Context

Like all NHS organisations, we are striving to provide the best possible care within an increasingly challenging environment. Honesty and openness about the environment within which we are operating, and the challenges it presents, have been key factors in producing this strategy - we have to be realistic about what we are able to achieve in all aspects of our work.

We have considered all of the feedback, clinical evidence, data analysis and historical and contextual information that we have gathered in producing this strategy. One of the broadest, and most important, conclusions that we have reached is that our capacity to fully meet the needs of the population we serve is insufficient. This situation mirrors the national position and is generally accepted by organisations such as ours and the wider health and social care system.

Sadly, there remains an inequity of resource allocation when funding for mental health services is compared to that for physical health services.

A number of inequities also remain for people with mental health, learning disability and neurodiversity needs, including their access to services, their physical health and their life expectancy. Given this backdrop, our strategy seeks to identify those priority areas where we can bring our unique expertise and experience to deliver the greatest benefit.

Nationally, it is recognised that there is still an imbalance in the funding between mental illness and physical illness, based on the level of need that exists

1. British Medical Association (2023). Mental health services under extreme pressure. 
2. The King's Fund (2023). Mental health funding in England: still falling short?
3. Royal College of Psychiatrists (2024). RCPsych criticises planned cut in mental health spending.

Context shaping our strategy

From meeting with a wide range of stakeholders, including people who use services, carers and staff, the following overarching themes emerged:

  • Communication and the importance of building good connections
  • Addressing gaps between services
  • Improving transitions between services, particularly between services for younger people and those for adults
  • Better signposting to services, support and resources
  • Fewer hand-offs and lengthy referrals between services
  • The importance of 'waiting well' - keeping people informed while they are waiting and signposting them to any other help and support that is available
  • Taking a balanced approach between face-to-face support and the use of digital technology

Other relevant context

The development of our strategy has been shaped by the priorities set out by Devon's Integrated Care System (ICS), of which we are an integral part. These are: 

  • Digital working and innovation 
  • Prevention, early intervention and self-help 
  • System working to deliver better outcomes 
  • Support for, and respect for, patients, carers and their families as experts 
  • Integrated neighbourhood health and social care structures 
  • Right care in the right place 
  • Addressing equalities and respect for diversity 
  • Maintaining a focus on wider determinants of health. 

Our strategy has also been informed by plans and developments at the national level. Key among these are the three 'strategic shifts' that are identified in Lord Darzi's 2024 review of the NHS. They are: 

  • Moving care from hospitals to the community 
  • Embracing digital transformation 
  • Shifting the emphasis of care from treatment to prevention. 

These shifts are very closely aligned to the direction of travel that our organisation has been pursuing for some years. We are striving to support only those people who really need to be in hospital on our inpatient wards; we are actively exploring how we can safely use digital technologies to improve care and we know that there is more that we can do to prevent people from becoming unwell. 

Our strategy is also aligned with the core ambitions set out in the existing NHS Long Term Plan for Mental Health. The government is currently undertaking a major engagement exercise on a refreshed 10-year health plan, which will be published later in 2025. We have been actively involved in this process, seeking feedback from staff, people with lived experience and other stakeholders about how we can improve the NHS. We are hopeful that the new 10 year health plan will set our clear plans and priorities for people with mental health, learning disability and neurodiversity needs. 

Alignment with other work

In addition to the local and national context, this strategy is also closely aligned with a number of other strands of work across our organisation. These include: 

  • Carers Strategy, which was published in 2024 
  • Clinical Professions Strategy 
  • Workforce Strategy 
  • Together Strategy, which is being refreshed and will be published in 2025 
  • Mental Health, Learning Disability and Autism Inpatient Transformation and Culture of Care Programme, which was launched in 2024 
  • Equality, Diversity and Inclusion (EDI) Policy and Work Plan. 

Next steps

Operational plans and quality improvement programmes will ensure that the priorities and strategic intentions set out in this document are delivered on the ground.

This will require continuing coproduction with people who use our services, carers, our staff and our partners. We will also strive to measure our success in implementing this strategy through a range of performance indicators and feedback from those that both use our services and work within them. We will use this information to drive further improvements in the quality and effectiveness of our care.

Later in 2025, we will also be refreshing our organisation's Corporate Strategy and the principles and priorities set out in this Clinical Strategy, alongside our Together approach to coproduction, will form an important part of that document.