Winner: Grampian health board, commissioning new employment services Runners-up: South Birmingham mental health trust; Wiltshire and Swindon Healthcare trust

Grampian health board

The health board serves a population of about 560,000 people in the north-east of Scotland.

Following the publication of Scotland's mental health framework, it decided to review and reconfigure Unicorn Enterprises, a 1960s NHS industrial therapy unit.

The health board decided it would have to 'lead from behind'. It agreed with Aberdeen city council that it would not directly commission alternative services from the NHS - instead they would be provided in community settings and be commissioned by the council. It also set up a pumppriming fund to help the new enterprises and enable users involved in the reconfiguration project to attend meetings and conferences.

The health board and council each took 50 per cent of the partnership, with a service user involvement approach to the reconfiguration, despite objections that this would be slow and 'not good for people'.

Service users were asked to choose representatives and reserves.

Two new social enterprises have been established in Aberdeen, providing employment and training for 36 people, along with an employment support team. A monitoring and evaluating committee was established, with users in the majority. This has spent a week in each of the new enterprises, evaluating their work. There is also informal benchmarking by service users in Aberdeen. The board has been asked to present its experiences at UK conferences and has been visited by Manchester HA.

The judges said:

The 50-50 project changes Aberdeen's approach to employment services for people with mental health problems. Moving from professionally defined services, it provides a structure driven by users. The judges were impressed that this project was entirely defined by its user involvement. An impressive and innovative employment project.

South Birmingham mental health trust

The Education Link Project is based at Shenley Fields mental health resource centre in south Birmingham. It began in 1995 when five clients started a short 'taster' course at Bournville College.

The project has grown considerably. It has a manager, two support workers and administrative support. The aim is to provide effective learning, training and employment services for people with mental health problems by making use of 'normal' community facilities.

The project has led to 130 clients attending courses at Bournville College, and 50 seeking training and employment through an employment services agency, and eight seeking voluntary work. The benefits have been improved self-esteem, concentration and motivation.

All clients are asked to evaluate their learning experience. Faceto-face exit interviews are being piloted as the first stage in looking for 'value-added' health benefits. A mental health forum with college and trust staff and users will be established next year.

The judges said:

We were impressed with the commitment and involvement that was demonstrated. Direct user testimony was used to demonstrate how education has changed people's lives.

There is clear evidence of evaluation and direct responsiveness to user need. This is a highly effective, locally based project delivering a high quality service.

Wiltshire and Swindon Healthcare trust

The Forget Me Not centre is designed to improve the quality of life of older people with mental health problems and their carers. It also incorporates care for younger people with dementia.

The centre was the result of collaboration between the trust's department of old-age psychiatry, charities and voluntary groups, Swindon borough council and other NHS organisations.

It opened in July last year and hosts a Forget Me Not club providing day care four days a week. It also provides short-term respite care on request and has a carer support club that meets every four to six weeks.

The project's governance group meets once a month to look at issues such as performance, risk assessment and improvements in service quality. Staff are encouraged to explore new approaches and undertake their own development.

The club is currently full and a waiting list has been established.

Attendance is 90 per cent.

The service is cost-effective and has generated out-of-area referrals.

The judges said:

We were impressed by the close partnership working that led to the project's development, as well as the commitment of the local 'product champions'. This is an often unrecognised client group and the team had clearly demonstrated real community support. A well-managed and worthwhile service that others would do well to consider.