Recently, I was lucky enough to be involved in Department of Health’s latest policy school. We were tasked with answering the question ‘How can the government ensure that people with mental health problems are discharged from hospital at the right time, safely and in a way that supports recovery?’
For the first time we were given a chance to visit one of our connecting partners as part of the policy school programme. We headed for Mile End Hospital, a community hospital in the heart of Tower Hamlets, to visit East London Foundation Trust (ELFT). Serving a population of around 750,000, ELFT provides specialist mental health services to one of the most culturally diverse and deprived parts of the UK. Before exploring the hospital we first heard from Andy, the brilliant lead nurse for the Borough of Tower Hamlets, who introduced us to the issues around discharge of people with mental health problems and the difficulties of working with local authorities under severe financial pressures.
One of the things that really struck me about Mile End was the tribunal rooms where patients can appeal against their sections. It’s probably one of those things that I knew but never really thought about, but unlike the vast majority of other people who use health services in this country, those sectioned under the Mental Health Act can be treated without permission and in some cases detained indefinitely. It was only on seeing the tribunal rooms (though they weren’t in use on the day of our visit) did I ever really consider the implications for those people, and also what that means for healthcare services.
Possibly the most interesting, and definitely most humbling, part of this connecting experience was the opportunity to hear from three ex-service users who were now involved in community and support projects to help those recovering from mental health episodes. Their passion, dedication and commitment was incredibly inspiring, but the thing that stood out for me was hearing how their involvement in these projects was a key part of their own recovery. For example, one of the ex-service users spoke about his intention to use the experience he’d gained as a peer supporter to embark upon more formal qualifications in nursing. I think the lesson here was seeing the rehabilitative role of empowering people.
This really got me thinking about my ‘day job’ in policy improvement. Bringing the voices of patients into the process of policy development is at the heart of the Open Policy Making agenda and the policy test question: ‘What do the people who matter think?’
Gone are the days (if they ever existed?) of clever minds in Whitehall devising a policy in their ivory towers before revealing their fabulous creation to the nonplussed world and the connecting programme is a great step in the right direction.
The connecting we did with ELFT and Department’s policy school was a brilliant insight into mental health care and mental health policy and the experience of visiting a hospital had a massive impact on how we all approached our policy challenge at policy school, and was seen in the emphasis that every group put on a ‘patient-centred’ proposal.
I think connecting has already changed, for the better, the way that we think about our relationship between policy and delivery. Now our team is working on a project with the Department of Health’s implementation unit, the connecting team and policy teams to investigate how we can use ‘deep dive’ connecting as part of policy development to better engage with staff, managers, commissioners, clinical leaders, and especially patients. More importantly, DH as an organisation is beginning to rethink how it engages the people who matter, and there have been some brilliant examples in the Department of patients, along with other external partners, co-producing policy. This is a change that I can only see accelerating and, from my perspective, this can only be a good thing.
So thank you to ELFT, the DH connecting team and to the policy school organisers for giving me, at least, lots of food for thought.