Hello my name is Phil Moore I am a GP I chair the Mental Health Commissioners
network for NHS Clinical Commissioners and I'm mental health clinical
co-director for London. I want to comment on the situation with the reset of the
NHS and I want to particularly focus on mental health which is where a lot of my
time is spent and if I was to reflect on what I've learned from the Covid-19
crisis there are a few things, one of the things that has terribly terribly
impressed me is the huge commitment of clinicians, support staff, managers in
primary care, in the provider sector and within commissioners as, well I've seen
such huge dedication to the task of actually looking after people despite
all the pressures that have put on people and despite the personal
sacrifice for many for some even the ultimate sacrifice and that has been
hugely, hugely impressive, often gone unnoticed is the critical role that
commissioners have played as they've been enabling many of the rapid changes
that have gone on throughout the system and will they will continue to use those
skills as we begin to emerge into an integrated care system in each area.
But those amazing relationships that have been formed throughout the crisis
have really been beneficial because I've seen the different silos of the NHS work
together in an effective way to bring about very rapid change, across
London I've seen work together to coordinate our response to the needs of
health and care staff but from a psychological point of view we've worked
together on suicide prevention related to Covid-19 and I've seen a
different kind of relationship with the general public as a result of the crisis
and the way that the health workers are working across the whole system.
So what do we go from now what what is this reset and what is it going to mean to us
I think the key thing for me is that the reset is a chance to reimagine health
and health care services when everything has been suspended so no longer do we
have to start from the place of well what do we stop but it's what do we start
and that's a fantastic situation to come along and it's a once-in-a-generation
opportunity to make a difference to the way that we do things and and to reset
the way we do things and to change fundamentally our behaviour and practice
as a health system I think if I was to summarise what I feel this happened with
the crisis I think it has been the acceleration of the inevitable a lot of
these changes were coming anyway the massive change in IT, the changing
expectations of people with health care, in fact we don't have to see our health
professional every time it can be dealt with in different ways what we've got to
do is to make sure that the bureaucracy doesn't return that actually gets in the
way of the rapid spread of innovation and we've seen that happen so well over
this crisis and it would be a huge tragedy if we were to see that disappear
we have to work very hard to minimise bureaucracy and enable the good ideas
the real innovation to spread without the kind of hindrance that often we
experience we also have to be ready for a predicted spike in the need for mental
health services and that's going to include primary care community services
our specialist colleagues IAPT and many many others and we have got to work
together to manage that if primary care isn't geared up we will overload our
secondary care colleagues IAPT won't cope if primary care isn't playing its
part so we really do need to engage everybody on board with this process we
need to look to trained peer workers to the voluntary sector we need to keep an
eye on implementing the community framework so that we don't bypass that
and do something different because that will deliver true integration around
primary care networks where we can deliver the interventions and the
support for those people who need it over this next coming period.
Primary care is going to have a pivotal role in this the system can't manage
if we don't play our part and so I think one of the things we need to do
is to bring forward the engagement of mental health workers within primary
care networks and that means bringing forward the funding from April 2021 to
as soon as we can because in the next month or two is when we're going to
begin to need them and indeed the increase in the presentations of mental
health problems is beginning to increase already.
We're also going to have to be creative about how we make the funding stretch to
the new situation we've got to do things differently we've got to not pick up
some of the things that we were doing that perhaps don't have the the benefit
they might have we've got to do things more effectively and efficiently.
I think that we've made real strides over the last few years but we still have a
service that has been traditionally underfunded for decades and we need
to continue to correct that the mental health investments will continue
to be there use that money differently so that we're more effective in what we do.
So how does to summarise what I think this reset of the NHS is I think it is
an unrepeatable opportunity for the future of health and care we miss it at
our peril, thank you.
