The document summarizes the work done through a programme to implement Leeds' Mental Health Framework. It discusses workshops held to: create a foundation for implementation; develop and implement a collaborative strategy using driver diagrams; and review the generated strategy and plans. The programme identified shared values, agreed priorities, and created champions to drive culture change. It benefited from bringing stakeholders together, accelerating the development process, and external facilitation to challenge assumptions. Personal reflections noted the large scale change process was helpful but more planning time between workshops would have been beneficial.

1. Implementing the city-wide
Mental Health Framework
Jenny Thornton
Programme Manager
Leeds Mental Health Framework

2. Our Vision
Leeds is a city that values people’s mental wellbeing
equally with their physical health.
“Our Ambition is for us all to be confident that others will respond to our
mental health needs without prejudice or discrimination and with a positive
and hopeful approach to our future recovery, wellbeing and ability”.
OUR VISION

3. Introduction to what you worked on through the
programme and your context
• The first day aimed to help us
create a firm foundation for
implementing the Mental Health
Framework
• Workshop 2 built on our
ambitions by working
collaboratively to develop and
implement our strategy. By using
Driver Diagrams we started to
drill in to our Mental Health
Framework to gain fresh insights
together. We also looked at the
implications of culture in creating
large scale change and the impact
we can have collectively to
improve “the way things are done
round here”.
• Workshop 3 built on our
ambitions by continuing to work
collaboratively to develop and
implement our strategy by
reviewing the driver diagrams,
prioritising activities, and aligning
the programme of work to the
Mental Health Framework and
wider system drivers.
• The final workshop reviewed the
strategy and plans generated by
the programme and their
alignment to the Mental Health
Framework and wider system
drivers

4. What is the impact, benefits and outcomes of the
programme on your system?
• Identifying our commonly
held principles and values
• Agreeing priorities
together
• New rules for service
design
• Service user contribution
and new ways of working
for the future
• Creating champions for
the programme and
culture carriers
• Pooled budgets
development
• Innovative governance of
the programme and new
system leadership roles
• Joint working with other
commissioning teams e.g.
Urgent Care and Children
& Families
• Engagement with Senior
Leaders and Boards to tell
the story and gain
support

5. What have been the highs and lows on your journey?
S felt her and other service
users’ ideas were genuinely
welcomed.
“It was like a big jamming
session where everybody’s
ideas were brought
together – and everybody’s
ideas were listened to”
• Joint Health & Social Care
budget proposals for the
programme.
• Investment in the
programme in the face of
challenging budgets.
• Parity of Esteem
No agreed Model yet

6. What challenges have you faced and how did you
overcome them?
• Agreeing the best place to start the Large Scale Change
programme as we had developed our Framework
document and were already “on the road” –
negotiation and sharing of key documents with IQ
team. Local face to face meeting.
• Getting the right representation in the room without
creating events so big as to be unmanageable –
allocation of places and good management of local
registration and targeting key people
• Key partners not always able to attend – quick turn
around of outputs from the events and updating
conversations

7. What contribution has the NHS IQ programme made?
• Given us a clear structure to enable us to work through our
thinking about the Transformation programme
• Facilitated the discussions and challenged some of our
thinking
• Were neutral commentators of our work – which drove some
of the discussions further than if led by a particular “sector”
• Threw in elements of theory – to shift the focus and set us
thinking
• Supported the development of stronger working relationships
across the sectors and particularly with service users
• Because we had four workshops over short space of time – it
drove the work at a pace that might have been slower within
them. So we have got a long way in short space of time.

8. What were the significant tools and techniques?
• Introductory exercises
• Newspaper Headlines ...in 5 years time
• Driver diagrams, Driver diagrams, Driver diagrams
• Prioritising and Impact and Do-ability assessment
• Developing the timeline
• Rule order
• BBC interview
• Quick turn around and circulation of outputs
(including photos) from the events - IQ
summaries very helpful

9. What was most useful about the programme?
• Detailed planning discussions with the NHS IQ
Team between each workshop – supportive
challenge
• Time to bring a large group of stakeholders
together in one room with a shared purpose
• Accelerated development of our process for
clarification of detail within the programme and
prioritisation of work
• External facilitation meant that local leaders
were able to focus on process in the room and
have time for conversations during the day

10. Programme Governance
1. Focus on
keeping
people well –
to build
resilience
and self-
management
2. Mental
health and
physical
health
services will
be better
integrated
3. Mental
health
services will
be
transformed
to be
recovery
and
outcome
focussed
4. We will
ensure
access to
high quality
services
informed by
need
5. We will
challenge
Stigma and
Discrimin-
ation
Mental Health Programme Board
Mental Health in the Community
Children and Families
Information
Crisis and Urgent Care
Key
overarching
projects
Wider must do’s and existing project work

11. If you knew then, what you know now, what would
you do differently?
• Have a face to face meeting at the start of the
process to meet facilitators
• Ensure the right local people attend
consistently
• Assign sufficient planning time between
meetings - it was very labour intensive
• Keep nimble and don’t be afraid to change
tack as required

12. What are your personal insights, reflections and
learning?
• Large Scale Change process is a helpful framework
• Outputs have created a Resource Bank – shared with
everyone
• Conversations change the world - nothing beats
bringing people together. These types of discussion
require time to talk through the issues – having an
externally supported structure legitimises the process.
• “There’s something unique about that external, slightly
removed eye watching us, with the NHS IQ expertise
being able to very gently and skilfully nudge us in the
right direction, using that whole suite of tools and
techniques to take us through the process.”