An innovative scheme launched by Primary Care Networks (PCNs) across Norfolk and Waveney has been shortlisted for a prestigious national award, as part of the General Practice awards 2023.

A team of skilled mental health nurses, working in general practice have been recruited to support our 19 clusters of GP practices, known as PCNs in Norfolk and Waveney, supported by experienced mental health team leaders. Alongside this, enhanced recovery workers have been recruited by Mind Norfolk and Waveney to support people with lower-level mental health needs and an identified wellbeing service worker who can fast track people for cognitive behavioural therapy or other talking therapy services provided by NHS talking therapies.

In addition, care navigators working in GP practices across Norfolk and Waveney have recently undergone training, to enable them to signpost people to the most appropriate support, based on their mental health needs. These teams, linking in with our Wellbeing hubs and Sanctuaries across Norfolk and Waveney have provided a welcome boost to providing low level, early mental health interventions to residents and communities. This investment is part of our long-term commitment to working with our residents, staff and communities to improve mental health services, bolstering support available in local communities.

The new mental health teams based in primary care are being supported by a range of hands-on training and development opportunities along with monthly mental health webinars and regular communication focussing on mental health clinical topics and pathways of care. This is helping to widen and deepen understanding of the resource available, both within and other services that can provide support to help people with their mental health.

Dr Ardyn Ross, local GP and Clinical Lead for Mental Health, NHS Norfolk and Waveney, said: “I am delighted that this vital new way of working has been recognised nationally.

“It is essential that mental health services and support is owned by all parts of our heath and care system, including but not limited to general practice, our vital Voluntary Community and Social Enterprise sector, through to specialist mental health provision for individuals who require more intensive support.

“Our mental health teams in primary care networks are just one of the ways we are investing in services to help people early on, supporting people at the right time and right place to help prevent mental health conditions deteriorating.

“The new teams are providing much needed support for people in every community across Norfolk and Waveney and I look forward to working with our residents, staff and communities in the future to ensure we continue to engage when people reach out for help, in ways that are more convenient, supportive and accessible to them.”

The new teams are supporting people at a much earlier stage in their journey. With a new level of expertise based in general practice we can ensure people have their needs met at an earlier stage by the most appropriate person. The teams will ensure that psychiatrists, psychologists, and pharmacists can in-reach into the general practice mental health teams so that only the people with most complex needs are prioritised for specialist care. Working with VCSE partners, people now have access to a wider range of talking therapies including trauma informed therapies, with a new bespoke service for people with complex emotional needs.

Dr Ross added: “The new mental health integrated community interface will triage people who may need secondary care into talking therapies or community mental health teams supporting general practice teams to manage those who are stepping down.

“Holistic needs are also being met through general practice team links with social prescribers, as well as health and wellbeing coaches. A new programme called Diaolg+ has been integrated into our general practice systems so we can capture people’s own recovery goals along their journey.”

Jossy Pike, Acting Director for Mental Health Transformation, NHS Norfolk and Waveney, said: “One of the reasons why these new teams have been so successful is linked to the fact that this additional support has been coproduced with people who have lived experience of mental services in Norfolk and Waveney, from design, right through to delivery.

“Our group of experts represent the demographics of our local population, including carers. They are reaching out into communities with quieter voices to promote awareness of the new teams and our wellbeing hubs.

“Patients who have accessed this new support via general practice have been extremely positive in their experience so far. The use of Dialog+ is now showing specific outcomes for our patients, helping us to provide a more holistic package of support to people in the community with their mental health.”

Almost 1,500 people have been supported by the new mental health teams based within general practice, so far and increasing numbers are accessing our Wellbeing hubs and sanctuaries.

The national general practice awards ceremony takes place on 8 December 2023.