Setting Up New Services in the NHS: Just Add Water

This guide for setting up a clinical service in the National Health Service is based on the author's experience of leading a nationally funded project to develop two new specialist services in different parts of the country and involving three separate NHS Trusts. The project successfully delivered two services for personality disordered patients based on the template of Henderson Hospital, a democratic therapeutic community (TC). Kingsley Norton takes the reader, step-by-step, through the entire process of setting up these new services. Unpacking Henderson Hospital's complex interpersonal environment into its ideological, 'cultural' and structural constituents, a development team that included ex-service users from Henderson used these ingredients to imprint the TC model in the newly recruited staff teams. The two replicated products were further supported and evaluated by the development team during their first 18 months of operation. The author reveals the complexity of the developmental task and shows that the process was never a case of 'just adding water'.