ABSTRACT
This chapter examines leadership within mental health services – a key arena for healthcare innovation which involves working across established organisational boundaries. As we have seen throughout the book this far, many of the major reform initiatives have sought to break down barriers between primary and secondary care. This was a central theme of the Five Year Forward View and it figures strongly in Integrated Care Organisations (ICOs), Accountable Care Organisations (ACOs) and the Long Term Plan. In this chapter we zero-in on three examples of recent attempts to lead across the primary-secondary divide in the domain of mental health services. Many mental health conditions involve long-term treatment and may require a range of different treatment and professional inputs over considerable periods of time. The integration of care across primary care and acute sectors as well as within each of them can be particularly problematic as well as crucial to patient and population health outcomes. Our aim in this chapter is to provide a detailed and fine-grained analysis of some initiatives to innovate and address these issues, including the obstacles to be overcome and the actions of the leading players. The chapter begins with two cases involving services for dementia before turning to a third case which addresses attempted innovations in the organisation of mental health services more generally.
