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.
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