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Offering people flexibility to find their own route to recovery – John Short

As Birmingham and Solihull join the Integrated Personal Commissioning Programme (IPC), John Short explains why he believes IPC will work well for people with enduring mental health needs, as a way to offer people the flexibility they need to find their own route to recovery.

The Birmingham and Solihull Sustainability and Transformation Programme (STP) Partnership has just become successful in joining the IPC programme as an early adopter, and I’m delighted to be part of the team. While our local ambitions extend to supporting a range of people with complex needs, including learning disabilities, my real interest is the work we’ll be doing to personalise care and increase choice for people living with significant mental health needs.

Our programme will work with people eligible for the Care Programme Approach (CPA) or those who use high levels of unplanned care, which is approximately 4,400 people across Birmingham and Solihull, so there’s real scope for change for people who have enduring mental health problems.

With a focus on personalised support planning and increased choice over how the money available for care is spent, IPC clearly works well with the recovery model of mental health. When we talk about ‘recovery’ we’re dealing with something much more complicated than ‘getting better’. We know that for many people with enduring mental health concerns, we don’t have any failsafe ‘quick fixes’ and for some it’s about finding ways to live with their mental illness as a long term condition, manage the day to day, avoid crises and still lead a full, meaningful life.

There’s no simple equation for working out the solution – it’s about enabling individuals to identify their personal struggles, develop their strengths and assets and understand what works for them. That could include medication or psychological therapy – but there are no drugs or treatments with 100% success rate, so we need to be flexible enough to help people find, and afford, their own solution. It may be about finding employment, managing physical conditions or developing social skills and confidence – and people need support to articulate their own recovery plan.

It’s common knowledge that we live in challenging times financially. One of the biggest challenges we all face is the reduction in resources and the feelings of powerlessness that people experience when they see services that they use changing or disappearing.

At such times it becomes more important to find new ways to empower our service users and compared to more traditional ways of commissioning services. IPC is a really important way to do this. People understand what it means to have their own money and personal health budgets (PHBs) enable people to really think about the most effective way to use that money so that people can stay well.

As a senior leader in a NHS provider I’m stepping up to be part of the solution, as to make partnership and integration more than just concepts we need to work together, beyond the boundaries and interests of our own organisations.

It’s true that health providers could see PHBs as a threat – with the possibility that patients will choose to go elsewhere – but that’s a risk we need to take to make sure people get the best possible care that meets their needs. Our focus in the NHS will always remain our service users and we must embrace this or fail to adhere to that guiding principle – if we are confident that we are delivering the best care packages we have nothing to be afraid of and if we aren’t then we should stop doing this.

I’m really looking forward to seeing service users around the table with commissioners and providers to work out how we achieve this together, and to see our people feeling empowered and able to make real decisions about their care
My aim is that we embrace a new and much more focussed customer care ethos in the NHS that ensures we put the service users absolutely are the forefront of our decisions and one that demonstrates that understand the importance of their experience.


John Short has been the Chief Executive of Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT) since April 2013. He has been at the forefront of the Trust’s work to improve staff, service user and carer engagement and demonstrate a real Trustwide focus on service quality.

He began his career as a mental health social worker with local authorities and worked in a number of different settings, before moving onto mental health services management in the NHS over twenty years ago. John has worked in a number of Trusts providing services ranging from inner city to rural services. He has held a number of posts including Senior Manager Mental Health Services at the West Midlands Regional Office, Director of Mental Health and Learning Disability Services in Shropshire, Chief Operating Officer at Cheshire and Wirral Partnership Foundation Trust and Director Change Programmes and Chief Operating Officer in Leicestershire. His first CEO post was as interim Chief Executive of Leicestershire Partnership Trust from 2011 until his appointment in Birmingham and Solihull.

John has led numerous service and organisational changes in his career, including steering many mental health services in their move from care in impersonal large asylums to care that is increasingly community and person centred and compassionate