Leeds and York Partnership NHS Foundation Trust is leading a piece of work to improve patient experience, reduce out of area treatments and save £1.5 million for the Leeds health system.
Until recently, around 10 mental health patients per month were being treated away from their local area due to a lack of capacity in the Leeds health and social care system. These people effectively get stuck in the system (i.e. waiting to be discharged, transferred or to access another service) and because they have an urgent mental health need, they are being transferred out of West Yorkshire area – sometimes as far as the south coast of England. These patients are receiving a poorer patient experience which can affect their recovery and this must stop.
The Leeds Mental Health Flow aims to deliver radical, system-wide, sustainable change to improve quality of care for patients, improve patient experience and improve the system that supports this. We started this improvement journey in September 2016 with a four day rapid improvement event with around 40 clinicians, health workers and managers from across the Leeds health and social care system.
The following work streams were established following the first rapid improvement event:
1. Community Mental Health Team criteria
2. Safety Culture
3. Purposeful interventions
4. Variation of Length of Stay
We’ve since held review events as 30 days and 60 days, and, on 24 January, we reached our 90 day review – which marked the end of the official rapid improvement process but is certainly not the end of the road for the work we’ve started.
Has this process made a difference? The simple answer is – yes it has!
The full data pack is available online (link: http://www.leedsandyorkpft.nhs.uk/_documentbank/Leeds_Mental_Health_Flow___90_day_review_data_slides.pdf), but in summary: Length of stay: great news here! Our average length of stay has reduced from 48 to 41 days – meaning people are now spending a week less in hospital than they were compared to a year ago.
Variation has decreased significantly as well.
Admissions: there’s nothing out of the ordinary to report apart from a slight increase in the average number of admissions – perhaps due to the increase in capacity we’ve created but that’s not verified.
Discharges: we’ve reduced the variance of the number of people we are discharging. One of the reasons for this we feel is the implementation of our Purposeful Inpatient Admission (PIPA) process, which aims to reduce variation in clinical practice across our services.
Occupied bed days: more great news. Over the last year, we’ve gone from using 103 of our 105 adult acute beds on average, to averaging 98 since October last year. This means we are nearly at the nationally-recognised optimum rate of 85% bed occupancy.
Out of area placements: have seen a massive reduction. We are now consistently below an average of five service users placed out of area since October 2016 – the best we’ve seen for two years if not longer.
Interested? Want to know more?
Visit the Leeds Mental Health Flow page (http://www.leedsandyorkpft.nhs.uk/professionals/Leeds_Mental_Health_Flow). Contact our Rapid Improvement Team on 0113 85 56713 or [email protected] or join the conversation on Twitter using #LeedsMentalHealth