The acute mental health consultation, how we got here

16 February 2024

By Graeme Caul, Chief Operating Officer at Central and North West London NHS Foundation Trust


It is vital that when we consider making changes to services we make sure that it is the best decision and we understand how service users and staff will be affected. Providing the best service for patients is our priority. This is why last year we started reviewing the way in which we provide mental health care in Westminster and Kensington and Chelsea.

But how did we get here?

In March 2020, 51 beds at the Gordon Hospital (provided by Central and North West London NHS Foundation Trust) (CNWL) were temporarily closed to ensure safe staffing levels and rigorous infection prevention and control (IPC) measures for patients and staff during the pandemic. Following the closure of these wards work commenced to determine their future.

In December 2020, CNWL opened applications for people in Westminster and Kensington & Chelsea to join the Voice Exchange. This project aimed to gather the lived experience of people who have used local mental health services. Here is where the future of the Gordon was first discussed. After the group met a report was issued which helped shape plans and the direction ahead of pre-consultation.

When developing plans, we are required to consider a full range of service change options that can improve outcomes for patients and staff and identify an option which is feasible and sustainable. 

The development of these options is informed by detailed analysis which incorporates:

  • Clinical evidence
  • Views of service users and staff which is gathered during pre-consultation engagement
  • Insights from other stakeholders
  • A patient’s journey throughout their care
  • Financial and workforce considerations 

Workshops were organised by CNWL to bring relevant stakeholders together and provide a range of different perspectives. Three sessions took place to help consider different options and their impacts.

The initial workshop considered what ‘good’ would look like. It looked at the best service model for mental health care and what the most important things were to deliver. This helped to draft a list of realistic potential options.

This led to the second workshop which reviewed a list of realistic scenarios drafted from the first workshop. It covered what priorities and criteria needed to be met and led to a final list of possible options being determined.

During the third workshop these options were presented and discussed. The aim of the workshop was to consider which option would perform best and why by reviewing evidence and identifying strengths and weaknesses of the options. *

By working with patients’, staff and other stakeholders we were able to develop our proposals and pre-consultation business case, which can be read here.

We proposed to:

  • Expand the mental health crisis assessment (MHCAS) service (previously piloted at St Charles) and move it to the Gordon Hospital. 
  • Keep 67 inpatient beds at St Charles (as now), supplemented by the MHCAS at the Gordon Hospital with room for 12 patients, including space for 4 patients to be admitted overnight alongside a full range of community-based services.

Cate Latto, One Community Lead and Open Dialogue Practitioner spoke about her experiences working with us on the consultation. One Community is an organisation set up to support people’s mental wellbeing from hospital to home. Users are able to create connections and a community from early on when they access mental health services.  

In January One Community met with colleagues to discuss the consultation and for all those who attended it was a powerful day. Cate was pleasantly surprised to see in depth discussions take place where people felt comfortable to share their views, notes were taken by those listening and those that attended felt heard. ‘People came away from the meeting feeling positive, empowered and expressed how they had enjoyed the experience.’

Cate explained that her experience working with us on the consultation was really positive – ‘the organisers were flexible with us and the team who attended were great and listened to what people had to say in their own space.’

Throughout the whole consultation process we have wanted to hear from as many people as possible - patients, residents, carers, members of the public, staff, voluntary sector representatives and advocates as well as partners. To do this we have specifically targeted our engagement. We have listened, gone to where we can reach those who would be affected and considered feedback to improve our engagement process.

There have been a number of in-person events, promotional activity across our social channels and flyers and social media assets produced to invite targeted audiences take part in dedicated engagement sessions and complete our online survey.

To read more about the pre consultation process click here.



*A list of all of the workshops and pre-consultation work can be found below:

Voice exchange – a summary of the work they were tasked to do

Workshop one

Workshop two

Workshop three

Consultation webpage

Accessibility tools

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