Making us fit for the future

The Trust and the environment it operates in are undergoing a huge amount of change as can be seen from the items in this newsletter. To address a number of challenges, improve access, and be better prepared to play an active role in the North Central London Integrated Care System and wider NHS, the Trust has been undergoing a Strategic Review. The final outcome of the review will be published next month. Here we set out the reasons and hopes for this substantial change programme.

Strategic Review banner

The Tavistock and Portman can be very proud of the contribution it has made over more than a hundred years to the development of mental health services in this country and internationally. It has pioneered the theories, trainings and practices behind community-based approaches to improving mental health. Amongst others, it is the birthplace of attachment theory, which first described the importance of early bonding experiences between parents and children on their future emotional resilience. It is a centre of excellence in clinical practice, training, and innovation in mental health, emotional wellbeing, and gender identity.

Since 1948 the organisation has been part of the NHS. This has been a great source of strength but has also required the organisation to adapt and respond to wider developments in the health and care systems. The Strategic Review, which we launched in 2020, recognises that we are at a point where the organisation must change significantly to be fit for the future and so that we can support more people more quickly and easily share good practice across our services.

Being fit for the future requires us to respond to the five challenges which we have highlighted consistently through the development of this work. These are:

  • A financial challenge – some significant changes in the way in which the Trust is funded have generated a financial deficit which we need to address
  • A system challenge – the development of Integrated Care Systems is prioritising integration and collaboration within the NHS and with its partners and we need to align our services in ways which make the greatest contribution to system goals
  • A diversity challenge – we work in one of the most diverse parts of the country but the shape of our workforce, leadership and services does not appropriately reflect this
  • An organisational challenge – the scale and complexity of our work has highlighted weaknesses in how we are organised
  • A data and impact challenge – whilst the value of the work the Trust undertakes is often recognised implicitly, we have failed to be able to use data to demonstrate the outcomes we achieve sufficiently clearly

Based on a great deal of analysis and consultation with staff we will shortly be publishing the outcome of this review. Some of the changes proposed will be implemented by the end of this year but much of what is proposed will take much longer to implement, recognising the need to plan and prepare carefully and a desire to reduce, where we can, the direct impact on staff.

Our main motivation through all of this has been to improve the experience of our patients and students while doing our best to support staff through this change programme. Throughout the Review, we have worked closely with the unions and our Staff Side representatives and will continue to do so through the implementation of changes.

We have an incredibly engaged and dedicated workforce which has fed back thoughtfully to our consultation proposals and we have listened. Our final proposals will seek to retain what makes this Trust so valuable to the system: its ability to work deeply and holistically, manage complexity, engage across disciplines and agencies in the interest of patients, and shape interventions fit for our times.

The Trust collaborates with organisations across professional boundaries and embraces the move to working at system level to improve the health and wellbeing of the population. We are making changes now to streamline how we operate, increase our agility, and demonstrate our impact. We know that the Trust can play a pivotal role in improving the mental health and wellbeing of our population in working in partnership with other agencies to support some of the most vulnerable members of our society.

Our combination of innovation, inclusivity, excellence in care, and empowering education makes us ideal partners with a unique set of assets and capabilities to engage across the NHS, in education, in local government, and beyond to address the complex health challenges we face as a country.

Combined with the governance review and work we have done to develop a new Race Equality Strategy, the Strategic Review will set the course for how the Trust will operate going forward. We look forward to sharing its outcomes in future issues.