The Trust Strategy 2021 to 2026 was launched in September 2021. The vision and values outlined in the Trust Strategy are supported by six strategic priorities, which outline key areas of focus for our Trust. This report provides progress against the six priorities since the last Board meeting.
Priority: We will put service users at the heart of all we do, supporting effective care, recovery and wellbeing
New gym facility at Chorley
Professional boxer Jack Catterall recently opened a new outdoor gym at our mental health unit in Chorley.
The light welterweight boxer from Chorley was invited to cut the ribbon at the official opening in June.
It’s a Chorley inpatient resource which can be accessed by service users at our Worden, Avenham and Duxbury Wards (all based at Chorley Hospital). The gym has been installed in a dedicated outdoor wellbeing courtyard.
Initial Response Service
The Initial Response Service (IRS) Programme has made excellent progress since April 2022, with the Pennine IRS centre based at The Mount, Accrington going fully live and the Central and West centre based at Avondale, undertaking their soft launch on the 18 May 2022. With these centres now operational, there has been positive feedback from all stakeholder groups regarding access to services, quality of service delivery and feedback relating to the friends and family test feedback submitted by users following their call to the IRS.
There is further positive evidence relating to the average call answering time across the IRS services of 10 seconds and an extremely low call abandonment rate of 2.4%.
In Pennine, services are handling 25% more initial referrals and self-referrals following the launch of IRS.
The increase in initial referrals in Central Lancashire has been a more modest 2% following the initial launch of IRS, but we expect phase two, when the service opens to self-referrals on 6 July, to see an increase in rates of access.
Street Triage has proven to be a particularly important development as part of the IRS model in Pennine, with mental health attendances at acute trusts reducing by 10% since Street Triage began (as police are less likely to depend on A&E for mental health advice) and the use of s136 by the police in Pennine Lancashire reducing by 33%. Street Triage is planned for Central Lancashire in September 2022.
Locations continue to be explored for suitable accommodation for The Bay and Fylde IRS sites.
Refreshed Trust website is live
Our newly refreshed Trust website is now live. The communications team have been working with colleagues and service users over the past few months to create an accessible, modern and user-friendly website which improves the overall user experience for all who use it.
You’ll notice a much more vibrant and image-led look with additional features, greater customisation and a better mobile experience.
Demand Headlines
We are continuing to see increased levels of demand across most of our services.
For example:
- District Nursing demand is now at similar levels to that seen in May and June 2021, and year-to-date is 18% higher than pre-Covid 2019 average.
- Demand on Treatment Rooms (lower level interventions) is similar level to 2021, and year-to-date is 69% higher than pre-Covid 2019 average.
- Stroke Services have seen a spike in demand in June, whereas COPD referrals have fallen to a level last seen during the initial phase of lockdown, outside the bottom of the typical expected range of referrals.
- CAMHS demand this year (January to June) has been 15% above 2021 levels, and 55% higher than pre-Covid
- With a similar picture for Eating Disorder service demand which is 16% higher than 2021 rates, and 103% higher than pre-Covid, though has notably eased in June 2022.
- The surge in routine Adult Mental Health referrals that began to materialise in early 2022 has continued and, in fact, increased in June. In part, this reflects easier access via the IRS model, but the underlying demand has increased, and demand is 17% higher than the pre-Covid rate.
- Having seen an easing in demand earlier this year (compared to 2021), Home Treatment Teams have been busier in the last three months than the same period last year, though they have seen 3% less demand for the year as a whole. Overall, compared to pre-Covid 2019, Home Treatment demand is 11% higher for the year to date.
- Similarly, referrals to Mental Health Liaison Teams in Acute Trusts are not quite as high as last year (8% lower for the year to date) but are 11% higher than pre-Covid levels.
- Older Adult Community Mental Health demand is the one area where we have seen notable reductions compared to pre-Covid levels, with demand this year 36% below pre-Covid referral rate.
- Bed requests for Adult Inpatient Wards have now eased back to levels comparable to pre-Covid, reflecting some of the easing in Mental Health Urgent Care demand, and the improved gatekeeping measures we have put in place. This easing is seen from December 2021. Demand is still 7% higher than same period in 2019, but 18% lower than the 2021 rate, with the reduced demand in June 2022 notable.
Right Care, Right Time
Quarter one of 2022/23 has seen the launch of our Right Care, Right Time (SAFER/Red2Green) flow collaborative, improvement training being delivered on Trust Induction and the impending launch of our AQuA-accredited Improvement Reward and Recognition scheme for teams across the Trust.
Continuing the excellent work from the LiA Red2Green Improvement programme, we launched the Right Care, Right Time collaborative at The Harbour in April. We have worked with Meridian to ensure connectivity between this improvement collaborative and the wider piece of flow work they are conducting, to ensure there is no duplication. The collaborative launches in The Bay in July, Pennine in September and then Central and West in October.
We declared an OPEL 4 escalation earlier this month in response to pressure within our urgent care pathways; allowing the Trust to bring all our partners in Lancashire and South Cumbria together to take additional steps to maintain safe services for patients and help us cope with growing pressures.
With active support and mutual aid from partners, everyone mobilised quickly to support in moving our patients to the most appropriate place as quickly as possible.
The multi-disciplinary team approach across whole pathway worked well but further work is needed to ensure sustainability when returning to “business as usual”.
Initial data showed:
- 15% of patients awaiting admission on the day OPEL 4 was declared were supported in accessing alternatives to acute admission.
- Of 14 patients in A&E or 136 suites, 7 patients were known to services and 7 patients were new presentations. Further work is ongoing to understand any missed opportunities for patients known to services.
Evaluation of OPEL 4 still ongoing to understand the final lessons learned.
The Trust recognises the continued efforts of colleagues and partners for their hard work in this respect, and thanks them.
Break the Cycle helps us to drive improvement
With engagement from operational and clinical teams, the Trust committed to an improvement week at the end of May which focused on patient flow and trialing new ideas and initiatives to ‘Break the Cycle’ ahead of the long bank holiday weekend including:
- Senior clinical reviews of our patients in out-of-care placements, with a real focus on working towards repatriating our patients closer to home
- Multi-disciplinary Discharge Events (MADE) across our inpatient sites
- Home Treatment in-reach reviews on our wards
Working with partners across the system many changes were introduced across the Trust to support bed management and improve the patient experience resulting in:
- 56 discharges from Trust and out of area placement (OAP) beds
- 11% fall in the total number of A&E, S136 and Mental Health Urgent Assessment Centre breaches compared to the first three weeks of May
- 37% fall in A&E breaches
- 33% reduction in the number of people waiting for a bed
All this was achieved whilst managing the highest level of demand for beds since December 2021.
NHS fast tracks mental health support for millions of pupils
More than 2.4 million children and young people now have access to mental health support in schools and colleges, thanks to the NHS fast tracking services to help address record demand.
The NHS rollout is already one year ahead of schedule – more than 500 teams will be confirmed ahead of the April 2023 ambition with millions able to access help when they need it.
NHS mental health support teams are now in place in around 4,700 schools and colleges across the country, with 287 expert teams offering support to children experiencing anxiety, depression, and other common mental health issues. A further 112 teams are in training and will start over the next year, with an additional 104 new teams starting their training in 2022/23, taking the total to more than 500 across the country.
Five additional Mental Health Support Teams (MHSTs) are now operational across Lancashire and South Cumbria improving access to advice and early help, supporting prevention and early interventions. The Change Talks programme of in school mental health support is working collaboratively with the MHST’s to increase access and expand the spread.
Mental Health Act Reforms
The Department for Health and Social Care published their draft Mental Health Bill, on June 27 which will reform the Mental Health Act 1983.
The draft bill is designed to reduce the number of detentions, tackle longstanding racial disparities in the use of compulsory powers and end the detention of people on the sole grounds of them being autistic or having learning disabilities. The draft bill is welcomed but we need to ensure funding for mental health services follows due to ever growing need and demand for services.
The draft bill will be subject to pre-legislative scrutiny in Parliament – with a committee expected to review the Bill and report in late autumn.
The Government plans to respond quickly to this report, amend the Bill in line with its recommendations, and introduce next year. Commencement (i.e. the law starting to take effect) will take place starting mid 2024/25, and will run to 2030/31.
Response to Industrial Action
Staff employed by OCS, who deliver facilities management services at some of our sites recently voted in favour of taking strike action.
Planned strikes took place on Wednesday 29 June, Thursday 30 June and Friday 1 July.
The action relates to an ongoing dispute with OCS regarding pay and alignment with NHS Agenda for Change terms and conditions for OCS employed staff.
The Trust has regularly and continues to, engage with OCS and Unison to understand their positions.
As a result, and in addition to the current contractual arrangements, we have made significant additional investments to achieve salary parity for OCS staff. This brings salaries for OCS employed staff in line with the NHS scale and above the National Living Wage
The majority of sites were unaffected by the planned industrial action which impacted catering and cleaning services at eight sites.
Patient care and safety is our priority and we enacted robust contingency plans to make sure patients received meals and our high standards of cleanliness and care were not adversely affected by the action.
Community Transformation
We are continuing to transform our community mental health services in conjunction with partners. Lancashire Mind have closed their engagement survey and started face to face workshops to understand what service users, carers and the general public would like to see in the new model of care.
The Peer Support service specification for Pennine, Central and West and Lancaster has been released with Red Rose Recovery awarded the service in Pennine and Lancaster and An Inclusive Future awarded the service in Central and West.
Personality disorder, eating disorder, rehabilitation and physical health/medication support pathways and workforces have been developed and the older adult’s services have drafted an options appraisal for their involvement in the community hubs.
Community Mental Health Framework can you put this as part of the community transformation above
In July 2021, NHSE released a position statement clarifying that the Care Programme Approach (CPA) had been superseded by the Community Mental Health Framework. At that point, the Trust had already commenced exploration of DIALOG+ as a new model to facilitate this move from CPA towards a more meaningful, intervention based model of care.
The first phase of implementation is due across four Community Mental Health Teams and nine Home Treatment Teams in October 2022.
DIALOG+ is an evidence based model of care that is based on quality of life research, concepts of patient-centred communication, components of solution-focused therapy and is supported by digital technology.
To support the move to DIALOG+, new Care and Safety Plan templates have been developed in collaboration with service users, carers and staff; these are designed to be much more person-centred and user friendly focussing on what service users and carers want from care and safety plans.
The Clinical Senate has agreed that Mental Health services will move to these new Care and Safety Plans on 1 September 2022 and over the summer there will be learning sessions to facilitate this transition
Priority: We will employ and retain the best staff because our work culture will be inclusive and a supportive place to work
Apprenticeship awards
Rachel Carruthers, Assistant Practitioner Apprentice, won the Rising Star and Apprentice of the Year, as well as Trainee Nursing Associate Apprentice at this year’s NHS Apprenticeship Awards.
Umar Zaka, Clinical Apprentice, was highly commended in the Apprentice of the Year and Clinical Apprentice of the Year categories.
The awards received over 250 nominations from health and social care providers across the region, with a total of 13 people from LSCft announced as finalists, reflecting the talent, dedication and excellent work undertaken by our team of apprentices.
LiA Wave Three
The topics for Wave 3 of LiA have now been identified and are based on:
- A review of the LiA Pulse Check 2022 themes
- Review of NHS Staff Survey 2021 results
- Engagement sessions with Service users, Carers and Peer facilitators
- Strategic and clinical priorities
An analysis of 1270 comments provided via the Pulse Check open question also revealed a number of potential areas for improvement. The selected topics for focus during wave three are:
- Appraisal
- Response to Violence, Aggression and Abuse
- Stronger Together: Mental Health Urgent Assessment Centre’s and Acute hospital partners
- Admin and Clerical Career Pathway
- Prescribing excellence in our hospitals
- Shifting the Balance (understanding where inefficiencies get in the way of care)
- Supervision
- Healthcare Support Worker (HSCW) Development
- Meaningful Co-production
Big Conversation events are now underway giving staff the chance to get involved in Wave 3 of our Listening in Action improvement programmes.
Celebrating our Reservists and our 'Veteran Aware' Trust status
June 25 was Armed Forces Day and the Trust celebrated some of our veterans and reservists on social media, in celebration of our continued recognition as a Veteran Aware Trust.
It was recently confirmed that LSCft remains a Veteran Aware Trust, following a one year review of the status. It means that we have established structures to support service users in appropriate care and treatment who are from the Armed Forces community. This includes prioritising those with service or transition related illness or injury.
In addition, we have a welcoming and supportive approach for staff who may decide to take up employment within the Trust who are also from a Forces background.
Festival of wellbeing
Our staff are our greatest asset, and their health and wellbeing is a priority so the Trust held a Festival of Wellbeing for staff at Brockholes Nature Reserve on 6 July.
The Festival of Wellbeing was about celebrating, reconnecting, reflecting and more importantly ‘moving forward together’. It was an opportunity to say a big thank you to everyone for the commitment and resilience they showed during the Covid-19 pandemic as we move further into post Covid recovery.
Staff could opt to take part in a range of wellbeing activities including Nordic walking, samba dancing, akeido taster, yoga, a sleep workshop and much more; giving staff a well-deserved opportunity to support their personal wellbeing.
Cost of Living
We recognise that the rising cost of living is placing significant pressure on many of staff – particularly those on the lowest incomes and those who travel excessively on behalf of the Trust in order to do their job.
All Trusts in Lancashire and South Cumbria, have increased the rate of mileage for people who travel more than 3500 miles per year in the course of their work, to 45p (from 20p) per mile. The existing rate of 56p per mile for all who do up to 3500 miles per year is being reviewed nationally, but remains as it is for now.
Staff can apply to draw down a proportion of their salary in advance of payday.
Staff can also claim back through expenses the cost of a Blue Light Card which enables access to a range of money saving offers, including 10% off food, clothing and homeware at Asda.
Pride Month
June was Pride Month and we celebrated by raising awareness of the NHS Progress Badges available to LSCft staff.
Launched earlier this year, the badges were discussed at our Pride themed staff Engage session held on May 30.
Progress Badges are just one way to show that LSCft is an open, non-judgemental and inclusive workplace for staff and service users that identify as LGBTQ+.
Wearing the badge demonstrates that colleagues and service users can be open about their identity and that you will do your very best support someone who is in need.
Priority: We will deliver SAFE care and we will embrace an open and learning culture, ensuring we continually improve
Reducing Restrictive Practice
There has been a 49% reduction in restrictive practices (restraint, seclusion and rapid tranquillisation) across our wards between the first baseline quarter (Q4 2018/19) and Q4 of 2021/22. This is a huge achievement given that this has been achieved alongside the challenges of the Covid pandemic and is a real testament to the commitment of our ward teams to deliver high quality, contemporary care.
This significant reduction in restrictive practices has been achieved through collaboration across teams and has resulted in shortlisting for four HSJ awards (Changing Culture, Patient Safety, Mental Health Initiative and Quality Improvement Initiative) and one Nursing Times Award (Patient Safety). The teams are now presenting the work to the relevant judging panels with Award Winners being announced in September and October respectively.
SPPA Ward Accreditation
We are delighted to announce that a further two wards have received Gold SPPA Ward Accreditation. These are Ribblemere, our mother and baby unit and The Cove, our children and young people's unit. Both units really impressed the assessing team and demonstrated the delivery of high-quality care. This brings the number of Gold accredited wards to four and demonstrates the continuous improvement being achieved within in-patient units.
Nursing Times Awards shortlist
The Trust has been shortlisted seven times across six categories at this year’s Nursing Times Awards, recognising the outstanding contribution of our nurses:
- Team of the Year
- Patient Safety Improvement
- Nursing in Mental Health
- Nurse Leader of the Year
- the Ann Shuttleworth Rising Star Award
- HRH Prince of Wales Award for Integrated Approaches to care
Our Recovery Riders Project was shortlisted in four categories including the HRH The Prince of Wales Award. The project driven by our mental health nurses sees unclaimed bikes donated by Lancashire Police be used to facilitate weekly patient rides around the West Lancashire countryside in Ormskirk.
Winners will be selected ahead of the ceremony, which will take place at the Grosvenor House Hotel in Park Lane, London on October 26.
HSJ Patient Safety Awards
We have been shortlisted eight times in five categories in this year’s Patient Safety Awards as follows:
- Mental Health Initiative of the Year
- Changing Culture
- Patient Safety Team of the Year
- Community Care Initiative of the Year
- Primary Care Initiative of the Year
These awards really help shine a light on the collaborative efforts and dedication of our staff members over the last 12 months to successfully implement so many services and initiatives to help support service users even more effectively.
Priority: We will respond to people’s needs by striving for the highest standards of quality, proactively reducing health inequalities
Award Win for Wesham
The newly refurbished Wesham Rehabilitation Centre won the Design in Mental Health award for ‘Project of the Year – Refurbishment’ at the Design in Mental Health Network awards.
The awards recognise excellence and innovation in mental health environments that improve patient recovery.
The refurbishment of the Wesham Rehabilitation Centre, which took place earlier this year is part of the Trust’s mental health rehab and recovery transformation work.
Quality Improvement Basics
Quality Improvement (QI) Basics is now in Trust Induction, ensuring new colleagues to the Trust are introduced to our continuous improvement approach and are linked to the improvement opportunities that are available, such as further improvement training, our Fellowship and improvement collaboratives.
July will see the launch of a scheme to recognise the involvement of wards and teams in QI. This scheme is essential to us being able to recognise those teams that fully engage with continuous improvement, both at a Trust level through collaboratives and locally through their own improvement projects and having their staff trained. An essential element is to also recognise input from service users in their improvement work and will help bring together our strategic objectives for priority 4 in our People, Improvement and Culture strategy.
This has been accredited by AQuA and has three levels of attainment:
- Foundation QI
- QI Practitioner
- QI Masters
Children and Young People – Thrive Redesign
In May 2022 the newly designed Rapid Assessment and Intensive Support Team (RAIST) launched within Central, West Lancashire and Chorley and South Ribble, in the first 2 months there has been an immensely positive impact on both our children and young people (CYP) and the wider system with a number of CYP being diverted from attending A&E, who have subsequently been successfully discharge from services. Additionally, referrals are now being received from core teams has prompted active engagement from RAIST.
Further recruitment is underway to extend the service within South Cumbria and the Fylde Coast.
An in reach support pilot is in the early stages of development designed to deliver an emotional wellbeing wrap around to those who are experiencing mental health distress and are admitted to a paediatric ward, aimed at reducing the length of stay.
Priority: In order to support our local communities by excelling at everything we do together, we will always collaborate with our system partners
CQC System wide inspection
The Trust has received the final written report from the CQC following the recent inspection of Psychiatry Liaison Services in March and April 2022, as part of their system wide review of emergency and urgent care.
The CQC looked at the impact of mental health liaison within an urgent emergency care centre, as well as any possible impact on patient safety. They inspected three domains – safe, responsive and well-led.
The report details the significant improvements made in these services since they last inspected in 2019, and confirms a higher quality of care and patient experience.
There were very many positive observations and comments throughout the report, with the CQC finding services provide safe care; staff assess and manage risk well; patients have access to a range of services to meet their needs; and leaders have the skills, knowledge and experience to perform their roles.
Importantly, staff said they felt respected, supported and valued and the culture at the trust promoted equality and diversity, supported career progression and enabled staff to raise any concerns without fear.
Patient comments included:
"I was very impressed by the kind, attentive and empathetic approach evidenced upon my arrival to Avondale. The staff had plenty of time to talk with me and give relevant support."
"First time receiving proper help and everything I needed to say was said and listened to."
There were also some helpful areas for improvement, which we will use to continue on our improvement journey The inspection was not rated, as no enforcement action was given and the CQC will publishing the report in full later this summer.
Trust wins The Ruth Young Award at the North West Coast Innovation Agency Awards
The Ruth Young Award recognises research initiatives or partner collaborations that have enhanced or improved frontline delivery to service users in any area.
Lancashire and South Cumbria NHS Foundation Trust, Health Education England, the University of Central Lancashire and Primary Care Networks across the region won the award in recognition of collaborating with General Practice and Community settings to implement findings about effective mental health prevention and promotion interventions.
The award winning initiative saw the team delivering a mental health prevention and promotion service within Primary Care Networks with a new workforce supply of psychological practitioners, referred to as the ‘Associate Psychological Practitioner’ (TAPP).
Lancashire and South Cumbria Integrated Care Board (ICB)
I can confirm that I have been appointed as a member of the newly established Lancashire and South Cumbria Integrated Care Board (ICB); representing the interests of mental health care service users as well as providers.
I think it is essential that we are represented on the ICB and I am proud to be that representative. I hope that my appointment sends out a strong, positive and reassuring message to all our stakeholders, confirming parity of esteem with physical health and ensuring that mental health is not overlooked as the whole system continues to recover from Covid.
The Provider Collaborative, which is chaired by David Flory and led by Kevin McGee of Lancashire Teaching Hospitals, and the Mental Health, Learning Disability and Autism Collaborative (which is led by LSCft) have ambitious plans and I am confident that with all local NHS providers working jointly towards shared objectives, we can reduce variation, avoid duplication, increase value for money and improve services for everyone.
The first Board meeting of the ICB took place on Friday 1 July - the day of its statutory establishment.
Provider Collaboration: Colleague Briefings
Chief Medical Officer Dr David Fearnley, Deputy Chief Executive Chris Oliver and I spoke at two ‘Colleague Briefings’ hosted by David Flory, for staff across the patch to hear more about the Provider Collaboratives, the five provider collaborative of NHS Providers and the mental health, learning disability and autism collaborative.
Over 1100 staff from across Lancashire and South Cumbria attended the two events.
Like all developments connected to the new NHS Lancashire and South Cumbria ICB (which assumed legal status on Friday July 1), the ambition is much greater partnership working between all health and social care providers to eradicate health inequality, geographical variations in outcomes and disparity between physical and mental health.
The sessions highlighted the welcome opportunity offered by the collaboratives to create system-wide learning; cement new robust relationships and improve the patient experience.
Independent report into leadership across health and social care
In October 2021 the government announced a review into leadership across health and social care, led by former Vice Chief of the Defence Staff General Sir Gordon Messenger and supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust.
The review focused on the best ways to strengthen leadership and management across health and with its key interfaces with adult social care in England. Following extensive stakeholder engagement, the review has now completed with the following 7 recommendations:
- Targeted interventions on collaborative leadership and organisational values
- Positive equality, diversity and inclusion (EDI) action
- Consistent management standards delivered through accredited training
- A simplified, standard appraisal system for the NHS
- A new career and talent management function for managers
- Effective recruitment and development of non-executive directors (NEDs)
- Encouraging top talent into challenged parts of the system
All seven recommendations have been accepted by the government and publication of the report will be followed by a plan committing to implementing the recommendations.
Priority: We will provide sustainable services that are delivered in an effective and efficient way, at the time people need it.
Finance Update
The Trust has £14.5m of uncertain income which it currently does not have a plan to bridge. Across all providers the risk against uncertain income in plans is £114m.
Additionally, all Trusts have a 5% efficiency challenge which represents a challenge beyond what is typically delivered. This amounts to £136m, a significant amount of which must be considered a risk to the financial position.
New Health Academy launched in Lancashire and South Cumbria
A new health academy has been launched to improve the health and wellbeing of people living in Lancashire and South Cumbria.
The Population Health and Health Equity Academy will see health and care partners across Lancashire and South Cumbria come together to develop a consistent approach to reducing the differences in people’s health.
The academy is a partnership between NHS Lancashire and South Cumbria and The King’s Fund, a charity that works with the NHS to shape health and social care policy.
The Academy will deliver training on key topics for health and care leaders and staff to support the planned work, including sharing best practice and lessons learned across Lancashire and South Cumbria. The Academy will also look to develop an online platform to enable the sharing of intelligence, publications, case studies, videos, useful web links and online training.
Lancashire and South Cumbria ICS Chief Executive visits Central and West
Chief Executive of Lancashire and South Cumbria Integrated Board, Kevin Lavery, was invited to the Trust on 14 June to meet teams from across the Central and West network.
Kevin spent time listening to our teams and finding out more about our transformation journey for achieving integrated mental health care with world-class technology.
He was introduced to the new Instant Response Service (IRS) and heard how this has improved the service we provide our community, making sure patients get the right care at the right time. He then joined a roundtable discussion on the physical health community services, who showcased the fantastic services they are delivering.
Kevin finished his visit with a tour of the new Bed Hub to experience the integrated working between health and social care.
Consultation on new National Mental Health and Wellbeing Plan
In April 2022 the Department for Health and Social Care launched an open consultation to promote good mental health and wellbeing and provide effective, timely support to people with mental health conditions.
The discussion paper asked for support and ideas to develop a comprehensive plan that will help set and achieve the vision for mental health in 2035.
This discussion paper was published by the Department of Health and Social Care, and has been informed by conversations with stakeholders, people with lived experience and government departments.
The call for evidence via online survey ended on 7 July 2022 and the input will support the development of plans for wellbeing, mental health, and suicide prevention in England.