Mental health has led the move away from hospital care to home based treatment says guide

Several heads surrounding one head

This guide is an excellent example of developing resources to help learn from good practice. It has been written for all commissioners and providers, but in particular clinical commissioners, and mental health commissioners and practitioners.

Primary care mental health

The first section of the guide gives a comprehensive overview of the state of primary care mental health, looking at:

  • Where mental health care should take place
  • What mental health care is
  • Primary care’s role in prevention and early intervention
  • Managing physical and long term conditions in primary care
  • Commissioning primary care mental health
  • Implementing change in primary care
  • Standards in primary care
Key on a book

The authors have identified ten lessons for commissioners, organised under three key themes

Key lessons for commissioners

Looking at a range of current systems, the authors of the guide recognised that “there are pockets of good practice being performed” but that it is difficult to collate all this information in one place and then apply it. So this is what they tried to do. They have reviewed 108 case studies, international, national, and regional, and from these they have identified ten lessons for commissioners, organised under three key themes:

Theme 1: Community based mental health care

1) Local champions drive forward implementation
2) Effective Health and Wellbeing Boards can be enormously helpful
3) Primary care education and training will enable change
4) Money needs to move with the patient
5) Co-production will deliver ownership by people with mental illness and carers as well as better services

Theme 2: Accessible mental health services

6) The service needs to cover all ages
7) A mosaic of services needs to be provided to wrap around individuals and carers

People with plugs

Co-ordinated mental health care

Theme 3: Co-ordinated mental health care

8) Specialists’ time should be freed to look after people with complex needs and to be available for rapid advice and help for primary care
9) IT enabled communications between primary care and mental health is vital for a fully functioning service
10) Managing long term conditions

With these lessons identified, the authors continue to provide support to commissioners by going through each lesson and listing what needs to be done to achieve each one, and looking at what has worked well, and what commissioners should avoid. For each lesson, the guide refers back to a selection of relevant case studies, taken from the case study directory, compiled by the London Mental Health Strategic Clinical Network. 60 case studies out of the 108 reviewed have been included in the appendix. Information in the directory includes the title, description, location, and contact name and details.

Troubled young man sitting on the pavement

A mosaic of services needs to be provided to wrap around individuals and carers


This is a really useful resource providing the evidence base together with practical examples from all over. The directory of case studies provides tags for each case study, so if you are looking for a particular topic, it is easy just to search the tags and find relevant case studies for your work. The directory only contains a brief description of each case study, so if you need more information, the contact details of each project lead ones that are the greatest priority for your population group and then see the lessons that could be applied to improve primary care mental health commissioning in your area. Work together with your teams and stakeholders to identify your priorities and see how you can improve your commissioning activities.


A commissioner’s guide to primary care mental health (PDF)
Strategic Clinical Networks NHS England (London Region)
July 2014

Related documents

Closing the gap: priorities for essential change in mental health (PDF)
Department of Health
January 2014

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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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