The White Paper, Equity and Excellence: Liberating the NHS (Department of Health 2010) sets out a vision for the National Health Service that promises to be one the most extensive reforms in its history with the role of the general practitioner (GP) is at its heart. No Health without Mental Health (DH 2011), focused on empowering practitioners to have the freedom to innovate and to drive improvements in services. This included the establishment of GP consortia joint commissioning arrangements to develop innovative mental health services. Giodano (2011:6) suggests that it is vital that GPs develop leadership capacities to operate within a complex web of relationships and this includes capabilities such as:
- an organisational ability to self-organise quickly
- an organisational ability to learn and adapt
- a willingness to engender leadership behaviours in everyone at all levels and function of the organisation
- a culture of innovation
- the ability, among all parties, to understand at once the local context –from a unit as small as the office visit to the big picture (national policy)– and their place in it
These capabilities and the development of a more sustainable managed network to support primary care mental health leadership and commissioning are some of the challenges the SCN East of England aims to address via the development and delivery of two leadership programmes across the South and East of England regions.
The East of England Mental Health Commissioning and Leadership Skills Development Programme was formally established in 2012 with the aim of providing outcome focused, personalised and appropriate support to MH commissioning leaders. Early literature in relation to the programme was primarily aimed at GP commissioners, however membership is also open to non-GP, Clinical Commissioning Group (CCG), Local Authority (LA) and Public Health commissioners with attendance at the workshops reflective of this.There is no minimum skill or experience level required to take part in the programme and formal learning objectives are not defined, however the programme does take into consideration the varying skill level of those taking part.
The South England programme was part of a National initiative commissioned by NHS England across three national areas (North, Midlands and East, and South England). The programme was sponsored by Geraldine Strathdee, National Clinical Director for Mental Health and began in October 2014 and ended in March 2015.The aim of the programme was to develop and build on existing knowledge and skills in commissioning effective Mental Health services, and to equip GPs and commissioners with foundation level leadership skills and basic technical commissioning knowledge. The programme consisted of 5 modules and required participants to implement a work based (transformation) project. The programme was delivered across 3 geographical areas (South East, Central and West). Cohorts different within the areas with 2 mixed cohorts (GPs and non GP MH commissioners) and 1 cohort which were attended by GP’s only. Mind National provided PPI input via Lived Experience representatives.
To evaluate the extent of which the East and South of England programmes have:
- Supported GPs / commissioners to develop leadership and commissioning skills.
- Supported GPs / commissioners to commission integrated MH services needed by local patient and service users.
- Promoted the sharing of best practice and resources.
- To compare approaches and outcomes between both leadership programmes
The evaluation was completed by NIHR CLAHRC East of England in partnership with The National Centre for Post Qualifying Social Work at Bournemouth University.
The methodology used was based on an evaluation impact methodology developed at the centre which was designed to demonstrate the impact of the programme on both an individual and organisational level. This was achieved by using mixed methods, including self-evaluation questionnaires, follow up telephone interviews to gain examples of how learning was applied and a third party testimony to verify the impact of the programme on observed behaviour.
Key findings and outputs:
The findings illustrate the impact of the South and East of England Mental Health Leadership and Commissioning Skills Development programmes on both the personal development of GP Mental Health Commissioners and commissioning practice. The evaluation demonstrates that face to face workshops can have a positive impact on networking and as a result, commissioning practice. Results from this evaluation provide a valuable contribution to the limited evidence base in this area. Programme characteristics contributing to impact could be likely success criteria for future programmes and could be used to inform the development of future learning programmes for mental health commissioners as part of a national approach to improving mental health provision.The evaluation method applied in this example could also be used to understand the impact of learning and development programmes across other areas of the NHS.
Dickerson E, Fenge LA, and Rosenorn-Lanng E, (2017) “The impact of leadership development on GP mental health commissioning”, Leadership in Health Services, Vol. 30 Issue: 3, pp.343-351. (PDF).
For a ‘BITE’ sized summary of the research, please see:
For further information on this project, contact Emma Dickerson at Emma.Dickerson@cpft.nhs.uk