case study:
Norfolk and Waveney Children and Young People’s Mental Health Transformation Programme
Norfolk and Waveney commissioned Rethink Partners to design and implement a transformation plan for its mental health services for children and young people. We worked with the NHS and Norfolk County Council to put together a sustainable plan to provide better mental health services to children and young people in the community.
challenge
To transform Norfolk and Waveney's mental health services for children and young people, building on the initial plan that had not been actioned.
solution
An extensive review into the services, including focus groups, implementing new processes and procedures within a sustainable plan of action.
outcome
Putting children and young people back to the centre of the service, and introducing new skills to local staff, enabling them to collaborate and take over the transformation.
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challenge
Although Norfolk and Waveney had a plan in place to transform its mental health services for children and young people, it had been in the pipeline for two years and progress had stalled.
Norfolk and Waveney is a large and complex health and care system. Leadership of mental health services for children and young people was fragmented across the system and individuals frequently lacked a clear mandate from their partners. System plans for service transformation had been underway for 2 years and progress had stalled, but ambition remained high.
Whilst the system had a clear vision for the future of mental health services – rooted in breaking down traditional tiers, focusing on prevention and resilience and driven by outcomes – this was not owned or well understood by partners. Nor had it been translated into a clear route map that all organisations own, setting out how it would be delivered.
As well as much more detailed articulation of plans and priorities, meeting this challenge required partners to develop mature, strong and trusting relationships, rooted in common values and objectives.
Stakeholders were diverse and spanned commissioning and provision; statutory organisations, private, not for profit and third sector; health, social care and education; clinicians, allied professionals and youth workers. This also includes parents, carers and young people: some of whom were representing both camps.
There was some way to go before these were in place, with partners recognising there was considerable tension between organisations, a lack of joined-up thinking and a reluctance to surface and address difficult or contentious issues – even though it was understood that this was necessary.
solution
Rethink Partners’ solution involved firstly reviewing Norfolk and Waveney’s Children and Young People Mental Health Services and then creating a bespoke plan that has successfully transformed the health system’s impact.
The initial work included a review into Norfolk and Waveney’s Children and Young People’s Mental Health Services, which analysed the current process for identifying the needs of children and young people and their care pathway.
Together, we reviewed commissioning arrangements, the current system and pathways, finance and performance data.
We held 15 focus groups and conducted 229 conversations with professionals (both clinical and non-clinical/statutory), third sector and held 10 focus groups with children and young people.
We then worked together with the NHS and Norfolk County Council on an intensive system-wide programme of redesign and transformation, which the authorities have managed to take forward, unassisted.
We worked intensively across the whole system to stimulate and drive this work through mobilisation in a way that would allow the system time to build different relationships and sustain the pace and ambition of this work into the future.
We needed that energy and capacity to really drive what became a huge programme with 14 workstreams.
outcomes
Brought children and young people back to the centre of the transformation
Building capability in local staff to carry on the work and avoid further external support
Stakeholders can see where the money is flowing and where the accountability is
The system has learned how to involve staff in transformation work and the benefits of doing this well
Minimised cost and maximised ownership
Created new opportunities for innovation as partners (new and emergent) now know where to take concepts and proposals for discussion
