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…
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.
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.
1.1 Ownership
KIC1 LEADERSHIP,
STRATEGY &
PEOPLE
The Brief...
1.2 Innovation
1.3 People Development
1.4 Clinical Leadership
1.5 CCG/LA Relationships & Support
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:
-
2.1 Access MH multiagency forum
reporting to Urgent
& Emergency Care
Network
2.2 Single point of access
with all stakeholder
Involvement
(ambulance, police,
primary and
secondary care)
2.3 OOH Hub & Rapid Response Team
Reducing admission to inpatient
services
Reducing length of stay
Improving quality care
Reducing overall costs
"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.”
Dawn Chamberlain, Chief
Operating Officer, South West
London & St Georges Mental
Health NHS Trust
KIC 4 Alternatives to Inpatient Care
KIC 5 Acute Inpatient Care
3.1 Home Treatment Teams
4.1 Crisis Houses
5.1 Early Discharge planning
3.2 Specialist mental health
in primary care setting
4.2 Psychiatric Decisions Unit
(PDU)
5.2 Care planning and
standardised care pathways
3.3 Effective step down and
accommodation pathway
4.3 Evening access - Crisis Cafes
5.3 Performance management
and reporting
4.4 Crisis Resolution Teams Brief
intervention
Care Packages
5.4 Out of hours admissions and
discharges
2.4 Raid Teams, Liaison Psychiatry
3.4 App based care for reduced
services and EIS providing specialist
admission/readmission.
support
LOS
Results
-
KIC2 Access
KIC 3 Primary/Secondary Integration
with Urgent Care
Admissions
Cost per bed
Quality
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 2018. All Trusts have
agreed this is realistic.
•Standardise delivery of initiatives within The Partnership Framework above across all London
MH Trusts.
Contact us: 0121 674 4230/0203 494 4930 - [email protected]
Birch Collaboration: Brook House, Moss Grove, Kingswinford DY6 9HS