Tees, Esk & Wear Valleys NHS Trust and Avon & Wiltshire NHS Trust

New approaches to team working handover and escalation by in mental health trusts

Overview

This pilot is a joint project between two mental health trusts; Avon and Wiltshire Mental Health Partnership NHS Trust and Tees, Esk and Wear Valleys NHS Trust. The joint bid was inspired by the realisation that work done in the acute sector to ensure compliance with WTD 2009 is not applicable to mental health. Mental health inpatient units are often small, and may be a considerable distance from the nearest general hospital. There are small numbers of senior house officers (SHOs) on rotas and no options such as cross cover between different specialities. This joint pilot presents proposals for a service in line with modern mental health practice which will deal with the difficulty of matching the training and experience of junior doctors and compliance to WTD 2009 and builds on the experience of both trusts in developing New Ways of Working (NWW).

Organisational background

Challenges

Specific objectives of the pilot

• Re-profile the work of the SHOs and F2 doctors on the inpatient unit to be compliant with WTD 2009
• Eestablish at each site an inpatient continuity team which is multidisciplinary and provides overlapping skill sets
• Extend the range of work carried out by other professionals
• Integrate SHOs more comprehensively into a multidisciplinary inpatient team
• Improve working practices, timeliness of response and communication.
• Improve patient safety and satisfaction on the inpatient unit.
• Improve working practices on the inpatient unit to utilise the hours of doctors in training to provide a better training experience.

Delivering compliance

• Compliance with WTD 2009 and New Deal which is cost neutral or offers savings
• A sustainable and demonstrable reduction in the workload of SHOs
• Development of a more flexible inpatient workforce better able to meet patient needs
• Better integration of SHOs into the multi-disciplinary team
• Use of established networks to disseminate learning to the wider NHS
• Twin site approach to maximise support and minimise risk
• Joint pilot reduces risk, enhances learning and increases the validity of results.

The pilot started in July 2006 and is will be complete in July 2007.

Resources

Final Report

Evaluation questionnaire

Appendix A - Organisation chart
Appendix D - Protocol for involvement of duty doctor
Appendix E - Briefing paper
Appendix F - Inpatient acute care pathway
Appendix G - Inpatient swim lanes
Appendix H - Skills development package
Appendix I - Project programme
Appendix I - Training package 1
Appendix I - Training package 2
Appendix J - Results of the day ward
Appendix K - Crisis operational policy
Appendix L - Project terms of reference
Appendix L - Redesign of services for adults of working age
Appendix M - Skills for Health - Workforce Projects Team evaluation report
Appendix N - Evaluation questionnaire results