Alongside the co-production, local system partners began to pilot integrated models of care. A key enabler to this was an innovative move by the local Voluntary Community and Social Enterprise (VCSE) sector, in which seven local mental health charities came together under a formal framework called the 'Mental Health Northants Collaboration' (MHNC). This had the significant benefit of allowing local commissioners to fund system-wide VCSE support under a single contract. Northamptonshire clinical commissioning group (CCG) started where the need was greatest, and where there were clear benefits to some of their most vulnerable service users – the acute and crisis care pathway.
The CCG tested delegations of responsibility to a lead provider, in which the NHS trust took on management of all mental health inpatient flow. The result was a sudden and significant reduction in out-of-area placements.
Further delegation for crisis alternatives involved the NHS trust partnership/ sub-contracting the MHNC to co-deliver crisis cafes, crisis houses and a new 'hospital@home' service. Each quickly proved their value in preventing avoidable admissions and A&E attendance, as well as delivering positive service user feedback.