Session J: Care When It Counts – Rapid Re-design of a Direct Access Mental Health Pathway

East Lothian Health and Social Care Partnership takes an innovative approach to the development of Primary Care services as set out in the 2018 National General Medical Services (GMS) Contract and considers mental health a key priority in line with the National Mental Health Strategy 2017-2027.

In response to the Coronavirus (COVID-19) Pandemic, re-mobilisation required addressing existing challenges to accessing support for mental health as well as new pressures on workforce sustainability in Primary Care. 

Primary Care and mental health colleagues collaborated to rapidly redesign and establish a new mental health pathway. The Care When It Counts mental health service has challenged traditional models of working. Embedded Primary Care models have been replaced with direct access to specialist support from a multi-disciplinary team via a single point of contact. 

This session will explore how collaborative approaches were used to ensure ongoing development of the service, including joint Quality Improvement work with GP and mental health colleagues, staff development sessions to ensure team ownership for creative problem solving, and informal discussions to build confidence in the service. This joint working and transparent communication, along with a continued commitment to patient care, has ensured wider buy-in and sustainability of the service. 


Alastair Clubb

Primary Care Clinical Lead, East Lothian Health and Social Care Partnership, NHS Lothian

Alastair Clubb qualified as a General Practitioner in 2001, and has worked in various roles in Primary Care, in the South East of Scotland.


Melissa Goodbourn

Primary Care Service Manager, East Lothian Health and Social Care Partnership

Before joining the Primary Care Team, Melissa Goodbourn worked as a Social Worker, in Scotland and the United States, in a mix of frontline, research and policy settings.

Fiona Graham

CWIC Team Lead, Mental Health Occupational Therapist, East Lothian Health and Social Care

Fiona Graham graduated as an Occupational Therapist in 1988. Fiona’s experience in mental health spans over thirty years, across acute, forensic and rehabilitation settings.

Dr Alyson McClure

General Practitioner, Tranent Medical Centre, East Lothian

Dr Alyson McClure has been a General Practitioner partner in East Lothian for over fifteen years and has an interest in General Practitioner education and innovation within general practice.