Delivering real change and achieving parity of esteem in mental health care requires dismantling the current fragmented system and reimagining service design and delivery. The 24/7 Neighbourhood Mental Health Centre 75 pilots seem to be genuinely transformative. The experience from Trieste, and early evidence from Barnsley Street, show that radically different, individualised, community-based care gets results. We also heard that the model shows possible cost savings for the wider system. Realising large- scale reform will depend on sustained and ringfenced investment to enable stretched Integrated Care Boards to take the action needed. This must be matched by a profound cultural shift across the system from clinicians to commissioners to government. (Conclusion, Paragraph 91)