Hi all. I’ve been lucky enough to work with Nick in his clinic but - as we prepare for our tour around England & Scotland to explore Open Dialogue within the NHS I thought it might be interesting to share my experience of being part of a team working to implement dialogical work at first point of contact with secondary services.
3 weeks ago, I began an honorary contract with KMPT’s new Open Dialogue team. This was particularly exciting my first day just happened to be the first day of the team as a whole. Like in many areas, my understanding is that prior to this team’s launch practitioners were adding in network meetings on top of their usual duties … with trainees gathering together to see families/social networks in as flexible a way as possible. But 3 weeks ago something changed. Rather than an add on to TAU, Open Dialogue became TAU (on a small, but growing, scale).
The new Open Dialogue team takes a set number of referrals each week in a specific area, including new referrals to the Early Intervention in Psychosis service and urgent referrals via the single point of access (ones that would usually go to the crisis team). It isn’t about whether someone thinks working with families will be helpful - we just accept the first 5 new referrals each week to slowly build the number of people we’re working with.
What’s kind of amazing about it is that we sit across the acute and community service lines … we are their first contact with secondary care and we can work with people until they decide they no longer need/want our support. We’ve been able to see people really quickly, in their own homes with their family/network and - at the end of the meeting - ask the all important question: when would you like to meet again? without having to stick to set times.
It’s early days and there’s much to learn, but it feels really good to be with a great bunch of people who are working out how to embed this approach within the system we have (where we have all the same requirements on us as CMHTs). We’re only 8am-8pm Monday to Friday at the moment, and the team is small (but will be growing over the next month or so and we’re planning to extend our service over the weekend when we’re able to). One of the coolest things is that the people who are using our service don’t have to know what Open Dialogue is - that this is just the service we offer. It gives me hope that it IS possible for the NHS to change the way things are currently structured.
I’m sure there’ll be lots of learning over the next few months as we find our feet - but I’m happy to share my experiences of it with anyone that’s interested
Best wishes, and solidarity