The NHS needs to think differently about working with others

Some would say the NHS has three textbook responses to a problem: restructuring, blaming lack of money, or asking staff to work harder. Whether or not you agree with this assessment, none of these feel like realistic responses to the significant, complex, multi-faceted health and care needs we're seeing in our local communities.

Challenges such as our ageing population and increasing numbers of patients with long-term, multiple health conditions are well known. But when you throw the physical and psychological aftershocks of COVID-19 into the mix, alongside the impact of the cost of living crisis, the health and care needs of local communities look pretty stark.

The last thing you're likely to hear patients asking for is a further shake up of NHS infrastructure. And in the current financial climate, it's unrealistic to expect extra investment (and legitimate to ask whether the NHS always makes best use of every pound of public money it already receives). In terms of the workforce, it would be naïve, unfair and unreasonable - at the very least - to bank on there being an endless reservoir of goodwill that can be drawn upon. We know from the annual NHS Staff Survey that people are experiencing high levels of stress.

So, what is the answer to the challenges we face?

Fresh thinking to mobilise the sector

Rather than falling back on traditional solutions, we need fresh thinking about how best to mobilise the expertise, experience and energy of the whole health and care sector. 

There's a huge breadth of specialist expertise, agility and innovation available to the NHS

In Sussex, we have a rich and diverse range of over 10,000 VCSE organisations. These range from small, grassroot operations to larger organisations, some of which are aligned to national charities. There's a huge breadth of specialist expertise, agility and innovation available to the NHS, it's just that the NHS isn't always adaptable, sufficiently flexible or committed in practice to working in partnership.

We want to change that in Sussex. We're undertaking a fundamental reset of how the VCSE sector and NHS work together to meet the needs of people with mental health problems, learning disabilities and neurodiversity. 

Our joint approach across the VCSE sector and NHS involves a number of steps.

Our step-by-step approach

This first step was to determine the most effect way for the NHS and VCSE sector to engage with each other. At times, engagement doesn't go an awful lot further than invitations for VCSE representatives to attend multiple NHS meetings. To address this, VCSE mental health sector leaders have joined together to create the Sussex VCSE mental health Strategic Leadership Group. This involves VCSE organisations working together to mobilise its collective time, resource, expertise and voice. The group has its own annual plan of aims and priorities, bringing the NHS and other statutory stakeholders to account on their actions to support delivery.

The second step was establishing a 'two sectors, one partnership' compact agreement: The Sussex Compact. This defines how we will work together differently on behalf of our local communities. Developed in co-production, the agreement sets out a shared statement of intent, alongside the principles and commitments that will underpin how we work together.

This agreement includes the commitment to listen to each other, understand and respect the different expertise across the two sectors

This agreement includes the commitment to listen to each other, understand and respect the different expertise across the two sectors. It includes a recognition that there will be times when we will need to explore disagreements. Doing this in a spirit of mutual respect and collaboration is key.

Finally, we needed a mindset shift to place the NHS and VCSE sector on an equal footing as strategic partners, each with its own unique strengths and expertise. This meant moving the role of the VCSE sector from a ‘reference’ or ‘consultation’ partner to one that's central in shaping and delivering mental health, learning disability and neurodiversity services. 

The suite of Staying Well services we have launched together in Sussex is one example of what this partnership means in practice. These community-based hubs provide a place where people can go, without needing a referral, when they feel at breaking point and in need of urgent mental health support. It is about getting them crisis support in the right place, rather than in NHS acute hospital emergency departments. It involves the VCSE sector talking the lead, supported by NHS clinical expertise.

We've also been working together to improve the way we help people to understand how to get help in a crisis

We've also been working together to improve the way we help people to understand how to get help in a crisis. People have told us that it can be confusing to know where to go when your mental health needs are urgent. For the first time in Sussex, we will be developing joint, clear and consistent signposting to get people to the right place.

We want to explore other new ways of providing services. And, in doing so, we are committed to challenging traditional ways of working and moving beyond organisational and sector silos that can get in the way of innovation.

Of course, no one programme of work can deliver all the solutions that are needed to meet the health and care needs of our local communities. But the work we are doing together illustrates the art of the possible when it comes to thinking creatively, being bold and taking concerted action in partnership to improve services. 

Neil Blanchard is CEO of Southdown and chair of the Sussex Mental Health VCSE Strategic Leadership Group.

Dr Jane Padmore is CEO of Sussex Partnership NHS Foundation Trust.

You can follow Neil on LinkedIn