In Autumn 2015, four lovely psychiatry trainees were appointed as part-time Sustainability Scholars, charged with taking forward the work begun by Daniel Maughan in his 2013-15 Fellowship.
While Daniel focused on research and policy development, the Scholarships are about getting things into practice. With support from CSH, each Scholar is paired with a forward-thinking clinical commissioning group (CCG) to work on practical projects for sustainable commissioning.
So what have they been up to...? Here is a brief run-down:
Dr. Arif Ahmed, ST4 Older Adult Psychiatry, North West: working with Liverpool CCG on review and redesign of liaison psychiatry services
Project: Applying principles of sustainable commissioning to a review and redesign of liaison services. Development of sustainable outcome measures.
Dr. Suhana Ahmed, ST5 General Adult and Old Age Psychiatry, South West London: working with Brighton & Hove CCG on commissioning a new integrated homelessness service
Project: Development of recommendations for evidence-based treatments that can be incorporated into mental health assessment/ engagement period for homeless people.
Dr. Oliver Bashford, ST6 Older Adult Psychiatry, South East London: working with Hackney & City CCG on redesign of the urgent referral (crisis) pathway
Project: Review of different models of Single Point of Access to optimise the sustainability of a new service; developing a business case for socially sustainable models of crisis intervention.
Dr. Mike Pearce, ST4 General Adult and Old Age Psychiatry, Oxford: working with Oxfordshire CCG on redesign of the older adult functional mental health service
Project: Reviewing risk factors and potential prevention strategies to reduce the development of depression in the elderly population, and mapping CCG assets; Performing a sustainability appraisal of a Young Person with Dementia service (Berkshire) with emphasis on positive social outcomes and carbon footprinting.
Joint working
As well as working individually, some joint projects are planned - including carbon footprinting pilots and a possible learning event for CCGs.
And what have we learned...?
Relationship building with CCGs has taken time and effort. This is partly because of the novel format of the programme, in which trainee doctors are embedded within commissioning teams, and partly because everyone is still working out the best way for recommendations on sustainable commissioning to be applied in practice. However, each Scholar has successfully connected with the relevant people at their CCG and has been assigned to a commissioning team for a mental health service that is currently being redeveloped. By attending meetings and liaising with CCG leads, and with support from myself (at CSH) and Dr. Phil Davison (RCPsych Sustainability Lead), priorities have been developed and projects are now taking shape.
Although challenging, working in the complex real-world environment of mental health commissioning is crucial. Without this, sustainability guidance will remain theoretical. The experience has also been invaluable for the Scholars, who are gaining different perspectives on healthcare and developing skills in communications, project management and commissioning.
Look out for more updates from the Scholars over their final six months!
Thanks Frances,
I would echo your comments about the challanges we have faced in integrating with the CCG's. However for CCG's to even be open to this new format and to allow us into their meetings is a positive step. In addition, one of my hopes is that we can document some of the challanges as a group and some of the solutions in order to help future scholars or those in similar positions.
I would also echo your comments about our own learning. We are gaining varied management experience and also I have noted that teaching others about sustainability forces me to get to grips with the concepts too!
I look forward to hopefully providing more updates
Thanks for this post Frances.
I'm not sure what I expected when I started the scholarship and I can't believe we're already 6 months in.
i think the challenge in the first 6 months has been to try to carve a rle for ourselves within the CCG. As it's a new role, this has taken time to do. And although at times this has felt frustrating at times as we have felt we're not making progress, I think it's played an important role in helping us to understand and cement our understanding of sustainability. I now feel alot more confident talking to others about the concept of sustainability which I wouldn't have done 6 months ago.
It's also made me realise how important sustainability is for the future of our health services. The challenges the health service face are immense and we need to think about how we can incorporate the four concepts into new services and ones being reviewed....otherwise there won't be health service in 10 years time.
Now we're abit more clear on projects, I feel quite excited about the difference we could potential make and how we could carry on using the expertise we develop this year into our future careers.
I feel really lucky and priviledged to have been given the opportunity to be a scholar!
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