'Mental health has occasionally painted itself as the eternal Cinderella, with the result that some commissioners feel obliged to treat it accordingly'
HSJ readers will know that following its hit status in the West End, the Darzi review is off on a national tour from Berwick to Scilly, stopping at all stations. Some critics felt the London version of the NHS review was lacking on mental health, although its promoters have dropped strong hints that this will be rectified.
What's certain is that strategic change in mental health needs strong commissioning. There has been talk for some years about the need to improve mental health commissioning capacity, and maybe junior health minister Lord Darzi will be the catalyst to turn talk into action.
Mental health has been in danger of entering into a cycle of victimhood. Some have yet to recover from the descent from grace from 2000-02. Mental health went from one of the three clinical priorities in 2000's NHS plan, to being barely mentioned in 2002's Delivering the NHS Plan: next steps on investment, next steps on reform.
Mental health has occasionally painted itself as the eternal Cinderella, with the result that some commissioners feel obliged to treat it accordingly.
The answer has to be a strong relationship between mental health trusts and commissioners. This is about going beyond crude perceptions of an untrammelled competitive free market, and recognising that system-management for the benefit of service users in modern mental health requires partnership.
In Camden and Islington Mental Health and Social Care trust, our commissioners have their foibles, but a lot fewer than many others we hear about. They are fully integrated joint commissioners with a genuine history of investment in mental health. Key decision-makers are senior, experienced people. Commissioners and providers have made an earnest long-term commitment to relationship management.
We have worked together to reduce delayed transfers of care - with or without the financial incentives available in the acute sector. We mutually recognise the important role voluntary sector colleagues play in delivering a range of services. While we do have a lead commissioner, an outside observer would be very hard-pressed to guess who it is.
We also try to look to the future - for example by getting around the table to discuss sensible ways that payment by results might work in mental health. We have had our disagreements, but always on a principled basis and with the knowledge that we are on the same side, dedicated to better services.
The plan probably needs to include a commitment to invest in mental health commissioning capacity, not least in public health needs assessment, and the development of clinical networks for mental healthcare.
So the question for mental health trusts is: by the time the Darzi roadshow reaches your local emporium, will your local health and social care economy have got its act together to get the most out of it for mental health?