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The Royal College of Psychiatrists Improving the lives of people with mental illness

Dr Daniel Maughan

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12/05/2016 10:38:41

The CSH and RCPsych sustainability scholars

CSH  and RCPsych have four sustainability scholars who are advanced Trainees in psychiatry. They are using their special interest day to work with their local CCG to improve the sustainability of commissioning. They are now half way through their scholarship. They have each started working in their own ways to embed sustainability principles into the redesign of mental health services commissioned by their respective CCGs. Mike Pearce at Oxfordshire CCG has undertaken a sustainability appraisal of a 'Young Person with Dementia' service, evaluating the service from an environmental, financial and social perspective. Arif Ahmed is developing sustainable outcomes for a MH liaison service in Liverpool. Oliver Bashford's work is on redesigning of City and Hackney CCG's crisis pathway and Suhana Ahmed's is working on a new mental health homeless service with Brighton and Hove CCG. Please see below for their half term reports.

Dr Daniel Maughan

Suhana Ahmed

Half term report: RCPsych scholarship and Brighton and Hove CCG
Nearly midway through the RCpsych Sustainability Scholarship, I’ve been thinking about the last 6 months and where I am at the moment. Having been paired with Brighton and Hove CCG, the first few months were getting to meet the relevant people and gain some understanding about the sustainable aspects of the CCG by reading through their sustainability plan and the progress they had made so far. It was clear from early on that they were keen for me to be involved and highlighted a new service being commissioned and piloted called ‘Mental Health Hostels Link’. The aim of the pilot was to gain a greater understanding of the mental health needs of the homeless within hostel settings and to identify barriers to mental health treatment and support.

Whilst significant progress has been made to improve health outcomes of the population as a whole, inequalities remain for many socially excluded group, one of which is the homeless population, with evidence of lower life expectancy and poorer health outcomes. In March 2014, services estimated that 132 people were rough sleeping in one night in Brighton. In addition, there are approximately 400 people in emergency accommodation and the city has 288 hostel places, with a current waiting list of 125 people.

The first few months of the scholarship involved me carving a role for myself in this project, with the 4 principles of sustainability being key in this. Various possibilities were discussed including patient related outcome measures (PROM) and focussing on the restoration of social capital, leaner, more effective pathways and training and empowering hostel staff with training.

In the last few months, after some very informative and useful meetings with individuals at the CCG, we identified an area of focus for the project which would have a sustainable basis and also be helpful in developing the service. To research the evidence around mental health intervention from the 1st stage (every contact counts) and how ‘treatment’ could be incorporated into the engagement process which can be time consuming in this complex population. How does this link into sustainability I hear you say? Improving value – by ‘treating’ from the very first contact, we are delivering interventions that provide the maximum benefit for the least cost (in theory reducing the time spent in the service by ‘treating’ and engaging side by side rather than one after the other). Prioritising prevention – aiming to prevent this population from becoming homeless again by equipping them with skills to build resilience (there is well known ‘revolving door’ phenomenon in the homeless). Empowering individuals and communities – promoting self-management and independent living.

And there you have it, the first 6 months of my scholarship. Let the final 6 months proceed…


Oliver Bashford

Half term report: Sustainability in crisis pathways and the RCPsych scholarship
The first half of the RCPsych sustainability scholarship has brought fascinating insights into the workings of a CCG, and the steps involved in the commissioning of services. I was involved in a GP members engagement event in which priorities for commissioning were discussed and ideas invited from participants. I was part of a session on waste reduction in which we spoke with local GPs to generate ideas about how local services could be improved and waste reduced. I have also been involved with a review and redesign of the crisis pathway in the local area. I looked into best practice from elsewhere around the country to identify efficient models of organising services, which led to a recommendation that a Single Point of Access could be developed in alignment with a new service in another part of London. The work with the redesign of crisis pathways has led to the current project which involves analysing data about the users of crisis services in order to inform decisions about how resources should be most effectively focussed. If we find that particular demographic groups are over-represented in the use of crisis services in this locality, this may allow for focussed intervention to support these groups. Related to this we will be looking at social sustainability in relation to crisis care, including a review of models of services such as street triage, crisis cafe and a peer-supported 'open dialogue' approach currently being implemented in other parts of the world...

Michael Pearce:

The first half of the year has been a busy one so far in my role as a psychiatry sustainability scholar… As-well as collaborating and learning with the other enthusiastic scholars, attending and presenting at conferences and engaging with NHS colleagues in the ideas of sustainable healthcare, I have been undertaking 2 main projects: I have been working with Oxfordshire Clinical Commissioning Group to try to apply the principles of sustainable commissioning to the reviewing and commissioning of older adult mental health services. This involves working with the CCG team to review whether current services are sustainable, and to feed sustainability principles into the redesign to ensure all aspects are considered. Examples have included highlighting guidance on early identification of patients, generating guidance on specific risk factors and prevention strategies for functional illness in older age, helping to map which services or innovations/pilots might be best placed to tackle the risks, and others in the works. I have also been undertaking a sustainability appraisal (possibly the first of its kind!) of a young person with dementia service. This service is an innovative charity which uses sustainable methods such as group activities in natural settings, to provide respite to carers/relatives of the sufferers. The project has involved evaluating the service from an environmental, financial, and social perspective (the triple bottom line). I hope to use this as a template for other services to be able to follow… I hope to be able to provide further updates as my work progresses, and I’m looking forward to more collaborative work with the other scholars.



Arif ahmed

The main focus of my scholarship to date has been involvement with Liverpool Clinical Commissioning Group (CCG) on their liaison service redevelopment. This has given me an insight into commissioning, business cases and the importance of networking. I have been able to attend important meetings at the CCG about the project and introduce them to the four principles of sustainability.

I have visited a local liaison service in Liverpool which has given some useful insights into the current setup. I am helping Liverpool CCG on the outcomes section of their business case, introducing ‘sustainable liaison outcomes’. The latter has been put together as an abstract and submitted to the liaison faculty for a potential poster and stand at the conference in Birmingham in May 2016. This has involved some joined up working with my fellow scholar Oliver and expert support from Phil and Frances.

You might be thinking what benefits there are to thinking sustainably in liaison psychiatry. Actually, by looking at a service’s structure and outcomes through a lens of the 4 sustainability principles, one might expect improvements such as these:

·         Improved patient and family satisfaction with services

·         Greater patient resilience through education and linking up with community services

·         Improved access to local psychiatric inpatient beds, meaning less travel and more convenience for family

·         Better outcomes for vulnerable groups such as the homeless and asylum seekers

·         Reduction in unnecessary investigations

These are just a handful of the potential positive outcomes – keep an eye out on the Psych Susnet blog over the coming months for a more detailed report.

As well as engaging colleagues at the CCG in Liverpool, I have also given talks on sustainability in Cumbria (where I work) to the frail elderly pathway Vanguard group and at a dementia steering group meeting (given via teleconference!). I plan to further this with potential talks to trainees and medical students at educational sessions. There will hopefully be an opportunity to lead a session to my fellow higher trainees in psychiatry, which could increase awareness in sustainability and encourage others to take up future scholarships.

If time permits I would like to do a quality improvement project with Liverpool CCG on a selection of the sustainable outcomes. Another potential project is to measure the carbon footprint of the liaison service as a case study, possibly as a joint project with my fellow scholars. I am soon to work with Frances on the ‘improving value’ section of a mental health service review template.

At almost midpoint through this scholarship, I can genuinely say that I have been fortunate to have had this opportunity and enjoyed the journey so far. It has enhanced my training in psychiatry by opening my eyes to sustainability, commissioning and the impact one can have on the services we work in as psychiatrists. I look forward to the second half of the scholarship, collaborating with supportive colleagues and hopefully gaining further tools to be of greater benefit to my patients. For those doctors in training who wish to broaden their experiences and perspectives, I would recommend they consider a special interest in sustainability.



04/09/2015 11:39:28

The case for sustainable development in mental health care



Having come to the end of my two year RCPsych research fellowship in sustainability, it is time to do some reflecting…




I have found that sustainability is one of those words that people tend to slap onto the front of a new idea, service, or project to make it sound credible or perhaps ‘a la mode’. But sustainability is more than just a badge, it requires a broad understanding about the resources we use and impacts that we are having. But, does it have a place when thinking about mental health care?


Well, of course I am going to say, ‘of course it does’ given my role, but I do think the arguments for improving the sustainability of mental health care are compelling….



·         The NHS has run out of money

·         Expenditure on locums is vast

·         Mental health need is outstripping resources


·         Climate change has been heralded as the largest threat to human health in the 21st Century by the WHO and the Lancet Commission this year

·         The mental health effects of climate change are significant

·         The NHS is the largest contributor of greenhouse gases in the public sector in the UK, larger than a medium sized eastern European country such as Estonia

·         Flooding in the UK is becoming a larger problem because of climate change and this has significant mental health effects


·         Population mental health needs are changing

·         Patient expectations are increasing

·         Staff are struggling to cope with service cuts

·         Restrictions on and monitoring of health care professionals is growing

·         The internet is a game changer and services need to stay in line with how society is changing in this digital age


For evidence about these points, see the occasional paper; ‘Sustainable Psychiatry’ launched in March earlier this year.


Psychiatrists and all those working in mental health services need to think beyond the patient in front of them, beyond their standard practice and beyond next year to the bigger challenges that are going to affect mental health prevalence  and mental health services this century. Factors such as diminishing financial funds, ever increasing costs of care, unchecked population growth, food and water scarcity, climate change, ongoing wars and globalisation are already having a dramatic affect on mental health services in the UK and these issues will likely grow to dominate later this century.


There is much we can do in mental health….


1.      We need to think more broadly about the resources we have at our disposal. We shouldn’t just think of medications or psychology in our treatment plans but about local community groups, peer support, online education, activities with carers, employment support, volunteering, vocational skills training, adult education, natural settings and third sector organisations.

2.      As mental health professionals, we understand denial as a potent defence mechanism and we need to help society engage with the mass denialism that exists with regards climate change.

3.      We need to review our practice and reduce waste –as much as 10% of the carbon footprint of the mental health care is due to medications that are not taken.

4.      We need to utilise the internet more systematically in service design and think more creatively about how to use it to improve care.

5.      We need to be more aware about the importance of engaging with nature and being part of community. These are the natural setting for humans, are intrinsically beneficial to our mental health and need greater focus.

Despite my fellowship coming to an end, important sustainability work continues at RCPsych and across mental health in the UK. A JCP Commissioning guide on Sustainable Mental Health is being launched next month, aimed at getting CCGs and all other mental health commissioners to commission sustainable services. Three new RCPsych sustainability scholars, supervised by the Centre for Sustainable Healthcare, are lined up to start work with CCGs to develop new sustainable models of mental health care. Sustainable changes are happening across mental health, Psych SusNet continues to grow and evidence is emerging about the environmental impacts of mental health care.

How could you get involved?



11/05/2015 15:29:40

Mind games – why do we continue to ignore climate change?

Why is it that doctors, whose aim it is to improve health are, with the emissions associated with delivering healthcare, adding significantly to the health threat posed by climate change? One reason could be that climate change is too complex a phenomenon with which to engage, a circumstance which, combined with the complexity of mental health, has led to paralysis.


This problem is reviewed in an editorial published this month in BJPsych International by Professor Helen Berry and me. This issue of the journal had a theme on climate change and mental health and in two other articles, the evidence for the mental health consequences of climate change are discussed, which are both profound and worrying.


But what we can do about this as psychiatrists? One suggestion is made by a further paper in this themed edition, which suggests that non-attendance at clinic appointments is one factor that is potentially significantly contributing to wasted clinical resource, increased subsequent health care use and therefore an increased carbon footprint of mental health care.


We do not have to ignore this issue as psychiatrists.  There are ways that we can improve the quality of care that can have a dramatic effect on the carbon footprint of the services we deliver.

Mind games – why do we continue to ignore climate change?

More thought needs to be given to the principles of sustainable health care; prevention, empowerment, lean service design and lower carbon technologies.







25/03/2015 09:28:19

Sustainability in Psychiatry


Sustainability in Psychiatry Occasional Paper


Occasional Paper about Sustainability in Psychiatry on NHS Sustainability Day

It is a great pleasure for me, as sustainability fellow for the college, to be launching this Occasional Paper about Sustainability in Psychiatry on NHS Sustainability Day. It has been co-developed with the Centre for Sustainable Healthcare, who have been central in the development of the report and my whole fellowship.

Vanessa Cameron, CEO of RCPsych, who has been a crucial player in bringing about both this Occasional Paper and this focus on sustainability in psychiatry says that:


“the Royal College of Psychiatrists is committed to improving the sustainability of mental health care in the UK. We are delighted to be publishing “Sustainable Psychiatry” which is a key document setting out the principles of sustainable health care and what this means for mental health service delivery today.”


Sustainability is a new concept for psychiatry. It looks at how services can be more responsive not only to economic factors but also to environmental and social factors. Mental health care needs to continue providing clinically effective interventions, but to determine whether they are acceptable to patients and public, affordable for the NHS and responsive to the dwindling planetary resources requires a fresh focus on sustainability.


 This Occasional Paper explains how embedding the principles of sustainable health care can lead to services that are more person-centred and fit for the future. It provides an account of the carbon hotspots in mental health and what we need to do to reduce these aspects of care. It also provides several case studies of what sustainable models of care look like.


I hope you enjoy reading the paper. You can also join Psych Susnet the network for mental health professionals interested in sustainability.



02/03/2015 15:50:03

Mental health not included in the UN’s Sustainable Development Goals





The 2015 UN ‘Sustainable Development Goals’ (SDGs) due to be launched later this year, will dominate the post-2015 UN development agenda. Given the increasing concerns from all quarters about continued population growth and the increasing prevalence of consumption-oriented ways of living, it is unsurprising that these goals have focused on sustaining ecosystems, natural resources, water and agricultural practices.


Interestingly, a new goal has been added about climate change that states: “Take urgent action to combat climate change and its impacts”. This move towards tackling these multifaceted geo-socio-political issues, is an important development, as the easy-to-understand ‘Millennium Development Goals’ arguably did not address these more complex issues that have the potential to cause massive health impacts on a global scale this century, let alone this millennia! Including mental health impacts.


Developing these SDGs that aim to address these complex issues is not easy, and the UN should be applauded for attempting to tackle them in this new set of goals. HOWEVER…. An issue with these SDGs is the minimal reference to mental health. This is despite the fact that neuropsychiatric disorders make up about 14% of global disease related burden, with depression the leading global cause of disability. However, mental health services receive disproportionately low resources: the average across countries is under 4% of overall health-care budgets.


A vital initiative called FundaMentalSDG is lobbying the UN to include mental health in these SDGs. The college are in support of this initiative and I urge all members to sign up to this important agenda here.  Getting mental health as a goal on the SDGs is crucial in achieving parity of esteem for mental health, it is also crucial to social inclusion, equity, justice and sustainable economic development.



22/01/2015 14:20:16

What sustainability means for mental health care

If you are wondering what sustainability means for mental health care, take a look at the short 3-minute film.

In this film I try to define the major components of sustainability and how it relates to the delivery of mental health care. Examples used are how over-prescribing can lead to unnecessary environmental impacts and how broadening the available interventions delivered to include community support groups and social prescribing services can lead to improved sustainability.


02/12/2014 10:20:02

Wasted use of clinical resources in the NHS

Around 20% of mainstream clinical practice brings no benefit to the patient ...

I was the lead author for an Academy of Medical Royal Colleges Report about wasted use of clinical resources in the NHS. It was launched last month and can be found here.  The report states that to sustain the standards of care provided across the NHS, waste must be reduced. Around 20% of mainstream clinical practice brings no benefit to the patient. Investigations, medications, hospital beds, and theatre time are clinical resources that can be wasted if not used appropriately to maximise value for patients.

This report received significant media coverage and I spent an exhausting morning doing 14 live radio interviews for BBC regional radio stations, followed by a live interview on BBC News 24. Sir Terence Stephenson, Chair of the academy, was interviewed on the Today programme and by the Guardian. The real scoop however, was when he was asked to present the report to the Parliamentary Health Select Committee last week, for a session looking at financing the NHS. I attended this and it proved to be an interesting meeting as, while the other presenters stated that there is simply not enough money in the system and more funding is needed, Professor Stephenson was able to give a nuanced discussion about how providing a high quality health care system would actually lead to reduced costs.

As responsible stewards of the NHS, he stated that we could provide more effective use of constrained resources. He discussed the many influences that affect how we use clinical resources including individual practices, defensive practices, time pressures, and responding to senior or patient pressures among many others. He called for a move towards targeted, focused and specific use of clinical resources.

Reducing waste is a fundamental principle of sustainability and has a triple imperative; it improves value, while reducing costs and carbon emissions. Deciding how and when to use these resources are clinical questions that can only be answered by those with sufficient training and experience. Waste arises from using these clinical resources inefficiently or unnecessarily. Inappropriate use of clinical resources is waste and relates directly to clinical practice and needs to be tackled, not by managers, but by clinicians.













18/11/2014 15:09:59


 - a model of social sustainability



"... work is life’s remedy”

On the 17 November I visited Navigo, which really is a remarkable organisation. It is an NHS funded social enterprise that provides mental health care across north Lincolnshire. They have three mental health wards, an older adult ward and an eating disorder inpatient unit alongside community services. The remarkable thing is that they do all this with a twist…

15% of all staff at Navigo are ex-service users and this is no accident. A central feature of Navigo is that they don’t stop acting when resolution of symptoms has been achieved, they also provide supportive structures within the community for service users to engage with that can help them stay well. Kevin Bond, CEO of Navigo, explains that to improve mental health resilience and confidence, people need to work as part of a team and be valued by others. Because of this realisation, Kevin began a project called ‘Tukes’ which could do just that. 

Tukes  was originally set up in July 2003 as a project within Navigo to provide training and employment opportunities for people who have little or no previous training, qualifications or work experience due to their mental health problems. Tukes, now a separate and successful business, operates five cafes within the local area, external catering services, external cleaning services, conference facilities, delivery of NHS cleaning and catering contracts, laundry, property maintenance, horticultural services and a second hand shop. They also provide a dyslexia screening service and numeracy and literacy classes where required. At any one time it has over 100 service users involved in various projects and can meet most people’s needs and ambitions by providing such a range of options.


Good links with local businesses have been developed so that, following working in Tukes’ projects, relevant paid employment can be found. Navigo itself employs a number of these people and also has contracts with Tukes to provide cleaning and catering throughout the organisation. A GP from the south Wales valleys, when commenting about the poor mental health and the lack of employment opportunities in the local area said to me (in his broad welsh accent): “work is life’s remedy”. Navigo embody this phrase in a delightful way. They have created relationships, positive social identity, neighbourliness and hope through creating feasible opportunities for service users to contribute to the local community.


Counteracting social exclusion within the labour market is a real challenge and Navigo have found a successful way of doing this, we should all learn from their success.




31/07/2014 14:40:04

Why aren’t psychiatrists talking more about climate change?



The evidence is pretty clear that the mental health effects of climate change are significant.



This year has been an interesting year for weather, from terrible floods to wonderful heat waves. Do we have to accept that from now on weather systems are going to become more unstable? If we do, how on earth will all this weather affect mental health?


We are, of course, a nation that loves talking about the weather. Perhaps we will all become happier because there will be so much more weather to talk about? Will more heat waves mean that dilapidated seaside towns like Great Yarmouth get rediscovered and become tourist havens once again?


Sadly this is unlikely to be the case. The World Health Organisation and the Lancet Commission have both stated that climate change is the largest threat to human health in the 21st Century. That means it is the AIDS, malaria or TB of today. The floods earlier this year were an awakening to the devastation that severe weather can have on our lives, even here in the UK. It was clear to all that the people affected were under a huge amount of stress. After the 2007 floods the Health Protection Agency stated that flooding has significant mental health effects, while a paper in the Psychiatric Bulletin stated that flooding exacerbated anxiety and depression in older people. Droughts have been shown to be associated with increased stress levels, and cyclones have been shown to cause persisting PTSD in young people. Another interesting paper found that every 1oC increase in mean temperature above 18oC was associated with a 3.8 and 5.0% rise in suicide and violent suicide respectively. They also found that suicide increased by 46.9% during the 1995 heat wave.


So the evidence is pretty clear that the mental health effects of climate change are significant. Furthermore, last year the IPCC report on climate change stated “Warming of the climate system is unequivocal, and since the 1950s, many of the observed changes are unprecedented over decades to millennia. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, sea level has risen, and the concentrations of greenhouse gases have increased.”


SO, why are no psychiatrists talking about it? Climate change could potentially drastically affect people’s mental health in the near future and therefore will have a large impact on the way we work in mental health. I think one reason could be that climate change is not a classical disease entity and therefore we as doctors feel it is outside of our responsibility. Also, when you actually do take some time to look at the data, the outlook can become so terrifying that we choose denial rather than acceptance of the facts.


However, with the rest of the world slowly obtaining our embarrassingly unsustainable western lifestyles, alongside ongoing population explosions, the effects of climate change are only ever going to increase. I believe we will see these changes causing significant effects to mental health prevalence in the UK. Mental health services need to adapt to these changes, but most importantly, psychiatrists need to start talking about it. Perhaps then it will be harder to live in denial.


If you are keen to talk about this more then come to the Mental Health Sustainability Summit on the 1st October this year and join the Psychsusnet Network. 




06/10/2014 15:17:43

RCPsych sustainability summit

The fact that we are running out of money to fund the NHS is a major issue, and ‘more of the same is not the answer


On the 1th October we had the first sustainability summit run by a medical royal college in the UK. However, people continue to think that sustainability remains the remit of politicians and self-styled hippy tech companies. “What has sustainability got to do with mental health care or psychiatrists and what is a sustainability summit anyway and why on earth is the RCPsych holding one of these??”


Soon the videos from all the talks at the sustainability summit will be on the RCPsych website if you want to find out more. The summit brought together psychiatrists and other mental health professionals, clinical leaders and academics. There was vibrant discussion about how to tackle these issues and which issue should take priority in the busy milieu of clinical practice. A big thanks goes to the Centre for Sustainable Healthcare for helping with the organising, running and hosting of the day!


Vanessa Cameron, CEO of RCPsych introduced the day then I provided an outline of sustainability and its relation to mental health. President of RCPsych, Simon Wessely gave his views on the constraints on mental health today and for the future. Professor Helen Berry, via video link from Australia, outlined the evidence for the mental health effects from climate change. Dr Judith Anderson, a consultant psychotherapist, discussed the issue of climate change denial and how mental health professionals who are experts in human defences such as denial, have a responsibility to help begin the difficult conversations about how to tackle the complex issue of climate change. The staff at the Greencare Centre for those with personality disorder in Slough provided an excellent talk about their work and David Pencheon, director of the NHS Sustainable Development Unit brought the day to an end by hammering home the importance of sustainability for health care.


Sustainability for health care is a paradigm that creates a focus on constraining factors that could affect health in the future. The sustainability framework for understanding these factors is the triple bottom line, which includes economic, environmental and social factors. The fact that we are running out of money to fund the NHS is a major issue and ‘more of the same is not the answer’. Another major issue is the fact that climate change is currently having a significant effect on mental health globally and these effects will continue to increase over the next few decades and are starting to affect the UK more each year. Drought, cyclones, flooding and temperature rise can all negatively affect our wellbeing and exacerbate mental health conditions (see my previous blog for more details on this). Another issue is the manner in which society is changing with increasing digitalisation of our progressively sedentary lives, over population and hyper consumerism. “We have never moved around the world so much and we have never moved ourselves around so little!”


The RCPsych is leading the way in developing a conversation about how doctors can get involved and can help mitigate the effects of health care on the environment. Other Royal Colleges and all doctors need to advocate for a more widespread response to what the World Health Organisation have stated is the largest threat to human health in the 21st Century.



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Fellowship in Sustainability blog






Our College is working with the Centre for Sustainable Healthcare to create a network of those interested in promoting sustainability in mental health services.


Sustainable healthcare is about ensuring we provide good quality health care today without compromising the ability of future generations to provide the same quality of health care. As clinicians, we need to be more aware of the impacts that mental health services are having on society and the wider world. Mental health professionals could lead the way in promoting a health service that is good for the environment and is also good for patients and the communities they live in. Find out more...


  Dr Daniel Maughan  


Daniel Maughan is the RCPsych Associate Registrar for Sustainability. Daniel works with the Centre for Sustainable Healthcare and the RCPsych to stimulate the adoption of sustainable practices in mental health. If you would like to join Psych SusNet, a network for mental health professionals interested in sustainable models of care see here for more detailsJOIN THIS NETWORK

This fellowship’s aims include researching innovations and new models of care and stimulating the adoption of sustainable practices in mental health Trusts around the country. 

Daniel is pursuing this fellowship as an OOPE from his psychiatric training. He has recently completed ST5 in General Adult Psychiatry in Oxford Deanery and the NHS clinical leadership fellowship program. He is also a researcher with the Social Psychiatry Group at Oxford University Department of Psychiatry. 

If you would like to contribute to our Blog Zone series, please email an outline of your blog to: