Award Title: Optimising key components of the community mental health policy through implementation of the PARTNERS intervention: learning about personalisation, integration and team-based supervision.
Funder: Department of Health and Social Care

Abstract: Research questions   1. How can team-based supervision, alongside personalisation and coaching approaches be integrated into practice in the context of a community mental health transformation programme?  2. What enables implementation of the PARTNERS2 service and what are the lessons for policy?  Background  The NIHR funded PARTNERS2 research programme and NHS England s new policy framework for community mental health both seek to address the enduring problems of community mental health practice:    Poor integration between secondary care services, primary care, and the voluntary and community sector;  A gap in provision for those discharged from secondary care but not suitable for Improving Access to Psychological Therapy services; and  Poor integration between mental and physical health.   PARTNERS2 involves a cluster randomised trial and parallel process evaluation of a complex intervention which utilises a person-centred goal setting and coaching approach to address individuals  biopsychosocial needs. Co-designed with PPI stakeholders the intervention comprises initial and top-up training for Care Partners, a manual, one-to-one supervision and meta-supervision for supervisors. Concluding the trial and evaluation, we are specifying the mechanisms of supervision and the practices of personalised care, and of working with other services. Our evidence based learning about personalisation, integration and team-based supervision has the potential to optimise the key components of community mental health policy.  Aims and Objectives  Aim: To enhance the pilot phase of the NHSE community mental health transformation programme, by applying knowledge gained from PARTNERS2: providing evidence regarding the core components required to enhance policy specification and the successful delivery of place based mental health services.  Objectives:  1. To apply learning from core components of the PARTNERS intervention - supervision, coaching approaches and integration of care - within two of the policy programme pilot sites.  2. To evaluate and refine theory for how practice and supervision support personalisation and integration of care.  3. To develop policy and practice guidance for supervision, personalisation and integration of care for individuals with significant mental health problems.  Research Methods  Knowledge generated by PARTNERS2 will be applied directly within two new pilot sites from the community mental health transformation programme. We will co-design working arrangements with each site and tailor our approach to local context. An implementation-oriented realist evaluation (comprising stakeholder workshops, interviews, tape assisted recall, and rapid feedback to sites) will be guided by the Consolidated Framework for Implementation Research, focusing on areas which challenge and enable implementation, and to provide lessons for current policy.  Timelines   Co-design with PPI, clinical and policymaking stakeholders, implementation, rapid on-line evaluation, real-time feedback, and dissemination will be undertaken within 12 months.  Anticipated Impact and Dissemination  We will demonstrate how supervision can support personalised responses to individuals with a range of complex mental health problems, enabling policy makers to operationalise the vision of integrative and personalised health care goals. Building on our established involvement in the NHSE transformation programme, engagement and dissemination will be extended from co-design with the two pilot sites, to sharing findings and learning with all twelve NHSE transformation pilot sites, and wider clinical, academic and service user networks.

Lay Abstract: Background   We have been working for the past few years on a research programme called PARTNERS2. Developing a new model of care for people with mental health problems so they can receive better support in primary care. The idea is based upon improving three things:   •             Helping services to join up so that people s care is more coordinated.   •             Ensuring that the care people receive meets their specific needs, what we call  person-centred  care.   •             Creating a strong supervision structure, so that those providing support are well supported themselves.      We believe that the findings from our PARTNERS2 research will be useful for new policies that are currently being tested in twelve community pilot sites by NHS England. Three members of our team are involved with these community pilots and NHS England have agreed that learning from PARTNERS2 would be useful. Therefore, we are proposing a 12-month project to share our learning, directly to sites that might benefit, and gather more feedback so we can better support implementation of this community mental health policy.      What will we do?   We will support two community pilot sites to use learning from PARTNERS2. We will provide them written manuals, training and supervision for practitioners. We will collect more information to explore what works well and less well as they adopt and adapt PARTNERS2 to their locality. Specifically, we aim to:   •             Learn about how two parts of the PARTNERS intervention work: a) our coaching approaches b) the ways of joining up care for people across primary and secondary care and the voluntary and community sector.   •             Develop better understanding about how supervision supports person-centred and joined up approaches to care.   •             Produce more guidance to support implementation      This will be possible through the following research activities:   •             Workshops in each site with key stakeholders to understand their local mental health care systems, their community pilot site plans and how PARTNERS2 findings could be used and what may enable or challenge implementation;   •             Work with practitioners and supervisors, training and supporting up to twelve staff members in coaching approaches. Follow progress through research interviews and digital recordings of practice sessions.   •             Looking at data collected locally.      The information will be used to produce a series of case studies, to tell the story of how this work was undertaken and any successes or difficulties encountered. PARTNERS2 has an active service user advisory group and members will be involved in advising us and assisting with dissemination including blog writing, planning and hosting events, and developing a policy paper. Final outputs will include a peer review publication, infographic, a tweet chat, and zoom workshops to engage all twelve community pilot sites in this final phase.

Research Activity Codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health Categories: MENTAL HEALTH