The NHS in England
An insight into how mental health services in England are organised differently to Wales can be gained from this story published today.
Bristol's NHS Commissioning Group (no such thing in Wales) is no longer prepared to use just the local specialist NHS Mental Health Trust (no such thing in Wales) but is instead putting community services out to tender wholesale (theoretically possible in Wales but no likelihood of it happening any time soon) because of widespread dissatisfaction among patients and families.
The likely outcome is a new service run in partnership between a number of community-based organisations.
Service users and carers have been extensively consulted and Lou Winstone, who has used mental health services and took part in the consultation, said she looked forward to "an improved and modernised service" which would be "more responsive and compassionate".
Of the consultation she said: "There is a sense that the service users' and carers' experience, views and expertise have been valued considerably more than in the past". She added that she hoped the new approach would make "recovery the norm".
And local MP Dawn Primarolo (Labour) says the new arrangements offer a "once in a generation" chance for change.
Now, time will tell whether the new service is better but it is interesting to reflect that the independent commissioners can try something new when the current provider doesn't deliver.
In Wales the potential "commissioners" (Local Health Boards) are of course also the providers and I leave it to you to decide how likely it is that they will reject their own services and look elsewhere other than on a marginal basis.
England's NHS structure leaves much to be desired but this side of the border we do need a Welsh solution to the challenge of ensuring choice in mental health services, whether it is choice by commissioners based on what patients tell them or (better still) choice by individual patients who can select what they want and reject services which don't respect them or don't help them stay safe and recover.
