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 participating organisations:

(I) Executive coaching

• ~2 hrs, monthly
• Supporting executives and/or senior operational leaders to (i) cultivate an organisational culture of equity & equality, (ii) empower colleagues to create locally-led change, (iii) 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.

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

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

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

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.