Working better together

This page highlights the importance of effective communication in planning and implementing preventative approaches across organisational boundaries for people with serious mental illness.   

Evidence shows communication and process breakdowns across organisational boundaries cause poor care and fragmented pathways. Better cooperation and communication between preventative initiatives and health care sectors can help ensure a range of different access points to preventative interventions.

Actions to take

  • Providers and commissioners across health and social care need to work very closely together to reduce fragmentation of physical health pathways. These pathways need to be available and effectively support those living with serious mental illness (SMI). This should cover interventions for alcohol use, smoking and substance misuse.
  • Pathways should explicitly include physical health needs and how shared care arrangements across the whole pathway should be conducted including management of acute deteriorations in mental and physical health. The points at which people and information cross organisational boundaries – the interfaces – should be assessed to see where improvements can be made. Example areas include NHS health checks, health promotion programmes and community-based health and wellbeing resources.
  • Improve information sharing about non-NHS providers and support the development of clear navigation models for providers to access community based interventions and wellbeing initiatives – regardless of current care setting.
  • Reduce unplanned admissions and support improved identification and management of acute and long term conditions through improving coding, shared learning and interventions to reduce unplanned admissions:
  1. Mental health trusts to work with acute trusts in implementing and improving services for people with SMI who present to Accident and Emergency (A&E).
  2. Mental health trusts to work with primary care practices to reduce unplanned admissions.
  • Apply or develop existing commissioning and contracting levers (e.g. Commissioning for Quality and Innovation – CQUINs) that support collaboration and joint accountability across sectors.
  • Protocols should delineate roles and responsibilities for mental health, substance misuse and physical health care interventions and care planning. Areas addressed should include: cross sector training and education, service and clinical information exchange, systems for rapid cross sector clinical advice, care co-ordination, attendance at Care Programme Approach (CPA) meetings and responsibilities to conduct physical health assessments.

Previous | Next


Tagged: ,

« Back to Prevention