the people who use them.
Q. What issues do you expect CCGs to face when they implement the sustainability and transformation plans?
A. My experience from co-production is that all stakeholders need to be involved for there to be ownership across the system, including patients and front- line staff. The main challenge I see is the timescale for the work, and balancing this between building relationships across so many different organisations.
Q. How do you think vanguards are developing?
A. The vanguards are excellent opportunities for testing out new ways to work. I hope the wider system will be able to share in their learning. In a truly equitable world, every area should have the opportunity to be involved in a vanguard.
Q. If you could improve one thing in the NHS, what would it be?
A. Everyone in the NHS is working towards caring for the population. I would like to see improved relationships and the formation of networks between teams and across organisational boundaries.
Q. What do you want to achieve in your CCG in the next 12 months?
A. To demonstrate to the system that if we do the right thing for patients, system flow is also improved. To continue the focus on improving the quality and improving quality and working towards population outcomes.
Q. What are the biggest flaws in our NHS system and how do you think these can be overcome?
A. Changes take time to embed into the system. All stakeholders need to be clear on the vision of the organisation to understand their role in the overall purpose. However, the effects of the well- documented pressures and challenges on the NHS should be addressed at the most senior levels, as often there isn’t enough time for teams to communicate face to face. The investment in the system should include time for teams to come together to work on solutions.
Dr Gwyn Elias is a GP at Rawdon Surgery in Leeds and clinical lead for mental health, dementia and learning disabilities at NHS Leeds West CCG