Mental Health

The escalating demand for Mental Health Services within the community has presented a series of intricate challenges for Trusts. Addressing this multifaceted demand necessitates a high level of coordination and strategic planning. The goal is to ensure that treatment is seamlessly administered throughout the pathway journeys, optimising the available resources and harnessing the diverse skill sets of mental health professionals. This must all occur at the right juncture and with the necessary support.

Community Health Teams have embarked on a successful collaboration with Meridian to alleviate operational constraints. This includes the streamlined management of physical facilities to deliver clinic bookings and operations. The outcome of this effort is the maximisation of face-to-face patient contact time. Additionally, this partnership entails equitable distribution of caseloads and a meticulous allocation of available capacity and skills to uphold defined service standards. The result is a reduction in waiting lists, promoting timelier access to care, and fostering the consistent delivery of standardised treatment to vulnerable demographic groups.

Case Studies: Mental Health

School Nursing Service Redesign Programme

The analysis revealed that the service provided to each school and by each nurse varied widely. There was no formal expectation of required deliverables and a need to strengthen their negotiation position in the approach to the end of their contract.

Community Services Administration Support – Mental Health

The analysis identified: Differing practices and a lack of standardisation across locations, different responsibilities and roles for staff with the same titles and grades, substantial variation in mix and volume of workloads.

CAMHS/Adult Community Mental Health

Meridian was tasked with an analysis CAMHS and the Adult Community Mental Health Directorate to look at levels of demand in comparison with current capacity, existing discharge planning and the current management control systems.

Child & Adolescents Mental Health Services – Humber NHS Foundation Trust

The Executive Board invited Meridian to conduct an analysis with the view to answer the questions “how do we improve the quality of our service delivery?” and “how do we know how much resource is required to match the demand?”

Productivity Increase & Cost Reduction Program in Adult & Older Adult Community Mental Health

The project was designed to increase the amount of time spent clinically with patients whilst increasing the quality of service provided to all users, and to make financial cost improvements for efficiency purposes.

Mental Health Services – Intensive Community Therapy Team and Social Inclusion Team

The Trust wanted to improve the service given within their ICT and SI teams, reduce the size of their waiting list, improving efficiency and their work allocation process.

Integrated Community Teams & Therapy for You

The analysis identified that there was a lack of management control, effective target setting and reporting. There was a low utilisation within specialist services through a lack of standardised allocation, clinic templates and ways of working.

Community Services

There was little control over resources and capacity need was based on historic demand and historical team sizes. There were no tools to control and balance the demand and capacity at any level of the organisation.

District Nursing and other Clinical Services

There had been little knowledge of the demand and capacity of each team with the spread of resources based on historic customs. Contract performance was poor with waiting list breaches and overspending, savings needed to be made.

Substance Misuse Services

The Executive Team invited Meridian to conduct an analysis to highlight and quantify where the costs could be reduced through improving the way the teams managed their own resources.

School Health Service Programme Redesign

The study identified that 24% of nurse time was spent in contact with children/parents, Face to Face (FTF) the majority of nurses’ days were spent in lengthy case conferences, as well as safeguarding and care planning meetings.

Mental Health Advice and Assessment Team

Meridian conducted an analysis with the view that the new systems and processes would answer the question “how much resource do we need to deliver this service within its service targets?”

Children and Adolescent Mental Health Services & Intellectual and Developmental Disability Services

Meridian was tasked with supporting the trust to achieve a CIP saving of £1.8m across the Specialist Services Directorate. This included Community CAMHS, IDD and Inpatients services.

Adult Mental Health Services

Meridian was tasked with supporting the Trust to achieve a CIP saving of £580k across the Adult Mental Health Service. This included Local Mental Health (LMHT), Crisis Resolution (CRHT), and Inpatient services.

Home-Based Treatment Teams Project Improvement Programme

The analysis showed a lack of control over activity, expectation, and performance, with no way to accurately plan, nor to review performance. The face-to-face contacts observed averaged 17% of the total time in work.

Community Mental Health Team

The CMHT Services management system showed a lack of productivity indicators, defined expectations and planning mechanisms. The study identified an ineffective work allocation, missing links between the caseload volumes, complexity and the available capacity.

Community Mental Health Team Medical Workforce

The overall goals of the project were to develop targets, a standardised way of working, to implement skills mapping and to review the allocation process.

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?”

Mental Health Community & Inpatient Services Improvement Programme

The analysis identified that discharge dates were not routinely set or known by clinicians in the care pathway. ‘Out of trust’ bed night usage of 31 beds per night on average and variances within the Trust’s control were causing delays to discharge.

Integrated Community Mental Health Teams, Crisis Resolution and Home Treatment, Inpatient Wards and Adult Psychology Services Improvement Programme

The analysis identified a number of key management procedures, either under-utilised or not in place. As a result, the current system showed a lack of control over activity, expectation, and performance.

Adult Mental Health – Acute Inpatient Wards & Community Mental Health Teams

Meridian identified that there was no discharge planning or discharge dates for patients, therefore no review of planned discharges and no proactive action to remove the barriers to discharge.

Mental Health Community Teams and Inpatient Wards

Prior to the project, there was no systematic way of measuring productivity, and the method for calculating productivity varied according to the service.

Case Studies: Mental Health

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