1. Birch Foundation, South West London & St
Birch Foundation, South West London & St. George’s Partnership (The Partnership)has been bringing Trusts together to combat high bed occupancy
The Partnership is a Healthcare systems and processes benchmarking and knowledge sharing community. It has brought every London Mental Health Trust together with the aim of reducing bed occupancy across all Trusts to 85% by 2018.
The Parnership methodology has been proven to help Health Trusts improve the efficiency and outputs of their services by following a systems engineering approach for health care, and sharing best practice. .
The Approach…
1) THE ROUTE MAP TO EXCELLENCE:
We have co-developed a model outlining 16 ‘Key Improvement Categories’ (KIC’s) for achieving excellence from extensive research and engagement with Mental Health Trust partners shown below. This structure is we consider applicable to any provider of healthcare services.
The Partnership Identified the following as vital components of achieving excellence:
Excellent Leadership, Strategy & People +
Bespoke range of Key Improvement Initiatives =
Reduced Los, reduced inappropriate admissions, reduced cost per bed per day, Improved quality of service and patient experience.
2) DIAGNOSTICS
For each of the participating Trusts, we undertook a high-level ‘diagnostic’ held over two days to establish the current state. Each diagnostic involved a number of interviews, observations on wards and process mapping sessions and helped to gain valuable insight on delivery processes, technology, and requisite leadership and behaviors and were crucial for identifying potential areas for improvement.
3) IMPROVEMENT CALCULATOR
A prototype The Partnership Improvement Calculator is being developed for each Trust, which takes the financial, performance and diagnostic results data to identify gaps between a Trust’s current performance and best practice, and identifies the opportunity for improvement in terms of patient experience and cost.
What next...
Participants agree that there is real benefit in extending this approach and are working together to:
Agree their bespoke route map for achieving excellence, based on the above, to save millions of pounds collectively and hit the target 85% bed occupancy target by All Trusts have agreed this is realistic.
Standardise delivery of initiatives within The Partnership Framework above across all London MH Trusts.
The Brief...
BIRCH facilitated the nine acute Mental Health Trusts in London. It aims to deliver improved patient experience & value for money through a single London wide Urgent Mental Health care system in response to the vision set out in the Crisis Care Concordat.
WHAT ARE THE BENEFITS?
The programme aims to assist all Trusts to achieve a 25% reduction of bed occupancy by 2018, focusing on four key areas:
Reducing admission to inpatient services
Reducing length of stay
Improving quality care
Reducing overall costs
KIC1 LEADERSHIP, STRATEGY & PEOPLE
1.1 Ownership
1.2 Innovation
1.3 People Development
1.4 Clinical Leadership
1.5 CCG/LA Relationships & Support
KIC2 Access
KIC 3 Primary/Secondary Integration with Urgent Care
KIC 4 Alternatives to Inpatient Care
KIC 5 Acute Inpatient Care
2.1 Access MH multi-
agency forum
reporting to Urgent
& Emergency Care
Network
3.1 Home Treatment Teams
4.1 Crisis Houses
5.1 Early Discharge planning
2.2 Single point of access
with all stakeholder
Involvement
(ambulance, police,
primary and
secondary care)
3.2 Specialist mental health
in primary care setting
4.2 Psychiatric Decisions Unit
(PDU)
5.2 Care planning and standardised care pathways
2.3 OOH Hub & Rapid Response Team
3.3 Effective step down and accommodation pathway
4.3 Evening access - Crisis Cafes
5.3 Performance management and reporting
2.4 Raid Teams, Liaison Psychiatry services and EIS providing specialist support
3.4 App based care for reduced
admission/readmission.
4.4 Crisis Resolution Teams Brief intervention
Care Packages
5.4 Out of hours admissions and discharges
Results
LOS
Admissions
Cost per bed
Quality
"Being part of this programme is helping us deliver the right solutions for a sustainable urgent mental health care system. Birch facilitated 9 Trusts working together and share learning. We have reduced our bed occupancy by 25%, removed the need for Out Of Area beds, improved quality of care and saved millions of pounds.”
David Bradley, Chief Executive at South West London & St. George’s Mental Health Trust
Contact us: /
Birch Collaboration: Brook House, Moss Grove, Kingswinford DY6 9HS