Community Services

Community Services have gained increasing prominence within the health and social care landscape, contributing to enhanced patient and service user access while simultaneously creating supplementary funding avenues for Trusts. However, it’s common to find community staff and managers operating autonomously, often without a clear understanding of specific performance targets, including those outlined in commissioned contracts.

Meridian collaborates closely with both Trusts and Local Authorities to establish robust management controls. This ensures that every staff member attains their targeted activity levels on a daily, weekly, and monthly basis. This involves working alongside the executive leadership and management hierarchy to define transparent and equitable expectations for daily workloads.

Through meticulous demand and capacity analysis, teams are right-sized and meticulously modelled to strike the optimal balance between delivering quality patient care and ensuring cost-effective, productive resource utilisation. The deployment of a unified, streamlined information reporting suite empowers every organisational level with precise data, facilitating informed management decisions and showcasing tangible, quantifiable improvements.

Case Studies: Community Services

District Nursing, Rapid Response, Therapies

Statistical analysis of District Nurses showed variations in face-to-face contact times between the different PCT’s of 32.8 minutes to 72.1 minutes for the same activities.

Health Visiting, District Nursing, Bed Management

The new APO had one mission; to take over the running of all provider services for Outer Northeast London. It was vital that they could run a streamlined, productive and well managed system of community services.

District nursing Occupational Therapy Intermediate Care Health Visiting

The services lacked robust reporting tools, systems and processes that would give the managers the necessary information on productivity, demand and capacity at a regular frequency to effectively manage their teams.

Children and Young People’s Service: Community

The Trust engaged in an analysis with Meridian to identify opportunities to redesign CYPS’s community services and ultimately increase productivity through a reduction in agency, bank and overtime spend.

Children’s Young People and Adult Specialist Services Improvement Programme

It was crucial for the success of the project to ensure that the staff were engaged in every step of the programme and the work was done WITH them rather than to them.

Residential Facilities and Community Outreach Team

Prior to the project, there was no way of measuring productivity, and the management tools within the organisation provided no real assurance on performance, quality, or sustainability.

Urgent Care Service Improvement Programme

Meridian was invited to undertake a project with the aim to identify demand by base, reduce bank & agency spend and avoid incurring costs due to the implementation of a new Clinical Assessment Service (CAS).

Nursing, Therapy and Urgent Care Community Services

The analysis uncovered issues including a lack of reliable performance data, clear targets and expectations for staff, robust planning standards and resource planning that disguised workload and work content.

Integrated Community Teams Improvement Programme

Historically, there had never been a link between the demand on each team and the resource provided. Meridian conducted an analysis to identify, evidence and implement control of the required level of resource to service each localities patient needs.

Call Handling in Children and Young People’s Service

Meridian engaged in work with this Trust on the third occasion, with the aim of reducing unanswered calls, complaints made due to communication and to develop a standardised way of working across the teams.

Specialist Nursing, Community Nursing & Community Therapy (IAPT)

The analysis identified an opportunity to generate savings (£200k) in Specialist Nursing Service by increasing productivity by 15% and the need to increase productivity in the IAPT Service to meet the 15% Access target.

Community Services

In the past there had been no knowledge of the capacity or a forecasted demand for each team within the service. The spread of resources was based on historic information, and not on activity levels.

Community Mental Health and Bed-Based Support Teams – Learning Disabilities

The lack of common ways of working and standardised processes made it hard for management to determine the cause of waiting list build up and to deal with it effectively.

Mental Health Acute and Community Teams

The Executive team invited Meridian in to facilitate the design of new systems and processes that would help them answer the question “how much resource do we need to deliver this service within its service targets?”

Integrated Care Teams Improvement Programme

The main issues identified were excessive agency, overtime costs and a lack of management control over capacity and demand and work assignments for staff.

Community Hospital Avoidance Service

The analysis highlighted the variance in procedure between the geographic divisions. At directorate level, there was a desire to standardise the service across locations, however this was not reciprocated through the management structure.

Mental Health and Learning Disability Services

The Health Board involved Meridian with the view that new systems, processes and behavioural change would help them answer the questions “how do we increase our productivity?” and “how do we match our resource to demand?”

Community Mental Health Services, Working Age Adult & Older Adults and Older Adult Inpatient Wards

The Meridian study identified opportunities within the Working Age Adult and Older Adult Community teams to improve productivity and reduce the average length of stay on the Older Adult inpatient wards.

Aberdeenshire Health and Social Care Partnership Community and Inpatient Ward Improvement Programme

Since their integration, the joint board had been working to align service provision to allow for a more coordinated approach to the way health and social care is provided.

Community Mental Health, Psychology, OT & Inpatient Wards Improvement Programme

The system within Community MH Teams and Inpatient MH Wards showed a lack of control over activity, expectation, and performance, resulting in only 21% direct clinical contact in the community and significant lengths of stay.

Mental Health Services for Older Patients

“The study identified low productivity across the community teams, averages ranging from 2.2 to 3.2 contacts per WTE day and barriers to discharge from the inpatient service causing extended length of stay.”

Physical Health Services

Meridian supported the Trust to achieve a CIP saving of £1.18m 3 Physical Health Directorates, including District Nursing, Therapy Services and other specialist Physical Health Teams Including 4 inpatient wards.

Community Paediatrics (Outpatients) and Diana Services Improvement Programme

The service suffered from a lack of performance data, clear targets and expectations, planning standards and a systematic and robust way of allocating work ensuring clinic maximisation as well as an effective follow up process.

Medical Capacity Planning

The processes implemented provided Medicine Division management control over the proactive governance of the booking teams, rostering and operational variances, as well as visibility on a daily basis of individual and team performance.

Case Studies: Community Services

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