Building Foundations Across NHS Wales
2025–26Wales' Open Access Mental Health Support Model brings the principles of Stepped Care 2.0 to life within the Welsh context, offering a flexible range of supports designed to respond to people's needs and preferences.
Overview
Laying the Groundwork for Open Access Mental Health Supports
To address escalating and changing demand, workforce pressures, and increasingly complex needs, Wales launched an ambitious national system transformation under its Mental Health and Wellbeing Strategy 2025–2035. Powered by Stepped Care 2.0® (SC2.0) principles, the country aims to become the first nation to offer same-day, open-access mental health care. Partnering with NHS Wales Performance and Improvement (NHS P&I), Health Boards, service providers, and lived and living experience experts, Stepped Care Solutions continues to help translate this vision into a scalable, nationwide Open Access Mental Health Support Model focused on flexible, needs-led care.
Fifteen demonstrator projects across all seven Health Boards are now beginning tests of change focused on rethinking the “front door” to mental health services and integrating the One-at-a-Time (OAAT) mindset and approach into a variety of services, including OAAT Therapy. Alongside implementation, partners are building the evidence base to understand and strengthen the model over time.
Highlights
- Established a national-to-local governance structure to strengthen alignment and communication between the National Implementation Support Team (NIST) and local Health Boards.
- Provided advisory and methodological support to NHS Wales Performance and Improvement and academic partners in developing a successful £3.4M research grant to evaluate Open Access Mental Health Support across Wales. Led by Public Health Wales and Cardiff University and funded by the National Institute for Health and Care Research, the research will examine the model’s effectiveness, implementation, and sustainability, with ongoing learning informing continued improvement.
- Authored and deployed a structured four-phase Implementation Workbook and Maturity Matrix to help local teams track progress and support continuous quality improvement, with the first two phases released this year in both Welsh and English.
- Engaged more than 175 leaders, clinicians, and stakeholders through SC2.0 learning sessions, workshops, and discussions, building shared understanding and capacity across the system.
- Supported the skills and capacity building of a team of National Implementation Coaches, helping bridge the national vision with implementation across local Health Boards.
The input from SCS has been invaluable to enable us to have a very strong start to the transformation of our mental health system in Wales. SCS has enabled us to develop a comprehensive understanding of the Stepped Care 2.0 model across stakeholders, consider how the model could address our strategic priorities and create a momentum and clear plan for implementation.
You have taken the time to build relationships with key stakeholders and through your curiosity and diligence have developed a deep understanding of the system in Wales to ensure your recommendations are extremely sound. I have personally learnt so much from working with you and have valued your patience. It's been a joy, thank you!
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