New Ways of Working implementation programme and sustainability

It is clear that NWW is present and acknowledged within mental health services in England. It is referred to repeatedly in clinical and managerial meetings up and down the country. The early results from the national survey indicate that the vast majority of mental health provider Trusts surveyed are fully aware of its importance, and that most of them have a variety of services or developmental plans in place to modernise practice along these lines.

The message has clearly been heard, but will it be sustained? Many Trusts are now engaged in the journey towards foundation status, and the messages of NWW – efficiency, competence and effectiveness – are in complete accord with this strategic direction. It is also a message that will be equally appreciated by Boards of Governors and commissioners alike.

Some Strategic Health Authorities (SHAs) are involved in applying the ‘Toyota lean principles’ method of continuous improvement to their health community, and there is clear alignment with NWW for the workforce to provide an efficient service that the ‘customer’ (read: user and carer) really wants. It may be surprising to some, but there are many parallels between the efficient production of motor vehicles and a person-centred and effective care provision system!

A further challenge for NWW will be to communicate its value to commissioners at the local authority, Primary Care Trust (PCT) and practice level. For NWW to be truly effective, there needs to be clear linkage between the different commissioning arms and an avoidance of piecemeal, disjointed commissioning and perverse measurements of activity.

In order for NWW to be sustained, there must be continued ownership by all the professional bodies: their endorsement and active promotion is essential. Without clear leadership from these agencies, schisms will develop.

Finally and most importantly, it is crucial that service users and carers express their wishes with respect to NWW, and continue to put pressure on Trusts, PCT commissioners and SHAs to develop and implement a system of care that they themselves have asked for and that challenges so much traditional and professionalbound practice.

In summary, therefore, NWW is entering a new phase. It is already present within the culture, but it needs to be more firmly established as the primary means of delivering mental healthcare. For this to happen, there needs to be support from throughout the healthcare system – from the Department of Health and SHAs to Trusts, commissioners, users and carers. Over the next 12 months, working in conjunction with key national, regional and local stakeholders, the NIMHE National Workforce Programme will support implementation to help roll out NWW effectively.

Next Steps

This is a progress report. There can be no doubt that substantial progress has been made since our last report in October 2005, as can be seen from the NWW survey and from the individual reports set out in Section 7, Chapters 2 to 10. However, a lot more remains to be done before NWW and the new and extended roles are fully embedded in mental health services.

In 2007/08 it is intended that:

• the joint post that has been agreed by the National Institute for Mental Health in England (NIMHE) National Workforce Programme and the Royal College of Psychiatrists to emphasise the importance of NWW nationally will be filled;
• all the products of the work from all the key stakeholders will be placed on the new website that has been established (www.newwaysofworking.org.uk). Examples of positive practice will be collected here and local organisations will be encouraged to share and document their work;
• a series of collaborative NWW Implementation Learning Sets, organised through the Royal College of Psychiatrists Centre for Education, will be run in each Care Services Improvement Partnership (CSIP)/NIMHE region for director-level staff within Mental Health Trusts. These learning sets are intended to assist Trusts in taking a strategic approach to NWW;
• organisations will be asked if they are interested in undertaking the Creating Capable Teams Approach (CCTA), and workshops will be run in each CSIP/NIMHE region for identified facilitators. Although it is an ‘off the shelf ’ tool, it is challenging to carry through, and a CCTA network will be established to assist facilitators throughout the year;
• a short NWW Implementation Best Practice Guide will be produced to help organisations focus on the outcomes of NWW;
• specific work will be undertaken, as agreed with the Department of Health, to take forward the implications of NWW for pharmacy; and
• the National Steering Group for NWW will continue its role of guiding, co-ordinating and troubleshooting NWW.