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Of primary importance: Commissioning mental health services in primary care

Each and every day in my GP practice, I see people who need support with their mental wellbeing. Some will have a diagnosed issue, such as anxiety or depression or bipolar disorder. Many others, however, will have a long-term physical condition which is making them feel more mentally vulnerable. And a considerable percentage will be struggling with complex social issues like domestic violence, poor housing, or unemployment.

As my colleague Rhiannon England comments later in this report, you don’t have to talk to a GP about the social determinants of health, or the complex connections between physical and mental wellbeing. You don’t need to instruct us on what patients want from services. It’s what we see every single day.

That’s why I firmly believe that clinical commissioners are so well placed to determine which provision can best meet mental health need. And in many instances I believe the answer will be services based in primary care but with collaborations across the health and care system.

We believe in collaborations at the Mental Health Commissioners Network. It is our aim to share experiences, lessons learnt, and examples of best practice. We want to help colleagues across the country become better mental health commissioners, achieving better outcomes for the people they serve.

Publications are an important part of this. We have previously released briefings on crisis care and recovery, and on commissioning early intervention in mental ill health. Encouraged by the reaction to these, we decided to release a similar publication this year and commissioning primary mental healthcare services seemed like a natural choice of topic.

This publication contains a number of examples of good practice in this area. Through specific case studies, it shows how such services can deliver better care for patients – crossing the physical/mental boundary, as well as the health/ social care one – while at the same time reducing pressure on GPs and hospitals.

It also includes a series of top tips, drawn from the experiences of people who have fundamentally changed the model of primary mental healthcare in their area.

Clinical commissioners know what the need is, and what kind of services can meet it. We’re working with a range of partners to develop innovative primary healthcare services and we’re keen to go further and do more. I hope this report provides some inspiration for the creation of services up and down the country.

Dr Phil Moore
Chair of NHS Clinical Commissioners Mental Health Commissioners Network and Deputy Clinical Chair of Kingston CCG