The PSC page: programme-phases

Overview

Overview
"This has been the most rigorous and 'outside comfort zone' process we have been through as a team… It has hooked us completely, and we will continue. The best is yet to come."


Matron, MHA QI pilot site

"The project support is really excellent and I know the team are keen to take this opportunity to learn and grow."


Medical Director, MHA QI Pilot Trust

"Being involved in this project has been an invaluable experience. The clinical team have already implemented simple changes regarding cultural diversity and religious needs onto the ward, which were identified during the project planning stages.

Whilst discussing the project and planned changes with the clinical team, it has raised awareness amongst all staff members and some have proactively made changes in their practice and cultural awareness as a result.

I am in no doubt that without the opportunity to engage in this project, our subsequent plans for various clinical improvements regarding patients religious and cultural needs would not have been identified."


Consultant Psychiatrist, MHA QI pilot site

"We’ve learned a lot about how to do improvement projects. The attention to detail in your coaching sessions has gently held us to account, and your suggestions have made a big difference to our work. There can be a lot of doubt for teams embarking on an improvement project, and your positive coaching style has been crucial in developing momentum."


Associate Medical Director, MHA QI Pilot Trust

"Our team has really valued being part of the pilot and we have also valued the Chair, Chief Executive and Board involvement"


Chair, MHA QI Pilot Trust

"It’s really great to be on board and thank you for allowing me to have the platform to contribute and for valuing my inputs.

You have been a fantastic coach; we are very thankful for your gentle probing and consideration of our capacities & abilities.
"


Community Engagement Lead, MHA QI pilot site

"How fantastic that we've discovered new avenues for facilitating conversations about culture, race, and identity more frequently...feels like we're continually on an upwards trajectory."


Assistant Director, MHA QI pilot site

"These conversations we've been having and the small things we've done already have made a big difference. Communication on the ward - with staff being more present with patients and asking questions - is hugely improved. I'm really proud of the team's work."


Ward Manager, MHA QI pilot site

Working with 52 mental health inpatient services across England

Working with 52 mental health inpatient services that provide care of people detained under the Mental Health Act, to develop and implement co-produced change ideas that put into practice the principles set out in reform of the Act.

 

The programme works with:

  • General adult and older adult acute mental health inpatient services - including Psychiatric Intensive Care Units (PICU) and dementia inpatient services
  • Children and young people’s mental health inpatient services - General Adolescent Units (GAU) and PICU
  • Specialist inpatient services for adults with a learning disability and autistic adults
  • Adult secure care mental health services

 

This programme incorporates the input of Lived Experience at all levels, from the co-production of change ideas on the ground, to involvement in the core programme delivery group and representation on the programme's steering group.

 

It offers two levels of expert quality improvement coaching to particpating organisations:

(I) Executive coaching

  • ~2 hrs, monthly
  • Supporting executives and/or senior operational leaders to
  • cultivate an organisational culture of equity & equality empower colleagues to create locally-led change embody humble & compassionate leadership

 

(II) Service leadership and frontline-delivery coaching

  • ~1.5 hr, weekly
  • Equipping leaders of services & teams with the skills & confidence to lead QI work aligned with the programme aim
  • Supporting inpatient services & teams to co-produce change ideas alongside people with lived experience, and then deliver and achieve impact through these change ideas using QI methodology

 

Our approach ensures a focus on addressing inequity, reinforcing a “locally-led, centrally supported” approach to QI, and facilitating knowledge-sharing between teams at all levels.

Programme aim and drivers of change

 Programme aim and drivers of change

Improving equity of experience for groups experiencing significant inequalities under the MHA

The programme aim is to:

"Improve the equity of experience for people from ethnically diverse backgrounds and people with a learning disability & autistic people when detained under the Mental Health Act in hospitals across England, including improving the cultural appropriateness of care they receive."

 

This is underpinned by four primary drivers of change - viewed through an individual patient & carer lens, and systemic lens:  

Individual patient and carer lens 

1. Patients and their carers are empowered to share their individual experiences and diverse needs with staff on the ward

2. Patients, their carers, and lived experience practitioners work in partnership with staff to deliver support that meets people’s individual and diverse needs

 

Systemic lens

3. Staff work alongside patients and lived experience practitioners to explore and understand the barriers that compromise equity in the settings they work in

4. Patients & carers, staff and lived experience practitioners adopt a shared discourse and co-produced set of relational practices that empower them to proactively challenge discriminatory practice, and promote equitable system change

Links with other national workstreams

Patient Carer and Race Equality Framework (PCREF)

Links with other national workstreams

Aligning with the principles of PCREF

From 2023/24, NHS Mental Health Trusts will also need to embed the Patient and Carer Race Equality Framework (PCREF). The PCREF is an organisational competency framework that will support Trusts to advance race equalities across all mental health care pathways, in order to improve access, experience and outcomes for racialised and ethnically and culturally diverse communities.

 

The PCREF will support trusts to put in place steps it can take to achieve practical improvements in three domains: leadership and governance, organisational competencies, and patient and carer feedback.

 

This programme is aligned with the principles of PCREF and has the potential to support the implementation of improvements across these three domains.

Pilot phase

Pilot phase

Participating pilot services

We’ve selected 15 inpatient services to join the pilot phase of the programme, covering all regions and service types within scope.

General adult and older adult acute mental health inpatient services - including PICU and dementia inpatient services

  • Delderfield Ward, Devon Partnership Trust
  • Logandene Ward, Hertfordshire Partnership NHS Foundation Trust
  • PICU Miranda House, Humber Teaching NHS Foundation Trust
  • Osprey Ward, Rotherham Doncaster and South Humber NHS FT
  • Shannon Ward, The North London Mental Health Partnership (includes Barnet, Enfield and Haringey, and Camden and Islington NHS FT)

 

Children and young people's mental health inpatient services  - General Adolescent Units (GAU) and PICU

  • Kent and Medway GAU, North East London NHS Foundation Trust (NELFT)
  • Leigh House and Bluebird House, Southern Health NHS Foundation Trust
  • Parkview GAU, West Midlands CAMHS Provider Collaborative - Lead Provider Birmingham Women and Children's NHSFT

 

Adult secure care mental health services

  • Bowman Ward (Low Secure Unit), Cornwall Partnership NHS Foundation Trust 
  • Rydal Ward (Medium Secure Unit), Greater Manchester Mental Health NHS Foundation Trust
  • Calder Ward (Medium Secure Unit), Lancashire and South Cumbria NHS Foundation Trust 
  • Forest Lodge (Low Secure Unit), Sheffield Health and Social Care 

 

Non-secure specialist inpatient services for adults with a learning disability and autistic adults

  • Larches Ward, Black Country Healthcare NHS Foundation Trust
  • Orion Unit, Nottinghamshire Healthcare NHS Foundation Trust

 

Secure specialist inpatient services for adults with a learning disability and autistic adults

  • Rowan View (Medium Secure Unit), Mersey Care NHS Foundation Trust 

What changes are pilot sites implementing?

Overview of the pilot phase and programme drivers of change, change ideas implemented at MHA QI pilot sites, and overarching 'problem to be addressed' through improvement work.

Change ideas implemented at pilot sites

Wider implementation phase

Wider implementation phase

Participating wider implementation sites

Having completed our pilot phase, we have now begun our wider implementation phase in which a further 37 organisations are being coached, covering all regions and service types within scope.

Participating trusts

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