New Ways of Working for Allied Health Professionals in Mental Health

Key recommendations of New Ways of Working (NWW) for Allied Health Professionals (AHPs)

• Service users and carers should be actively involved in the development and delivery of training and education, and as partners in their care (at both individual and service levels).

• AHPs should use the Skills for Health competence-based approach to service delivery (www.skillsforhealth.org.uk) and the Creating Capable Teams Approach
• AHPs need to demonstrate to commissioners the cost-effective contribution their specialist skills can make to improving the health and well-being of service users and their carers.

• AHPs should extend links with local authority and other services to ensure clinical protocols and care pathways for service delivery across organisational boundaries are in place.
• AHPs should take advantage of their transferable skills in order to lead service development across mental health services.
• AHPs should make explicit the contribution they can make to improving a person’s quality of life through reducing their reliance on services and by promoting health and well-being.
• The ten essential shared capabilities (underpinning values for all mental health staff, www.nimhe.csip.org.uk) should be integral to training, induction and the continuous professional development of all AHP professionals and support staff.

‘Dialectical Behavioural Therapy (DBT) hits the button for me. It is the first treatment I have been offered that directly addresses my destructive behaviours. The team who facilitate this – occupational therapist (OT), psychological and nursing staff – have been helpful and understanding. My primary therapist is an OT.’

Background

AHPs work with individuals from all age groups and within all clinical specialties. Their particular skills and expertise can be the most significant factor in helping people develop and maintain their independence through both physical and mental rehabilitation. AHPs work across many sectors and settings including health, education, social services, primary care, secondary care, the independent and voluntary sectors.

There are specific AHPs working in specialist mental health roles. They include art therapists, dietitians, drama therapists, music therapists, occupational therapists, physiotherapists, and speech and language therapists. However, other AHPs also make a valuable contribution to mental health service users via promoting positive mental health. A unique contribution of AHPs is their ability to meet the combined mental and physical health needs of service users.

New Ways of Working for AHPs

NWW represents a cultural change in the delivery of mental health services. The future is a person-centred values-based approach where services and roles are responsive and flexible. The policy context includes the White Paper, Our Health, Our Care, Our Say and proposals for improving access to psychological therapies and social inclusion, as well as mental health legislation.

One recommendation from New Ways of Working for Psychiatrists (Department of Health, 2005) was to take forward NWW for AHPs via the Mental Health Allied Health

Professionals Advisory Group (MHAHPAG). Representatives on this group included service users, carers, the AHP Federation, other NWW workstreams, Skills for Health, the National Institute for Mental Health in England and the Department of Health.

This chapter is a summary of the full report of NWW for AHPs which can be found at www.newwaysofworking.org.uk. NWW for AHPs has developed practical guidance illustrating how AHPs can enhance and evolve their practice to meet the needs of working in a modern mental health service and ensure wider social inclusion of service users and carers. It demonstrates and provides examples of how AHPs make the best use of their skills, competence and capacity to work across and between organisations.

The MHAHPAG identified four key themes relating to NWW which have been explored through project groups. These were:

• education and training;
• new roles;
• system reform (Our Health, Our Care, Our Say White Paper); and
• teamworking.

Common issues, challenges and recommendations of each theme are discussed in the main report.

Several cross-cutting themes have emerged both within the project groups and other NWW workstreams, including improving access to psychological therapies, regulation, preceptorship, social inclusion, recovery approaches and complexity. All of these are addressed in the NWW for AHPs full report.

Chapter 8 of the final report of the New Ways of Working for Psychiatrists (2005) identified actions to be taken in respect of a number of Allied Health Professions to promote NWW. Updates on these are included in the full report.

Innovative practice

North Central London occupational therapists have developed a training resource pack for senior occupational therapists to deliver training to support staff. The target client/service groups included adult mental health and dementia services. The training is currently being piloted with a view to using it as part of an NVQ course at Middlesex University.
Contact: Delia Thomas at This email address is being protected from spam bots, you need Javascript enabled to view it or Vanessa Papas at This email address is being protected from spam bots, you need Javascript enabled to view it

Innovative practice

The Adult Mental Health Joint Training and Development Strategy Group in Leicestershire has service user and carer trainers working with professionals/workers to deliver training that models good partnership working and hugely enriches the training experience.
Contact: Rebecca Pritchard at This email address is being protected from spam bots, you need Javascript enabled to view it

Innovative practice

Occupational therapists at the Hartington Unit at Chesterfield Royal Hospital have a new role, working in the Crisis and Home Treatment Team. The occupational therapy team formulated a Crisis Care Pathway and aims to complete intervention and discharge in eight weeks. Benefits include reducing the number of acute mental health hospital admissions and establishing more links with community networks.
Contact: Kate Singleton at This email address is being protected from spam bots, you need Javascript enabled to view it

Innovative practice

A weight management programme for adult mental health clients in Barnsley helps clients to manage weight gain that is due to a variety of factors, including the sideeffects of medication. It is a three-month programme run by a senior physiotherapist and exercise specialist with input from dietitians, pharmacists and psychiatrists, as well as psychology, nursing and leisure centre staff. It has demonstrated that clients taking anti-psychotic medication are able to lose weight if they are prepared to change their exercise and eating habits, and that this results in corresponding improvements in self-esteem. The programme is constantly being modifed in response to feedback from clients and staff – for example, a stress management component has recently been added to the programme.
Contact: Roderick Newsome at This email address is being protected from spam bots, you need Javascript enabled to view it

Occupational therapy

‘The activities my son was involved with were going shopping, preparing and cooking light meals, art, constructing wooden models and computer work... He explained how, by being given a choice, he felt he had some empowerment... My son felt the therapists were interested in him as a person, as an ordinary human being.’

Other useful websites

DH (2005): New ways of working for psychiatrists: Enhancing effective, person-centered services through new ways of working in multidisciplinary and multi-agency contexts. Final report ‘but not the end of the story’. DH Publication Ref 270394A/B/C.
Contact: Wendy Osborn, Professional Head of Therapies, Berkshire Healthcare NHS Trust