Realising Potential our own and others

Support for change - making it happen

Leadership is critical for effective change, and AHPs of all grades need leadership skills to meet the service change agenda. Effective leaders motivate staff to perform optimally, enable team working and collaboration and contribute to overall organisational effectiveness.

Much effort over the first year of implementing the Realising Potential action plan focused on developing leadership in AHP mental health services. It was felt that without strong leadership, attempts to take forward the action plan's recommendations would lack direction and drive. That is why Realising Potential recommended that NHS boards and AHP directors should identify an AHP mental health lead to develop a sustainable clinical leadership function that reflects proposed service delivery changes.

AHP mental health clinical leads have now been identified within each territorial NHS board. They have been working diligently within their boards, using a range of methods to heighten awareness of Realising Potential within the workforce and among service users, carers and families. Local needs are determining how the AHP clinical leadership role is being developed within individual NHS boards.

The National AHP Mental Health Clinical Leads' Group includes all the clinical leads and meets every two months. The group has developed and agreed a schedule of work to promote implementation of the action plan across the country. Part of the group processes involves action learning sets in which members' leadership potential is explored through posing powerful questions designed to change their perceptions of the leadership role in progressing the Realising Potential agenda.

The clinical leads' group is accountable to an implementation group and links formally to the AHP Mental Health Reference Group. This enables continued engagement with key stakeholders, including service users, carers, families, AHP directors and professional bodies.

But the message about the need for strong leadership to drive Realising Potential forward has been delivered to all levels of the AHP workforce, and among students on AHP programmes, to build leadership-consciousness among all those planning, managing, delivering and supporting AHPs in providing mental health services. Professional bodies have shown strong leadership by embracing Realising Potential, with many hosting workshops and events for specific professional groups to heighten their awareness and to encourage them to integrate the action plan into their normal ways of working. There is also great momentum building in joint work with colleagues in physical health and social work services - we should always remember that Realising Potential is not only for AHPs in mental health.

This is truly about realising the potential, and raising the profile, of AHPs in mental health to enable them to empower themselves and others. And the national lead for vocational rehabilitation and the AHP consultants in forensic and dementia care are proving to be inspirational leaders who are working nationally to drive and enable transformational change.

Showing leadership - developing a structure at NHS board level

The leadership structure adopted in NHS Greater Glasgow and Clyde provides an example of how leadership is being developed within boards at strategic level.

The AHP Realising Potential Mental Health Executive Group set up within the health board area has a remit to provide strategic direction to the development of AHP services in mental health, particularly in relation to overseeing the implementation of the Realising Potential action plan. It assumes ownership and sign-off of the action plan, monitors progress and ensures delivery. The group, which meets quarterly, is also responsible for agreeing communication structures to share progress related to the action plan. Members include senior AHPs, a senior mental health manager and service user/carer representatives from ACUMEN (Argyll and Clyde United in Mental Health and the Greater Glasgow Mental Health Users' Network).

The group designs and implements evidence-based projects to support action plan implementation and evaluates and reports on the impacts of its work. It has a work plan linked to action plan recommendations which details the activity, timescale and lead person responsible for delivery.

Through networking and sharing ideas at the National AHP Mental Health Clinical Leads' Group, colleagues from NHS Lanarkshire have adopted a similar model to manage the workload and monitor progress associated with Realising Potential.

Showing leadership - developing the role of speech and language therapy in mental health

Evidence suggests there is a requirement for specialist speech and language therapists (S&LTs) to be involved in multidisciplinary service models for people with mental health problems. This fact has been recognised in NHS Lanarkshire, where a proposal to develop specialist S&LT provision in mental health services has been raised. It is envisaged that specialist S&LT provision would enable communication and dysphagia screening tools to be developed for the multidisciplinary team, provide education for team members on the impact of communication and swallowing issues for people with mental health problems and facilitate expert assessment and input to treatment planning for identified high-risk cases.

An example of the impact of S&LT inputs in mental health can be found in NHS Highland. A S&LT in a community hospital runs communication groups with clients in open ward areas, enabling them to relate to and connect with each other. The S&LT has also developed a system in which she engages with clients prior to ward rounds and multidisciplinary meetings to support them to achieve clarity about what they want to communicate, increasing their sense of empowerment and helping rounds and meetings develop more person-focused outcomes. The S&LT uses different ways of supporting clients to express themselves, including "Talking Mats",^[20] and is currently exploring the ACIS (Assessment of Communication and Interaction Skill) tool^[21] with clients with mental health problems.

Showing leadership - the experience of an AHP mental health clinical lead

Jane Fletcher, AHP Mental Health Clinical Lead in NHS Grampian, discusses her role.

"I was appointed as AHP Mental Health Clinical Lead for NHS Grampian in March 2011. My priorities were to revamp our existing mental health AHP meetings structure, to identify key stakeholders with regards to implementing the Realising Potential agenda and to establish a communications strategy so AHPs and others knew what was happening. The Realising Potential agenda fits well with the other current strategic drivers, and this has helped with securing buy-in from stakeholders in different sectors across Grampian.

"From the start, the director of nursing and quality has been very supportive and the recent appointment of the NHS Grampian AHP associate director signals the first part of a new AHP structure. This will be crucial in the further implementation of the Realising Potential agenda.

"The AHP Mental Health Clinical Leads' Group has been very important in enabling contact with others with the same remit in other parts of the country. Particularly useful have been the action learning sets, allowing us to share successes and lessons learnt. More recently, we have set up the North of Scotland Mental Health Clinical Leads Subgroup with representatives from NHS Grampian, Orkney, Shetland, Tayside, Highland and the Western Isles. This has provided additional links with colleagues working on similar issues who are close geographically.

"I feel as if I have barely started and there is still so much to do. My appointment as AHP Mental Health Clinical Lead for NHS Grampian is a great opportunity for me, but also a steep learning curve. I already have a greater understanding of how other parts of the organisation work and I have met many new people from different sectors. I look forward to the future opportunities and challenges ahead."