Two recent phone calls from different parts of the country got me thinking about what good management can do to make mental health and social care systems tick.
One call was from a foundation trust interested in incorporating the benefits of care trust values. The other was from a care trust looking for ideas to refresh local partners' enthusiasm for integration.
While the care trust summer of love 2001 never quite entered popular culture, and the care trust network had no cause to book Wembley for its annual conference, the importance of partnership and integration in delivering excellent modern mental health services has never been greater. The implementation of the amended Mental Health Act in November will offer new opportunities in employing approved mental health professionals.
But 2008 is the summer of world class commissioning, with previously mild-mannered PCTs stalking the streets in search of contestability, armed with little more than the latest Mark Britnell screensaver. But can mental health and social care systems seriously be improved by bringing in different new providers for specialist services here and there? Or does the experience of 21st century mental health services in England point to the primacy of the integrated, system-driven acute care pathway, with service user recovery as the central ambition, led by the statutory secondary care provider?
In Camden and Islington we have delivered phased and significant reductions in acute bed numbers, thanks not least to virtual elimination of adult delayed discharges. Fast-track access to assessment and urgent care, alongside rigorous medical director-led bed management, are fulcrums of the system. Local residents access mental health services judged by the Healthcare Commission to be excellent and local government services also judged to be top rate by the Audit Commission and Commission for Social Care Inspection. The model benefits from inpatient environments are also judged to be excellent. Clinical and service outcomes are tracked through "balanced scorecards" with a strong system of risk management and safety.
In a strong system, innovation and specialisation are supported and celebrated. We have seen the success of our partnership for older people project, a ground-breaking stress campaign, and an award-winning employment initiative.
Teamwork with our local authority partners remains hardwired into our culture. We will work together on further improvements and the delivery of Transforming Social Care.
As we see it, delivering recovery is based around five competencies: staff, partnership, care pathway, quality and governance and membership. And these are all underpinned by economy and efficiency. We believe in lean structures and investment in frontline service management.
Could this all have been delivered without partnership with local government and determined pursuit of integration? Some will try to argue that it could - but they will have to come from behind to win this argument.