Written evidence submitted by North London NHS Foundation Trust (CMH0129)
Parliamentary Submission: North London NHS Foundation Trust (NLFT) – Community Mental Health Services Inquiry
Introduction
North London NHS Foundation Trust (NLFT) is an NHS Trust that gives mental health help in North London. We serve Barnet, Camden, Enfield, Haringey, and Islington. Our goal is to give outstanding mental health care to everyone in our community with serious mental illness (SMI) and to work with other partners to deliver excellent mental health care and prevention in all our communities.
Our Community Mental Health Transformation (CMHT) Programme has been running for four years support by ongoing investment. Aligning with the NHS Long Term Plan and Community Mental Health Framework, as demand has grown for our services we have changed how we work. With the investment that we have received we now work more closely with GPs, social care, the voluntary care sector and local groups trying to make sure everyone gets fair access to mental health support and that they are given the right care in the right place at the right time. In particular we have significantly strengthened our links with the local authorities and voluntary care sector across each of our five boroughs. We see greater opportunities can be leveraged through Integrated Neighbourhood Teams, and see this as the framework to further strengthen collaboration.
To answer the questions set by this inquiry, we asked our community mental health services senior leaders for their views. Their thoughts have shaped this paper, Members can be sure that our submission reflects on the real issues mental health providers face every day, and gives voice to those who provide the care in our wonderfully diverse community.
1. What does high-quality care look like for adults with severe mental illness and their families/carers?
Good care for adults with SMI must be easy to access, well-planned, and built around each person. Those who use our services, their families and carers want to see the same team each time, so they don't have to explain two or three times what they want and need. Most of the patients we see need more than just mental health help, they need a team that keeps them physically fit, a home that's warm and comfortable, and a good steady job. Sadly, this is not the reality for many people.
People need care that is quick and easy to get. They should not have to wait a long time, and they should know where to go when they need help. If they have a long term need for support the care team should already know who they are and be ready to help. Families and carers should also be part of the caring process so they can help the person in need and understand what and why we are treating their loved one as we are.
By making sure care teams are well-staffed, work well with other services, and is focused on the person in need, we can help our patients recover and make a real change to their lives.
2. How could the service user journey be improved within community mental health services and when accessing support from other agencies?
Many people find mental health care hard to understand and even more difficult to get hold of. We need to make the process simple, friendly, and better linked up. Often, people have to tell their story many times to different people. This is tiring and can lead to many people opting out of treatment. If agencies and teams share notes better, that would help.
We think Technology can also help. Online tools are now every day for many of our service users and they let people ask for help, book visits, and check their care plans in a less intrusive way that many find better. Others thrive when we have staff with the time to guide people through the system alongside.
Mental health, social care, and housing teams need to work as one. At the moment, people are sent from one team to another. A simple, joined-up system would make care smoother and more helpful.
3. How could this be measured/monitored locally and nationally?
We need to check if care is working well. We can do this by looking at how fast people get help and if they feel better after using our services. We can ask them and their families and carers for their views as well. Measuring the impact we are having is possible but it must not become a means to an end.
We would like to check our services against those offered elsewhere across the country. We, and the patient, should be able to compare waiting times, how efficiently people move through care and feel better, and how many people need help in a crisis. Crisis situations will happen but if we manage conditions properly they should lessen. Digital tools can help track how we are doing in real-time and the data they produce might throw new light on what works well. Reviewing our services by outside groups with lived experience has also helped us to spot what works and what does not.
4. What is the current state of access for adults with severe mental illness to community mental health services?
In our experience some services like our Early Intervention in Psychosis, work well. Others struggle with long waits and growing demand. Over the past four years we have seen demand for our core services increase by 30% (slightly above the national average). The money we are given to treat these conditions has not increase at anywhere near that level.
People in some of our boroughs get fast access comprehensive care, while others wait too long. It is clear that those with more than one need, such as those without a home, find it even harder to get help. Demand for forensic mental health care and crisis help is rising, putting more strain on teams.
With investment we are adding more staff, increasing the way and making it easier to ask for help, and are introducing new systems offering a single point of access to patients to make the system easier to get around, but we need more funds to make the changes across the country happen quickly.
5. How could access be improved across the country?
To make mental health care better, we believe we need more staff to fill unfilled vacancies and to give them access to better tools and ways of working. We need to continuously update our staff's training and introduce a greater number of care workers into the system so that services can meet demand. Online systems that let people ask for care and get help faster are already making a difference.
We must also make sure mental health care links well with social care and local support. A clear national plan on wait times and service levels would help us to deliver equitable outcomes. There is no getting away from the fact that fixing big issues like housing and jobs will also cut the number of people needing urgent help and make care work better in the long run.
Conclusion
NLFT is working hard to make mental health care easy to get, well-planned, and built around people’s needs. The Community Mental Health Framework has helped, but we need more funds and better rules to keep it going. We ask for more teamwork between sectors and strong national leadership to make sure all people with severe mental illness get the care they need and deserve.
February 2025