23 September - mental health network - governance during the COVID-19 pandemic

Overheard during the webinar:

“We are facing a demand increase of 23% in our community teams, with young people’s waiting lists growing, and we have the challenge of how to support them while they are waiting to keep them safe. It is becoming particularly acute in high-risk areas, for example tier-four children and young people’s unit, where the unit is full and staffing issues are worrying.”

“The pressure is coming from two places: firstly, from the pandemic and the need to cope with this immediate challenge, and secondly the challenge of the post-pandemic. It feels like we are doing this well, but also having an ICS being developed with a focus on structures and delivery vehicles can feel quite dissonant. All four purposes of the ICS are critically important, but it feels like an additional pressure right now. But I remain proud of the collaborative work taking place across the NHS and the wider mental health sector.”

“We are developing a delivery model in the system, which will need both money and workforce to support its functioning. There is a priority across the system about supporting emergency and elective care, and whilst this is essential there is a concern that this could detract from mental health services.”

“We have about 60 contracts, and we are starting to approach how to be both a commissioner and a provider in this landscape, and the complexity of our governance role as a commissioner. There is also challenges as a trust we have acquired approached this in a different way, which adds complexity.”

“We are seeing increased demand and delayed transfer of care. We are restricting ourselves into a care group type organisation which they hope will help involve clinicians get more involved in all operational levels. The strength of management is very difficult, and the building of ICSs is putting additional pressure on this. Stability at board levels is a challenge too due to term ends coming up.”

“We are facing challenges – especially rising demand and complexity – but the morale of staff has remained generally high under the circumstances. I am most concerned about recruitment, with people leaving the NHS, and the difficulty of attracting new staff in at a time of increased demand. There is a concern we could be in competition for a limited number of people. The governance around provider collaboratives will be important, and focusing on outcomes is an important approach. I’m proud of our work to support veterans who face significant challenges when leaving the service – where we started with three trained staff to support veterans, now we have 700 staff trained.”

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