Case Study - Avon and Wiltshire Mental Health Partnership NHS Trust

Workload solutions

Avon and Wiltshire Mental Health Partnership NHS Trust’s project, which drew to a close in October 2008, set out to devise new solutions to the workload of its senior house officers (SHO)/F2s.

The trust wanted to analyse and change their way of working to establish which tasks could be performed by others and aim to have more than one type of professional to undertake most of the tasks performed by SHO/F2s. The pilot work helped the trust to ‘reprofile’ the work of the SHO/F2s by establishing new rotas, policies and pathways.

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Ultimately, one of the main things we learnt from the project was that junior doctors’ time could be used more efficiently and we have taken steps to address that and made changes to optimise their efficiency for the benefits of service users.
Dr Christine Vize

The trust also wanted to reduce the junior doctor call outs to a minimum whilst improving the quality and timeliness of interventions to service users. The project was carried out with safety in mind.

“We started to analyse how we worked. We carried out an audit of all the calls that junior doctors were expected to answer, we looked at our protocols and our triage systems to make sure that doctors would not be called out spuriously and we audited their activity both during the day and at night.”

During the pilot, the trust found that junior doctors were being called out unnecessarily. Dr Vize says the pilot helped the trust to realise new ways of working, including the development of ‘patient group directions’ which allowed nurses who had been appropriately trained to administer certain medications so that the trust’s doctors were not called on to prescribe and sign off all drugs, thus improving the quality and timeliness of interventions. She said: “Ultimately, one of the main things we learnt from the project was that junior doctors’ time could be used more efficiently and we have taken steps to address that and made changes to optimise their efficiency for the benefits of service users.”

Dr Vize says that she would encourage all trusts to carry out a detailed audit of the working patterns of their junior doctors to inform more efficient practices to help become WTD compliant, she said: “Any plans or decisions around changes in working practices should not be made in isolation as changes made in one area of the service are likely to have a direct impact on other roles and services that already exist in the trust.”

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