The Approach

We provided programme leadership to continue delivering the improvement programme across all adult inpatient services in Sussex. The programme was underpinned by a ‘locally-driven and centrally-supported’ approach to quality improvement, which came to life though the following principles:

• Tailoring improvements to the local context and services: Initiatives with evidence of success in the pilot phase were scaled up and rolled-out across the Trust. Our hands-on coaching method allowed for the design of these initiatives to not be imposed, but to be tailored to the ways of working on each service, while maximising good practice and sharing learnings across services.
• Maximising clinical and operational leadership to sustain improvements: We ensured that in each stage of the improvement process – through design, piloting and implementation, the project was led by local operational and clinical leadership. We worked closely with nominated leads to problem-solve knotty issues and ensure the work was manageable alongside their day-to-day responsibilities.
• Fostering collaboration between siloed teams: Many of the improvement initiatives required better collaboration between urgent, acute and community services towards a service-user-centred, pathway-based approach. Following pressures and changes to ways of working from COVID, the Trust had recognised that this system-wide collaboration was one of the key enablers to drive improvements. Our programme convened many of these services regularly and facilitated open discussions about their challenges and solutions to support their shared cohorts of service users.
• Embedding local lived experience into the improvement process: We worked closely with the Trust’s participation team to work with individuals with lived experience of using the mental health services, or those caring for loved ones with mental health difficulties. These experts by experience contributed regularly throughout the improvement process via working groups, building relationships with frontline clinicians and advocating for meaningful change.
• Creating visibility of the work to leadership: Our programme steering group consisted of Trust-level executives and operational leads to monitor key success metrics and facilitate strategic decision-making for the direction of the programme. We also used this an opportunity to highlight success stories and for frontline clinicians to showcase their work with the leaders.

The Impact

Over the 6-month period of this programme 2023, the Reducing Length of Stay programme :

• Contributed to the Trust’s work in eliminating their inappropriate Out of Area Placements and reducing the usage of independent acute bed contracts by 12.5%
• Helped to generate a recurring monthly saving of approximately £110,000 compared to their financial position at the start of the programme
• Engaged with a total of 22 inpatient wards to embed evidence-based improvement initiatives into their ways of working
• Supported with the design, pilot and implementation of new care pathways for individuals with complex emotional needs with tailored approaches in 3 local patches within the Trust
• Designed and delivered the ‘Innovation Week’ in Brighton & Hove, which became recognised as SPFT’s blueprint approach to delivering improvement sprints across urgent and acute care pathways
• Worked collaboratively with over 100 staff in the trust, ranging from frontline clinicians to operational managers in inpatient services, community mental health teams, rehab teams, Crisis Response and Home Treatment (CRHT) teams, urgent care teams and voluntary sector provider organisations

Feedback

“As a front-line clinician, I felt like I could influence things through this programme – and that was a significant shift.” – Principal Counselling Psychologist, project lead of one of the improvement initiatives

“You've been with us for so long - sincerely thank you, for leaning in and doing whatever is needed to move things forward. (…) We have learned a huge amount from your approach, and we’ve lifted and shifted it to other important initiatives in the organisation.” – Chief Delivery Officer

“All the people I’ve spoken to who were involved in this programme have felt empowered and motivated in a way that they haven’t been for a long time.” – Chief Financial Officer

The PSC Transformation team

The PSC exists to make public services brilliant. Our collaborative tried and tested approach to transforming services is focused on creating meaningful and lasting change. We work together to analyse and diagnose your situation, devise a programme of support, then make it happen. In doing so we empower your people to deliver, unlocking ongoing results. We would love to talk to you about how our Transformation team can support you and your team.

Author

Mikoto Nakajima