Designing better mental healthcare facilities

Gather momentum and start building up change

In the keynote presentation at May’s Design in Mental Health 2017 conference, delegates heard from Lord Nigel Crisp, a cross-bench member of the House of Lords who was NHS CEO and Permanent Secretary at the Department of Health from 2000-2006, and now chairs an Independent Commission set up in 2015 to address the issues facing adult acute mental healthcare patients in England. He discussed the background to, and findings of, a Commission report which found that ‘access to acute care for severely ill adult mental health patients is inadequate nationally and, in some cases, potentially dangerous’.

The Independent Commission on Adult Acute Psychiatric Care was set up by the Royal College of Psychiatrists in January 2015 in response to ‘widespread concerns about the provision of acute inpatient psychiatric beds in many parts of England and Northern Ireland’. It is chaired by Lord Nigel Crisp, with support from 14 Commissioners with a diverse range of expertise in mental health and related sectors. The Commission’s report, Old Problems, New Solutions: Improving Acute Psychiatric Care for Adults in England, published in February 2016, was the subject of the former NHS CEO’s forthright and very interesting conference presentation, ‘Old problems, new solutions’ on the first day of the conference at Design in Mental Health 2017. While the Commission’s work has been funded and supported by the Royal College of Psychiatrists, Lord Crisp emphasised that the Commission and its work remain wholly independent.

Before he took the stage, the session’s chair, healthcare architect, Wendy de Silva, explained that, a former NHS CEO and Permanent Secretary at the Department of Health, Lord Crisp is currently chair of the All-Party Parliamentary Group on Global Health. She said: “Much of his time is spent on global health, particularly in Africa, while last year he was a co-author of A Manifesto for a Healthy and Health-Creating Society, which was published in The Lancet in December 2016. Here he argued that Brexit, and the current state of the NHS, called for a re-think on the UK’s provision of, and approach to, healthcare, arguing that leaving the EU would only exacerbate current problems. He simultaneously acknowledged, however, that there are plenty of very positive developments, with scientific discoveries and digital technologies offering ‘unprecedented opportunities for improving health’. Closer to home in terms of our conference, and one of the conclusions of the report by the Independent Commission on acute psychiatric care for England was that ‘many people do not have access to high quality beds when they most need them’. The report pointed to the ‘symptoms of a whole-system failure’, and argued for ‘a new system-wide solution’. I should like to invite Lord Crisp to share his findings, and to set them in the wider context of health creation, both nationally and locally.”

Lord Crisp explained that, having worked for some time at senior levels at the DH and in the NHS, he now spends most of his time on global health, ‘but got involved in mental health again’ about 18 months ago, when the President of the Royal College of Psychiatrists, Professor Simon Wessely, asked him to do a bed commission. He explained: “I said ‘no’, but I did then end up chairing a group that examined the crisis that there was, and which I believe still exists, in acute psychiatric inpatient care for adults. In this presentation I will talk mainly about that, and the resulting report, ‘Old problems, new solutions’.”

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