This Foundation Trust is located in the North East of the UK and operates from over 60 sites.
In June 2015, Meridian Productivity Ltd was invited to carry out an analysis of the Forensic Inpatient Wards to identify opportunities for a productivity improvement.
The key objective for the Trust was to “sample” Meridian’s methodology on a smaller scale with a view to engage in a larger piece of work following a successful completion of the project.
The Teams which Meridian mainly worked with included the Allied Health Professionals, Psychologists and Medics who work on three acute admission facilities which house males who have a mental disorder and who have come into contact with the Criminal Justice System.
The unit in the project scope consists of 3 forensic inpatient wards and was the second most expensive and yet the smallest forensic unit in the country at the time of the analysis.
Reference costs per occupied bed day per unit were not sustainable and the average cost was higher than the national average.
The service quality was above the service specification which also resulted in higher reference costs.
National guidelines specify that there should be 25 hours/week of meaningful activity provided for every forensic patient. The management controls which were in place did not allow to quantify the amount of activity each patient received and did not allow to track the amount of activity delivered by the MDTs.
Meridian analysis study showed that the professionals included in the project scope spent an average of 36% of their working day in direct clinical contact (face to face) with patients on the wards, which was lower than the F2F target in some community teams within that Trust, although no travel was required.
Following the proposal, Meridian were engaged in an 8-week programme which focused on improving the efficiency of the Allied Health Professionals, Psychology and Medical teams through developing new ways of working to increase patient-facing time.
Working with the Management of all levels, including the Specialist Services Group Directors and front line Management, Meridian assisted in designing and implementing a bespoke Management Control System. By introducing a new, SMART target (face to face time with patients), a workload planning process, as well as a robust follow-up system, the Managers were equipped with the tools to support their teams in achieving the performance targets and identifying negative variances early enough to minimise their impact.
The development of the new system elements was achieved through a combination of workshops and one to one sessions within each of the teams. All of the participating managers had the opportunity to contribute to the controls themselves, as well as to the productivity targets contained within them.
For the first time, the Managers and staff had the ability to demonstrate the amount of ‘meaningful activity’ delivered to patients in a clear and dynamic way, as well as monitor frequent DNAs and cancellations of sessions which allowed for more effective planning of care.
The staff involved in the training programme demonstrated a high level of engagement and ownership of the installed controls which enabled the effective perpetuation of the new system after the completion of the project.
The Trust has identified a financial improvement of almost £160,000 through a demand/capacity analysis.
A second, much larger piece of work was initiated upon the completion of this programme.