Clinical staff need not be based exclusively in hospital

The announcement by Jeremy Hunt of a new recruitment drive for mental health services has been met with a mixed response. Investment is always positive, of course, but some argue that the plans are not realistic. Whatever side of the argument you fall on, perhaps this debate gives us a much-needed opportunity to look at mental health services with fresh eyes.

As Claire Murdoch succinctly stated in a BBC report – “It’s about having a motivated and skilled workforce in place to deliver the work we need to do.” And that is precisely where we should start from. It’s not just about numbers in vacant roles. We need to go back to basics and consider what it is that we actually need to do.

If what we need to do is help improve the wellbeing of the people within our communities, let’s consider them before we consider our current structures and procedures. A person’s journey to recovery and independence doesn’t start and end with acute mental healthcare. It’s about everything surrounding that – their community networks, their sense of pride, independence, aspirations and a safe and comfortable home.

So what if we looked at how we can support individuals appropriately and consistently throughout their recovery journey. Surely that will provide a more sustainable and successful outcome for them?

Increasing a support worker’s skills base to enable them to deliver light touch talking therapy, for example, can support an individual to maintain their independence for longer

I’m a big advocate for social prescribing, but I do agree that it absolutely needs to be done in conjunction with clinical work – particularly for people living with severe and complex forms of mental illness. But what if the professionals offering these services are also empowered to deliver a psychologically informed approach? And what if it can be done within the home or community setting?

In suggesting this, I am not saying that a support worker could replace a clinical psychologist. But what I am saying is that increasing a support worker’s skills base to enable them to deliver light touch talking therapy, for example, can support an individual to maintain their independence for longer and reduce the need for more intensive support from already stretched NHS services in the future.

This is precisely why we are investing in clinical skills at Home Group. We have already recruited a head of clinical practice, Dr Nichola Stefanou, who now has a full team in place to drive our clinical offer forward.

Life skills

We are all serving the same population so by investing in clinical staff in housing, we are simply re-distributing some of the services. Primarily it will involve upskilling the colleagues we already work with in our supported services to provide specialist support. Why should a person, who no longer requires intensive support, need to see both a mental health and a learning disabilities specialist on a day to day basis, for example?

If their requirements have decreased, and their support worker is trained to offer low level specialist expertise in both areas, this makes life easier for the individual as well as the NHS. And what makes this even more accessible is that it can all be delivered in the home environment, allowing people to develop their wider life skills at the same time. This can also be encouraging for people who find it hard to engage with traditional services.

It’s about time we introduced more flexibility and innovative approaches to create services based on the needs of the people and communities we serve

We have already started taking steps in this area. In one of our health services in Devon, for example, we employ an EMDR (eye movement desensitisation and reprocessing) specialist who works with clients within our accommodation.

Holistic approach

And we’d like to take it further. What if a support worker was trained to take somebody’s blood pressure? Or was able to run smoking cessation or physical activity sessions? It changes the role completely – but why not? Why shouldn’t we reimagine things? After all, if we continue to repeat ourselves, will things ever get better?

This holistic approach provides the right balance of independence and clinical support to aid recovery. The close partnerships with our NHS colleagues mean that needs for more intensive, specialist care can be monitored and provided as required. However, it is our aim to improve people’s outcomes, help them to build their aspirations and take some of the pressure off our health colleagues.

It’s a bold move, but it’s about time we introduced more flexibility and innovative approaches to create services based on the needs of the people and communities we serve. I’m encouraged that Claire Murdoch is championing these collaborative approaches with housing, and that our new health colleagues see real potential in these new models. By working together across different sectors, we can reform our services, enable new funding models and improve people’s quality of life.

I can’t see why there would be any objection to that, can you?