Mental Health Transformation in Greater Manchester

From Vision to Reality

Despite the many brilliant practitioners working in community mental health in the UK, too many people still aren’t getting the help they need, when and where they need it. When the national Community Mental Health Transformation Framework was released in 2019, it aimed to tackle historic challenges in mental health support systems, which were buckling under the strain of increasing need, fragmented care, and funding cuts.

Uniquely, we help places and partners solve today’s urgent problems and grow sustainable solutions for the future – building a safe and credible pathway between the two.

Since 2020, we have been working with partners across the Greater Manchester mental health system – including the ICB, Trusts, local authority and the VCSE sector –  to radically improve mental health support, by moving towards a community mental health system. These efforts included adopting the Living Well model and adapting it to the ten localities in Greater Manchester. 

‘Living Well’ was a new approach to mental health care that was first implemented in Lambeth, London, in 2010. It successfully tested a new model: one which was holistic, flexible, person-centred, and easy to navigate locally. The ‘Living Well’ model recognises that non-clinical factors can be significant causes of mental ill health, including poverty, poor housing, or struggling to access benefits. An evaluation found that this approach supports people to make progress towards improved mental health and quality of life, whilst improving staff satisfaction.

Now, four years on, each of Greater Manchester’s ten localities has made progress by collaborating across sectors and organisations to define their vision for the mental health system of the future; and they have begun translating that vision into a design for local models. These models have emerged from people’s lived experience of navigating mental health support systems, as well as the lessons learnt by Salford and Tameside & Glossop (two localities who participated in the National Lottery funded Living Well UK programme starting in 2018).

We’re really proud of the impact that we have achieved with partners in Greater Manchester, to organise around a vision of a fit-for-purpose mental health system, now – responding directly to the most urgent problems – whilst building a better system for the future. The work has focused on four key strands:

Agreeing a shared vision, rooted in lived experience 

We played a key role in convening key partners, including amplifying the voices of the voluntary sector and people with lived experience of seeking mental health support. We helped partners come together to:

  • Connect with why transformation is needed in Greater Manchester
  • Create opportunities to share ideas and insights
  • Co-design a long term, shared and overarching vision for transformation
  • Ensure that lessons were learnt from Salford and Tameside’s efforts to implement the Living Well model

This provided a powerful grounding for change that people across locations and sectors were committed to.

Enabling collaborative leadership, learning, and governance

To bring this vision to life, we worked with key stakeholders to design and set up cross-sector groups and spaces, at local and regional levels. The Community Mental Health Coordinating Group provides a vital forum for leadership, coordination and accountability for Living Well and specialist team transformation, involving key cross-sector leaders and people with lived experience from across GM. 

“I can honestly say we would never have been able to do what we did had we not had IU alongside us bringing that external accountability, that drive and that different thinking.” Key GM stakeholder

Scaling new cultures and practices across the mental health system

One of the entrenched issues in mental health support, and more widely in social care systems, is the fragmentation of services and lack of collaboration between agencies. It was really important that we supported a practical and cultural shift towards a more integrated approach, where different people and organisations involved could work together to understand issues, solve problems, and contribute to shared learnings and policy development. 

There are other culture changes that the partnership enables, too: placing a greater value on lived experience and the complementary expertise of peers, voluntary and clinical professionals; taking a strengths-based, trauma-informed approach; and embedding a learning culture.

So far we have helped 7 localities adopt and adapt Living Well models, working with their managers, teams and wider cross-sector spaces to envision and plan how the Living Well model can be implemented locally. We build staff capability and confidence in convening, co-designing and prototyping new ways of working, with support and training in  key approaches, like facilitation, ethnography and co-production, and by providing clear guidance and tools, such locality Handbooks and the Greater Manchester Living Well Guide. 

The ‘Communities of Practice’ for programme managers and teams have also been particularly important spaces, enabling colleagues to support one another, share learning and develop their practice.

“IU have facilitated the Community of Practice… and now [colleagues] are actively sharing information and approaches. We wouldn’t have had that, hand on heart, it wouldn’t have happened had it just been the two organisations.” Key GM stakeholder

How we can continue to support Community Mental Health Transformation

There’s now a growing drive from NHS England to move national mental health policy towards a future in line with Greater Manchester’s own co-designed vision of a holistic, preventative, and responsive system. Nationally, momentum is moving towards approaches which prioritise:

  • Earlier intervention 
  • Supporting people to live well in the community
  • Integrated primary and community mental health services
  • Holistic, person-centred care 
  • Closing the gaps between talking therapies for anxiety and depression and secondary care
  • Improved partnership working between NHS and non-NHS organisations and recognising the importance of the VCSE sector

Greater Manchester has made great progress over the past few years, and we’re very proud to have been able to play a part in supporting them to make significant steps towards community mental health transformation. 

In the ongoing context of financial strain, significant vacancies, growing demand, and pressure to address out-of-area placements, we know it’s really challenging for mental health systems to sustain the momentum created by the CMH framework – especially when balancing immediate pressures with the clear imperative for long-term transformation 

We want to direct our expertise and methods to support mental health systems with wide-reaching, sustainable transformation programmes. We know that partners can hugely benefit from support when it comes to visions for change, cross-sector working, coproduction, and implementing new cultures and practices that bring the Living Well model to life. We would love to hear from mental health systems looking to further their impact on people and in communities – you can get in touch with us by contacting: 

Rachel Shapcott
Stacey Hemphill
Christina Cornwell