Quality improvement in mental health

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Part of Quality improvement in mental health care

Quality improvement approaches – increasingly well-established in NHS acute hospitals – could play a key role in improving the quality of mental health care.

A growing number of mental health providers (in the UK and beyond) are beginning to embed quality improvement across their organisations, with some encouraging results. The approach is based on the concept that sustained improvement is best achieved by empowering frontline teams, service users and carers to design, implement and test changes to services.

This report describes the quality improvement journey of three mental health organisations (two in England and one in Singapore). It provides key insights and lessons for others considering embarking on a similar journey.

Key findings

  • Embracing quality improvement requires a change in the traditional approach to leadership at all levels of an organisation, so that those closest to problems (staff and patients) can devise the best solutions and implement them.
  • Doing quality improvement at scale requires an appropriate organisational infrastructure, both to support frontline teams and to ensure that learning spreads and is taken up across the organisation.
  • Tools and approaches used in the acute hospital sector can be adapted for use in mental health care, including in community settings.
  • Success is most likely when there is fidelity to the chosen improvement method, and a sustained commitment over time.
  • The strong emphasis on co-production and service user involvement in mental health can be harnessed as a powerful asset in quality improvement work.

Policy implications

  • Regulators and other national bodies need to ensure that they operate in a way that allows quality improvement to thrive in local organisations.
  • NHS England and NHS Improvement have an important role to play in helping mental health providers to share good practice on quality improvement and connecting organisations with each other.

    Comments

    Sanjana Jio

    Position
    Public health lead,
    Organisation
    Wandsworth council
    Comment date
    26 July 2017
    Thanks please send any quality related emails to me .

    Anna Waters

    Position
    Digital Communications Assistant,
    Organisation
    The Kings Fund
    Comment date
    26 July 2017
    Hi Sanjana, you can sign up to receive emails here: https://www.kingsfund.org.uk/about-us/get-latest-news-kings-fund.
    Anna

    Chris Glynn

    Position
    Volunteer,
    Organisation
    The Childrens Society
    Comment date
    26 July 2017
    We are working locally with Forward Thinking Birmungham to improve outcomes for Muslim youth, focusing on co-production. Faith and ethnicity seem to impact on access and take up. Not an issue in your report do you have observations that might assist or could you signpost references.
    Thanks

    Dorothy Frizelle

    Position
    Consultant Clinical Psychologist,
    Organisation
    Mid Yorkshire NHS Trust
    Comment date
    26 July 2017
    I think the key issue here is collaboration and partnership working to prevent service 'improvements' falling into the realms of chaos and competition. The IAPT into LTC pilot pathways are a prime example of how an extremely laudable idea (improving psychological care for more patients) can generate waste by having a single-minded (NHS-E?) agenda of "deliver the service" without recourse to wider system, service, patient and organisation impact. Improvement isn't necessarily 'more' if 'more' is delivered in a fragmented, idiosyncratic and non-collaborative way

    Anna Waters

    Position
    Digital Communications Assistant,
    Organisation
    The Kings Fund
    Comment date
    26 July 2017
    Hi Chris, you might like to get in touch with our Information and Knowledge Services team, who can point you in the direction of further references: https://www.kingsfund.org.uk/library/got-question

    Nick Arkle

    Position
    MH nurse,
    Comment date
    26 July 2017
    Have you seen MH:2K Oldham A youth-led approach to exploring mental health. Similar issues raised.

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