OVERVIEW OF THE DELIVERY PLAN FOR “TOGETHER FOR MENTAL HEALTH”
When the Welsh Government launched its new mental health strategy “Together for Mental Health – A Mental Health and WellbeingStrategy for Wales” in October 2012, alongside it was also published aDelivery Plan: 2012-16.
The Strategy sets out the strategic context for mentalhealth in Wales for the next 10 years (2012 to 2022) and we look at it indetail on a separate page. The Delivery Plan (2012 to 2016) is just for theinitial 3 years of this 10 year period, suggesting that implementation of theStrategy will be reviewed throughout its 10 years and there will be furtherDelivery Plans, although this is nowhere explicitly stated.
REPLACING THE MENTALHEALTH NSF
Together for MentalHealth
replaces both the 2001 Strategy for Adult Mental Health Services and the 2005 Mental Health National Service Framework (NSF). The Delivery Plan has both some similarities with and important differences from the previous NSF,and comparing the two documents helps to illustrate what the Delivery Plan is and what it is not.
The previous NSF set out service improvements over a lengthy 8 year period from 2005 through to 2013,with targets linked to specific years. The Delivery Plan is more limited in scale, with a “shelf life” of just 3 years.
In terms of scope, the DeliveryPlan is more ambitious. The NSF was for adult mental health services only,while the Delivery Plan covers mental health services for all ages – children,adults of working age and older people. Another important difference is that whereas the NSF was primarily (although not exclusively) a document for health and social care mental health services, the Delivery Plan seeks to set an agenda that takes mental health well beyond health and social care services and makes it part of a much wider government agenda.
The NSF used the language of its time and was very much about “standards”, “key actions”and “targets”. It had 8 Standards, with 44 Key Actions, each withclear Performance Targets. The Delivery Plan focuses instead on “Outcomes”.It has 18 in total, and against each of these 18 outcomes there are:
– “Key Actions” with between 1 and 11 for each Outcomeand some 57 in all
– “Planning andCommissioning” responsibilities to implement the Key Actions
– “ImprovementApproach” and “Training and Development” explanations as to how the Key Actions will be delivered
– and “How will we know?” performance indicators to measure progress.
Content and Issues
In the NSF the standards, key actions and targets together set out a clear vision as to what a local adult mental service should be and what service components it should include. The Delivery Plan does not include this level of detail, but insteadsets out actions and outcomes way beyond mental health services and covers wideareas of government activity and walks of life for all age groups. On thepositive side it recognises that improving the country’s mental health is avery wide agenda. More negatively such a comprehensive approach creates its owncomplexities, and the scope of the Delivery Plan is so wide it is difficult toidentify any coherent plan. So it is not an accessible document, and anyonewanting to see what plans there are for a specific mental health issue willhave difficulty finding the information they are seeking.