This page is part of our decommissioning toolkit.

In a local Primary Care Trust (PCT), a review of referrals to a mental health inpatient unit for young people highlighted that the existing service was not meeting requirements.  The service model provided poor value for money and was creating a cadre of service users who were overly reliant on specialist support rather than community based services.

What happened?

The PCT with lead responsibility for the service undertook a wide ranging consultation with other PCTs, local health bodies, and patient representatives. This consultation led them to agree that the way the service was being provided did not reflect the local needs of young people with mental health conditions.

The PCT, other local health bodies and the Local Authority ran a number of workshops and mapped out how a local care pathway for young people with mental health conditions would best work. They also organised a series of consultation events for practitioners and service users, third sector organisations, parents and children and young people, and social workers and teachers to ask them about which elements of the service were working and which were not or could be improved.

A separate event was held with the providers, including those providing community based mental health support, to see what could be delivered and how third sector organisations (TSOs) providing community based support could work in partnership with other providers to ensure a seamless and more effective pathway for young people needing specialist mental health services.


As a result, the PCT:

  • decommissioned the current providers of the inpatient unit and the community based services;
  • issued a new specification based on an integrated pathways approach; and
  • re-commissioned the new service, provided by a consortium of TSOs with expertise in community based mental health services.

Table of contents

Decommissioning toolkit: Table of contents

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Understanding stakeholders

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Making a decision: What does good practice look like?