Photo by Craig Adderley from Pexels

What is the Transformation Project about?
Across City & Hackney, Newham, Tower Hamlets, Bedfordshire and Luton, we have been developing new ways of bringing together primary and secondary care with social care, other local authority services, our third sector and local communities to support people with severe mental health problems, including complex emotional needs associated with a diagnosis of ‘personality disorder’ and disordered eating. This pioneering transformation work – which began in our inner London footprint as one of the 12 national ‘early implementer’ sites in autumn 2019, and is getting off the ground in Bedfordshire and Luton from April 2021 – is an ambitious programme of change up to 2023/24, and involves lots of conversations with staff from stakeholder organisations, service users and local citizens to design and test new ways of working, and to help reshape community mental health services enabled by new NHS Long Term Plan investment. Through workshops, focus groups and localised work in newly-formed ‘blended teams ‘, we aim to coproduce improvements to mental health care based in and around primary care networks (PCNs).

PCNs are groups of GP practices that specifically focus on the needs of local populations. Our transformation work aims for NHS, social care and third sector services to work together to make a greater positive impact on the health and lives of groups and communities of people living with mental ill-health. Through providing more integrated care across mental and physical health services, and across health, social care, the voluntary sector and wider services, in inner London, we have been able to test new ways of working within our PCNs in the context of a new national framework for community mental health services. We are now applying some of this learning and tailoring our approach as transformation gets underway in Bedfordshire and Luton, as well as making some of our improved ways of working ‘business as usual’ through a process of implementation, and continuing to progress work in City & Hackney, Newham and Tower Hamlets.

Adopting a population health approach to transformation - linked to ELFT’s core mission to improve the quality of life for all we serve - has also given us lots of food for thought. Thank you to everyone who has contributed to the work so far, and don’t worry if you haven’t had a chance to contribute yet, as there will be more opportunities coming up

The idea is to better support more people with severe mental health problems in their local communities and create a more accessible and flexible system by bringing together mental health services with GP practices, social care the voluntary sector, community groups and activities. We are at the same time improving care for people with specific needs, including disordered eating. ELFT and its partners are working together with local residents and people with lived experience to make these exciting, wide-ranging changes happen.

We want to be able to give more support to people with severe mental health problems who have in the past not met the ‘thresholds’ for secondary mental health services by breaking down the divide between primary and secondary care, and removing these thresholds over time. There are a number of people in City & Hackney, Newham and Tower Hamlets, as well as Bedfordshire and Luton, who have a severe mental health problem but are not actively linked with ELFT. GPs tell us that some of these people don’t necessarily need the level of care that a community recovery team currently offers, but do need more support, often with life triggers like homelessness and financial insecurity, that can lead to a decline in their mental health. Our aim is to be able to use our funding to expand our staffing and fund our third sector partners to seamlessly provide a greater range of support across a greater range of needs, including higher quality care for people already under the care of ELFT’s various community mental health services.

We will transform primary and secondary community mental health services across these directorates by working collaboratively and blending the wide array of services. In addition to offering a wide range of mental health interventions, PCN-based neighbourhood teams will work hand-in-hand with a range of community workers from the voluntary sector, connecting people into local activities that they are interested in to promote social connectedness, positive mental wellbeing and build on their own strengths and potential, enabling anyone with a severe mental health problem to live a fulfilling life. This might be through music, sports and fitness, arts or social contact groups, for example.

We are also looking to support people with life issues that can trigger mental health problems, such as unemployment, housing and financial worries by working closely with social care and voluntary organisations that can help.

When people are first referred to ELFT’s services, we also want to be able to provide more interventions at the point of initial contact, as well as connections into the community. We know that if people get the support they need quickly it can help prevent their mental health deteriorating further.

By providing more support in neighbourhoods we will also be able to focus on providing more intensive and specialist support, and a better-sustained offer of complex and longer-term mental health care for the people who need it.

We have heard what residents, services users and carers have been telling us about wanting more support within their neighbourhoods, such as cafés, community centres, faith centres, libraries etc, and that’s why we are working with community organisations to do this together – in City & Hackney, Newham and Tower Hamlets, to build on progress to date, and in Bedfordshire and Luton, to begin our implementation work in earnest from now.

We will continue to ask people to get involved in lots of ways and will keep you posted on more opportunities. To find out more or let us know you are interested, please email and one of the team will get back to you.

You can also keep an eye out for news, events and other content relevant to the transformation programme through ELFT’s social media accounts. See @NHS_ELFT on Twitter and our East London NHS Foundation Trust page on Facebook.


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