14 July - Mental health network webinar

This week's guest is Matthew Taylor, Chief Exec of NHS Confederation.

To launch the meeting, Matthew shared his reflections on the current political turmoil and noted the impact on the long-term plan, which is likely to be put on hold until a new prime minister is appointed. He feels it likely there will be a new Secretary of State – what are the implications of this?

"The Confed will be pushing hard for a ‘reality reset’. There is a need to remove perceptions that have been built up under Boris Johnson’s leadership, such as that the NHS is awash with money. There is an opportunity to tell the truth and be realistic about the current situation, which in turn allows for a ‘bridge to the future’ narrative."

"The current crisis reflects the gap between capacity and demand and is a result of a decade of austerity, followed by Covid. Besides, there is an additional element regarding acuity of demand."

Matthew argues the model of healthcare could be completely transformed in 10-15 years, with the help of the NHS app.

"Quality of care in the NHS is excellent, but organisations themselves are inefficient. There is a need to move to a less clinical way of thinking about mental health and ‘split screen thinking’, which brings about immediate and pressing challenges along with the future vision."

Matthew spoke about an upcoming blog which focuses on approaching winter in a more collaborative and preventative way.

"There is a real energy within the Confed right now."

"All 42 ICSs have been recruiting and there is an ambition to work in supportive but challenging ways with them. The goal is to work more seamlessly with local government and engaging in conversations with NHSE around moving away from hierarchal health services."

A participant spoke of the importance of boards knowing their own reality and evidencing this via governance, data and metrics, as well as designing systems and structures to match the needs of recipients, such as the new 'virtual hospital'.

The group felt there are prevention opportunities in mental health that trusts are beginning to grasp in a way not seen in other sectors.

"Northamptonshire work closely with Mind and admission avoidance has been a key strand of activity. The formal collaborative has been contracted by the new ICB and, as such, will have the whole budget for mental health in one years’ time. The collaborative will commission all services, including the voluntary sector."

"No matter who the Secretary of State is, the control will come from the Treasury."

Some spoke of difficulties in being required to submit balanced budgets and the consequences of this: "There is far better value in working collaboratively, however this requires an open, honest conversation, which IM does not feel he can currently have outside of the board."

Others spoke about difficulties with radical transformation, resulting from years of top-down performance related approaches and difficulties in going from one system to another, resulting in only minimal changes. They also spoke of perpetually recycling good people who are steeped in the NHS.

To this point, Matthew noted opportunities to work more closely with local government and the need to get better at fighting back. He described the cycle linking lack of investment in health and care exacerbating economic challenges, highlighting the need to argue more strongly around this.

"It is essential to present a united view to government regarding budgets to allow for strength in numbers and a common narrative."

Finally, Matthew detailed the four critical ingredients of system working: shared vision and purpose, data, finance and relationships and spoke of commissioning a work piece on fast feedback loops in demand management. He agreed the focus must be on practical change, rather than abstract collaboration.

"There is a need to invest in the quality of relationships in order to do this."