Supporting people living with both mental and physical health problems is a priority for the UK health and care system. Someone living with a long-term physical condition is 2-3 times more likely to experience mental health problems than the rest of the population,1 affecting the care and support that’s needed for them to live well. The interrelationship between mental and physical health presents challenges for how health and care services – and the people working within them – currently operate. 2

To help address this, the Q Lab and Mind have produced a practical guide to support practitioners to improve health care services for people living with mental and physical health problems. The findings come from a 12-month project exploring how care can be improved for people living with mental health problems and persistent back and neck pain. The insights from this topic are relevant to the broader mental and physical health debate, and particularly transferrable to other long-term conditions (such as fibromyalgia, and other types of persistent pain).


About the guide

The guide is a result of collaborative research with over 100 participants and on-the-ground tests in practice with five teams from across England and Wales from September 2018 – September 2019.

The guide identifies six high level problems and corresponding solutions that need action to improve care in this area. These relate to:

  1. Local knowledge
  2. Skills and training
  3. Environment and processes
  4. Patient expectations and understanding
  5. Coordination, access and collaboration
  6. Evidence base and business case

To make the solutions tangible, each area includes suggested actions, challenges to prepare for and practical examples from others who are already doing this.

This guide is for a broad range of people, and aims to support improvers, practitioners and commissioners translate the learning from the Q Lab and Mind into action, and equip people with ideas and inspiration to drive change in their local area.

The learning that we’ve generated on this topic relates to the wider health and social care integration agenda, as well as highlighting challenges that relate specifically to the health and care services set up to support people living with mental health and persistent back and neck pain.

Not new, but not easy

We know this work isn’t easy and that policy changes are needed at a national level to address issues around workforce capacity, skills and health and social care integration. However, we’ve focused on how individual services and teams can work together to enable change in practice. The ideas and learning featured here are not necessarily ‘new’: some of our conclusions may seem obvious, some of them you may have tried before.

Drawing on the Health Foundation’s learning about spreading innovation, we know that picking up and adopting an idea to suit your local context and culture will require just as much effort as discovering it for the first time.3

The hard work of change exists just as much in the adoption and take-up of ideas as it does in the discovery of the new

Will Warburton, Health Foundation4


To respond to this challenge, we highlight learning from others to overcome the common barriers you come up against when doing this work and give attention to the critical success factors that are often overlooked, undervalued or taken for granted when doing this work.

The opportunities are there. People are doing this and we hope this guide will inspire action. Download it, share it with colleagues. You can connect with the teams on the Q website or join our online group to meet others working on this challenge.