Tackling Culture Change to Transform Mental Health
Forward Thinking Birmingham delivers mental health services for children and young people aged up to 25, combining the expertise of Birmingham Children’s Hospital, Worcester Health and Care Trust, Beacon UK, The Children’s Society and The Priory Group. The partnership’s vision is that Birmingham should be the first city where mental health problems are not a barrier to young people achieving their dreams. The transformational changes to the service were driven by the need to address disjointed and fragmented care provision, complicated service models, long waiting lists and rising demand. The service operates a ‘no wrong door’ policy and aims to provide joined-up care, focusing on individual needs, with improved access and choice for young people.
The change has brought about unprecedented challenges to the way services and organisations have traditionally been set up, the way mental health services are commissioned and delivered, and crucially to the way mental health professionals are used to working. Bringing together two previously distinct services (CAMHS and adult mental health), from two different organisations, both with strong identities and unique histories, has been one of the most challenging aspects of transforming the service. Many clinicians had concerns such as working with a different age range, making referrals to services outside the NHS and different working hours, to name a few. And for leaders across the organisation this new model has presented challenges in terms of professional status, decision-making and accountability, governance and information-sharing.
Changing culture in the workforce is crucial to the success of any transformation programme – maintaining morale and encouraging staff to adopt new ways of working while supporting them through the change process has been a huge challenge. Some examples of the work I have been involved in include co-designing and delivering strategy development sessions, running action learning sets (working collectively in small groups) with service managers, developing an induction programme for staff to explain the new model and setting up a ‘buddying’ programme for experienced and new team managers.
Forward Thinking Birmingham’s innovative model of service delivery calls for a particular type of leadership – leaders who can work across organisational boundaries; who are willing to share power and resource in pursuit of a shared vision; and who can, in the words of The five year forward view for mental health, ‘take decisive steps to break down barriers in the way services are provided to reshape how care is delivered, increase access to the right care at the right time, drive down variations in the quality of care on offer, and improve outcomes’.