Accelerating change

Improving the interface between mental health services and emergency departments is already a clear national priority, and the learning from this programme suggests that the challenge now is less about new policy and more about how existing commitments are aligned and delivered locally.

Current policy direction is strong: from the 10 Year Health Plan and the NHS England Medium Term Planning Framework, to the Urgent and Emergency Care Plan, GIRFT operational standards, and investment in Mental Health Emergency Departments and community-based crisis alternatives. Wider reforms, including Mental Health Act changes, expanded Mental Health Support Teams, 24/7 community mental health centres and the forthcoming Modern Service Framework for severe mental illness, all point in the same direction.

This programme reinforces that policymakers can accelerate impact by aligning funding, performance and accountability across partners, supporting better data sharing, recognising the time needed for complex system change, and embedding sustainability and lived experience engagement from the outset.

At a local level, successful improvement was not driven by policy alone, but by a consistent set of enabling conditions.

Teams that made progress typically shared a number of measures:

• Protected time and visible leadership support for improvement.
• Shared ownership across organisations rather than reliance on individuals.
• A small number of focused priorities aligned to operational pressures.
• Regular joint forums for decision-making and escalation.
• A clear, shared view of the problem informed by data and lived experience.
• Early attention to sustainability, embedding changes into everyday practice.

When considered together, these actions would help translate national ambition into sustained, practical improvement – enabling local systems to move from managing pressure to improving pathways for people experiencing a mental health crisis, and the staff supporting them.