Sussex Partnership NHS Foundation Trust — Niche Consult
Context and approach
The Sussex mental health economy wanted to review the organisation and delivery of acute mental health services in order to: ensure that people are cared for in the least intensive setting consistent with their needs; to meet the expectations of national standards and targets; and, to make best use of limited resources of both money and staffing.
Some of the key operational issues identified by the client included: the ways in which beds are organised and managed; the balance of inpatient and community services; and the physical locations of services across the local geography.
We worked with both provider and commissioners to undertake a comprehensive review of mental health services, combining meaningful stakeholder engagement along with our unique mental health simulation modelling approach. We developed a series of scenarios on the future pattern and delivery of services and tested these out in multi-agency workshops.
The scenarios we modelled were:
- Reduction in Delayed Transfers of Care (DToC);
- Development of alternatives to admission including a Psychiatric Decision Unit (PDU);
- Standardising inpatient length of stay profiles;
- Reducing acute readmissions;
- Delivery of CRHT Core Fidelity Standards;
- Reduction of inappropriate CRHT contacts;
- Standardisation of CMHT activity; and
- Enhanced gatekeeping of CMHT caseload.
We agreed and modelled targets for enhanced patterns of performance and delivery in the above areas and then combined these into an eventual ‘optimised model’ of mental health delivery over the coming years.
What we found
There were several key findings:
- There were significant opportunities to reduce the pressure on beds by implementing various combinations of the scenarios above. We modelled various options for changes to the acute bed configuration based on the likelihood of being over capacity. This is shown in the fig. 1. If the system worked at ‘gold levels of performance’ there would be no overspill at the current level of beds.
- Out of area placements could be eradicated by action on length of stay and the enhanced delivery of alternatives to admission. There would be a significant saving to the overall economy from this and better patient care closer to home.
- Enhanced and standardised community delivery could see the achievement of Core Standards being met and act as a catalyst for a shift in the balance from inpatient to community focused care delivery.
- There was general agreement that the changes proposed were deliverable though concerted action across all agencies was needed.
Fig 1
For more information about our capacity, demand and patient flow work and how we might help you
Contact Tom McCarthy
Tom.mccarthy@nicheconsult.co.uk
or James Fitton
Originally published at https://www.nicheconsult.co.uk.
