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Strategic Programme for Mental Health – Stakeholder update (May)

The Strategic Programme for Mental Health Programme Board provides a strong collaborative mechanism for the direction and delivery of objectives in line with shared national priorities. NHS Wales Performance and Improvement (formerly known as the NHS Wales Executive), Welsh Government, health boards, special health authorities, Third Sector and other key stakeholders in the mental health sector are represented on the forum. This update summarises key activity discussed at the Programme Board in May 2025. 

Programme update

Ciara Rogers, National Director of Mental Health, Learning Disability and Neurodiversity, in NHS Wales Performance and Improvement, gave an update on some of the key developments since the last Programme Board meeting. The Mental Health and Wellbeing Strategy 2025-35 and Suicide Prevention and Self Harm Strategy 2025-35, have both been published which provide a really strong policy direction in Wales – both strategies have received a lot of positive feedback and have been receiving international interest. Planning is already well underway around how we work with the NHS and our key stakeholder partners in Wales to deliver the ambitions outlined, particularly in support of Vision Statement 4 of the Mental Health and Well-being strategy.

The Strategic Programme for Mental Health plan for 2025/26 was presented and it aligns to the NHS Wales Planning Framework, NHS Wales Performance Framework, NHS Wales Performance and Improvement Remit Letter, and Delivery Plans for the Mental Health and Wellbeing Strategy and Suicide Prevention and Self Harm Strategy. The programme’s strategic goals for 2025/26 are:

  1. Improve performance against the national mental health performance metrics

  2. Improve access, experience and outcomes across all mental health services by implementing the flexible open access model

  3. Improve safety in secondary care mental health services

  4. Improve the physical health of people with long term mental health problems

Each of the strategic goals are supported by a number of actions that will be delivered by functions of NHS Wales Performance and Improvement including the Strategic Programme for Mental Health, Performance and Assurance, and Quality, Safety and Improvement. They are also supported by key enablers including strategic planning, assurance and intervention, research and evidence, quality management system implementation and strong communication and engagement support. The Strategic Programme for Mental Health will continue routine updates throughout the year about how it is delivering against the strategic goals. This will be done via formal reporting mechanisms as well as communication and engagement activity.

Reflections on the Wales Mental Health Leadership Exchange

Programme Board colleagues reflected on activity which took place throughout March and April as part of the Wales Mental Health Leadership Exchange. Mental health leaders representing a number of sectors participated in a series of events which were designed to establishing greater connectivity amongst partners to shape the future of mental health support in Wales. Leaders in a variety of roles, and across a diverse network of stakeholders have participated in a number of knowledge exchange opportunities which concluded with a conference held in Aberystwyth.

Programme Board members, many of whom attended the events, commented on the energy and enthusiasm for change that was created, as well as the diverse involvement of stakeholders. Colleagues were extremely pleased with the momentum that the events have begun to create around the delivery of the new Mental Health and Wellbeing Strategy 2025-35, and applauded the strength of national leadership that was demonstrated in a joined up way.

Read more about how the Wales Mental Health Leadership Exchange has sharpened the focus on mental health access.

 

Strategic Programme for Mental Health Programme Board development

Ahead of the Wales Mental Health Leadership Exchange Conference in Aberystwyth, Programme Board members took the valuable opportunity to meet in-person for a development session that was led by Avanti Change.

Members discussed existing and potential benefits of the Programme Board, including:

  1. Examining evidence to improve outcomes

  2. Supporting and influencing change, and improvements in quality and safety

  3. Supporting the implementation of principles into practice

  4. Whole-system leadership, stewardship, challenge, scrutiny and assurance

  5. Improving mental health and wellbeing for the population of Wales

  6. A mechanism that promotes and facilitates listening and understanding

One of the key takeaways from the session was an ambition to foster greater involvement of senior leaders at Board/Executive level - in health boards and other organisations included in the Programme Board membership - to further strengthen decision making and delivery capabilities. The Programme Board was also keen to reassess existing delivery structures in the Strategic Programme for Mental Health, in line with the new policy direction in Wales which is demonstrated through the new Mental Health and Wellbeing Strategy.

Ciara Rogers, National Director of Mental Health, Learning Disability and Neurodiversity, NHS Wales Performance and Improvement, presented a draft proposal on opportunities to refine governance of the programme to mirror evolving national priorities, in a way that reflects a shift to open-access models of mental health support and enhances the value of research, evidence and lived-experience in national design and delivery of mental health provision. The proposed adjustments would also see increased involvement from senior leaders in health boards and other key organisations in the Programme Board. The bold ambitions to shift to open-access, flexible and recovery focused mental health support in Wales will be a significant undertaking with huge impacts on patient experience and outcomes – continuing to evolve delivery mechanisms in a dynamic and adaptable way will be instrumental to success.

The Programme Board agreed and supported the proposed changes and there was a request from members for these changes to be implemented at pace to maintain momentum around transformation in this space. In the coming weeks, further work will be undertaken to bring the plans to fruition, and a further update on the detail will be provided in due course.

It was also agreed that the new governance structures should be regularly reviewed to ensure they are having the desired impact. Colleagues should note that these changes will apply to the national delivery structures under the Strategic Programme for Mental Health in NHS Wales Performance and Improvement only, and do not apply to other national organisations/ programmes or to local structures. NHS Wales Performance and Improvement will be working closely with health boards and other key stakeholders in the coming months to support local planning around implementation of open-access, flexible and recovery focussed mental health support.

 

Eating disorders early intervention model

In March 2025, the Eating Disorders Clinical Implementation Network presented a paper on a proposed model for eating disorders early intervention, requesting support from members to move forward with implementation plans for a Bespoke Model. Colleagues gave an update on the development of the work to date, including the various options explored and the appraisal process. It was acknowledged that it had been a challenging journey to get to this point with a consensus on a national way forward that creates greater equity, whilst still accommodating and supporting local choice.

Following the discussion, it was decided to pause the decision to allow health board members to seek further assurances from their local teams around what implementation of the new model might look like in local contexts.

Now, NHS Wales Performance and Improvement has further engaged with senior leaders across mental health services in Wales. Whilst there is broad agreement around many of the principles, there remains variation in views on whether a Bespoke Model or FREED Model (First episode and Rapid Early intervention for Eating Disorders) should be implemented.

The Programme Board has carefully considered the options available and recognised that each health board in Wales offers services in different ways and with specific local contexts. However, in order to reduce variation and improve experience and outcomes for people in Wales, the Programme Board agreed that doing nothing was not an option.

Chris O’Connor, Clinical Lead in the Strategic Programme for Mental Health, put forward suggestions to continue to finalise a national set of principles with a view to working with health boards to implement them locally. Programme Board members expressed views that NHS Wales Performance and Improvement has engaged well with local services and key stakeholders (including Royal College of Psychiatrists and Beat Eating Disorders) around the possible options and that the evidence base is clear. A decision now needs to be made around implementation with the relevant Executive Directors in health boards. Executive Directors will be engaged to inform next steps which will be reported at the next Programme Board meeting.

Members thanked the Eating Disorders Clinical Implementation Network for their work around these proposals in such a challenging context.