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Beyond ‘rearranging the deckchairs’, can Future in Mind really help us move forwards? – Frank McGhee

As commissioners gather for the National Children and Adult Services Conference 2016, NHS England’s National Transformation Adviser for Children and Young People’s mental health considers the opportunities available to deliver the shared vision of Future in Mind.

I have been thinking about the difference between Future in Mind being transformative and it being transactional. Put another way, how do we make sure we are not just rearranging the deckchairs, and investing in the obvious without achieving the Future in Mind vision of whole-system transformation.

Working within NHS England for the past three months has shown me that the challenges local councils face about budgets, further changes and down-sizing are the same wherever you sit – in the NHS, social care or education, North or South.  But being in the same situation also brings a shared understanding and can be the glue that binds us together in a common solution.

Right in the middle of this we have the massive opportunity that Future in Mind and the Five Year Forward View for Mental Health creates. I had long thought we needed a different approach around responding to emotional, psychological and mental health distress and the whole-system approach within Future in Mind and the Five Year Forward View for Mental Health is right on the money for me.

One of the features of being around for a while is that I’ve seen a number of approaches, from top-down targets to localism, but what strikes me is that the areas of the country that fare best are those where everyone – a leader, a middle-tier administrator or a frontline practitioner – has a clear sense of shared purpose.

The message I hear from colleagues is that the first Local Transformation Plans put many important foundations in place in areas such as crisis or emergency care, and there are clear signs of innovation, for example, with increasing work with schools.  What is obvious is that the LTPS created focus, shared priorities and plans, based on the clear vision of Future in Mind. One of the tests now will be whether they are sufficient, and ambitious enough, to move beyond aspiration to create change and deliver transformation across children’s services year on year.

We have some important levers other than LTPs to enable transformation. There is a clear expectation to connect the Sustainability and Transformation Plan (STP) with the LTP. I have no doubt the focus on ‘local and placed-based’ commissioning creates an opportunity  to look at the connections between schools, general practice and primary care and local community organisations in order to build early help and prevention within families, schools and communities. I am sure this will help manage demand differently.

We know Future in Mind is working across Local Authorities and Clinical Commissioning Groups. I work across both and it always seems to me we need to keep building on those relationships and developing a shared culture, language and approach, and finding solutions together. This is vital to enhance the development of more integrated models of care, indeed Future in Mind, the Five Year Forward View, the Five Year Forward View for Mental Health and the STP guidance share the same, unambiguous message to co-produce solutions, bring the right professionals together and involve the people we serve.

Future in Mind placed children and young people at the centre of our thinking and rightly so. A child or a young person does not recognise barriers between organisations and I do not think we will go far wrong if we listen to their experience and views. And I do think we all need to make sure we focus on children’s views as well as young people’s views. If we get it right for children and young people, as well as setting them on a path to achieving their own goals and become productive adults, we get it right for everyone.

At the different events I’ve attended since taking on this role, I have been struck by the energy, drive and commitment of professionals at every level, and their refusal to accept the status quo. This has been reflected in the many Local Transformation Plans (LTPs) I’ve read or helped to produce and I’ve seen clear signs of progress.

It seems to me we are at the first pit stop in our grand prix –  it is moving fast, there has been real effort and there is still a long race ahead.  We now need to keep our foot on the accelerator because this is the year we move from planning to delivery, from vision to reality, from process to outcomes.


Frank McGhee has worked for over 30 years in children’s services, with senior management roles in the NHS and Local Government. He is currently Director of Integrated Commissioning for children and young people working across Southern Derbyshire CCG and Derby City Council. This includes leading the Future in Mind programme. He is seconded to NHSE on a part-time basis as the National Transformation Advisor. He started his career working directly with young people and remains focused on wanting to see significant impact from the Future in Mind programme.

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