A wide-ranging review of Surrey’s mental health system is to pave the way for a series of improvements to the way that services work together to help residents in need of support.

The Surrey Heartlands Integrated Care System – a partnership between local NHS services, the county council and others – set up a taskforce to review mental health services following a rise in demand due to the pandemic and concern that some residents were being poorly served.

The taskforce, the Mental Health Partnership Board, marks a step change in approach as it brings together key partners including local NHS organisations, the police, the county council, district and borough councils, schools and charities. Its independent chair, Alan Downey, is a former chairman of an NHS trust and of the Maudsley Charity. 

The board’s review gathered evidence from more than 150 people – including those who have used mental health services and staff who work within them – before making a number of recommendations to form a system-wide improvement programme. With key partners involved, the plan is “everyone’s business”, with agreement between partners to hold each other to account.

The overarching aim will be to make sure that “no one who requires support for their mental health is turned away without an appropriate and safe relevant offer of help and the ‘bridging’ support required to access it”.

In addition, key recommendations include:

  • A “prevention and early help first” approach across all organisations
  • Analysis to be commissioned from specialist health economists into levels of funding for mental health in Surrey. The county receives the lowest allocation of funding for mental health nationally and the analysis will look at how we might secure more funding and/or change the way resources are distributed around the system
  • Closer working between services at local community level, such as GPs and housing
  • A “no bouncing” approach to avoid people being passed around the system – organisations wouldn’t be able to close cases simply by referring people to another service
  • More use of digital technology, such as online consultations and wellbeing apps
  • More work to understand needs of specific groups – starting with people who have multiple conditions, those from the BAME (black, Asian and minority ethnic) community, those with eating disorders and those aged 16 to 25

The commitment to improvement by all those who contributed to the review was evident throughout. As part of the improvement programme, a new, shared vision will be developed for the mental health system in Surrey, working with people who have experienced it.

Tim Oliver, Leader of Surrey County Council and chair of Surrey Heartlands ICS, said: “Just as the pandemic put a strain on the wellbeing of many it also made it harder for people to seek help and we must all now work together to tackle the mental health legacy that Covid-19 is leaving.

“We as a system set up this review and our focus now is acting on those insights to make a real difference for our residents. This positive new approach of bringing together all key partners will make it everyone’s business to deliver the improvements we’re seeking.”

Graham Wareham, Chief Executive of Surrey and Borders Partnership NHS Foundation Trust and Senior Responsible Officer for the improvement programme, said: “The NHS’s Long Term Plan for mental health recognised the need for accelerated spend on mental health. This report’s recommendations focus not only on the funding of the system, but also on how it can be better organised through user-led design to provide Surrey residents with the service they expect.

“Partners have all accepted the recommendations; as a system we are keen to get on with the work and have already started implementing a number of these.  I am confident this new partnership approach and the detailed recommendations will result in better outcomes and improved services for Surrey residents.”

Alan Downey, the independent chair of the Mental Health Partnership Board, said: “This report sets out a number of issues, weaknesses and, to be blunt, failures that have impacted on the lives and wellbeing of Surrey people, in some instances to a distressing degree. More positively, it confirms the desire and commitment of everyone involved to improve the situation and take the necessary steps required.

“There is a clear consensus around the critical issues amongst almost everyone engaged in the work. We must now deliver on the recommendations.”

People with lived experiences helped form recommendations

Clare Burgess, of the Independent Mental Health Network, said: “Members of the network worked with the team leading the review for the partnership board. Their lived experiences of accessing mental health services in Surrey, along with the experiences of people who have been unable to access support or services, were key in helping the partnership board to form the recommendations. 

“We all know that we need to do more to support the community in maintaining good mental health and we welcome the focus the partnership board has given to prevention. We must make sure that support and services are available for anyone who is living with a mental illness, those who experience periods of mental ill-health and carers for people with mental illness. 

“The Covid-19 pandemic has shone a light on some of the existing inequalities that people in our community face, and the partnership board were clear that equity must be a priority. The work required to meet the recommendations from the partnership board, and further work on deciding what the vision is for mental health in Surrey, will be co-produced with members of the community, people with mental illness/ill-health and carers and families.”   

Sue Murphy, Chief Executive of Catalyst, a non-profit organisation which supports people dealing with drug, alcohol and mental health issues, said: “Bringing together a multi-cross sector board involving the voluntary, community and faith sector to collaborate and discuss mental health services in Surrey has come at the right time during a pandemic that has impacted and affected people’s mental health.

“The insight gathered from people who use mental health services, residents and carers has never been more important in addressing a system that is overwhelmed by demand resulting in long waiting times and multiple referrals.

“Through desire and commitment to change mental health services in Surrey, there is a collective sense that mental wellbeing is everybody’s business and community assets are harnessed to promote good mental health, so no resident of Surrey is turned away without an appropriate and safe offer of help.”

The recommendations will be considered at an informal meeting of Surrey’s Health and Wellbeing Board on June 2nd. The review can be found here and improvement programme here.