Driving improvement in South West London mental health

Source: NHE July/August 2018

David Bradley, chief executive of South West London and St George’s Mental Health NHS Trust (SWLSTG), discusses the improvements and collaboration his trust has been involved with. 

Effective partnership working – including trusts joining up to improve care and value – is a major goal across the NHS. The CQC praised one such example in its recent inspection report for SWLSTG – which rated the trust ‘good’ across all five domains inspected. 

Inspectors noted how the trust is outward-looking and engaged well with its external partners and stakeholders, and in particular its role in the South London Mental Health and Community Partnership (SLP) – and how this was supporting the introduction of new models of care.

The SLP is a collaboration between Oxleas NHS FT, South London and Maudsley NHS FT, and SWLSTG – between them delivering mental health services to a population of more than three million people. It brings together clinical expertise, experience and innovation, aiming to improve quality, use resources most effectively, and deliver best practice consistently to all patients.

I’m proud that the work SWLSTG has been doing as part of the SLP was recognised by the CQC. Our intention, from the beginning, has been to work with our partners to support the introduction of new models of care, as well as facilitating learning and creating synergies to maximise the use of our resources. By working in partnership we can deliver the very best care and outcomes for patients consistently across south London and beyond.

It’s been pleasing to see colleagues from other forward-thinking trusts get behind the ethos of working together to drive innovation and improved services.

During its first full year (2017-18) SLP made real progress in improving care, experience and outcomes for patients across south London, particularly in two key New Care Models programmes – Forensic and Tier 4 children and adolescent mental health services. A new joint forensic service was established, including a team to assess out-of-area patients, and a central ‘hub’ managing new referrals. Clinicians across the trusts worked together to develop and implement five new clinical pathways. 

This consistent south London-wide model is already delivering results for patients – and financial savings for the NHS. In total, 26% fewer patents were in out-of-area placements in March 2018 compared with a year ago. Just 18 new patients were placed outside the partnership – down from 84 in 2016-17. Some 60 patients were repatriated or stepped-down – more than double target.

Jeremy Walsh, SLP director, said: “This work has made a rapid impact on patient care. These patients were traditionally placed many miles away from home and families, often in the independent sector. We know community-based support and interventions deliver better outcomes. Our strategy is to reinvest savings into developing more effective local services.”

This approach underpins much of the SLP’s work. Delivering the right care, usually closer to patients’ homes and communities, is allied to clinical innovation, and achieving best value for money and smarter use of resources. This enables the partnership to reinvest savings in new, more effective community services.

However, effective, genuine partnership working can be an unfulfilled aspiration. The three trusts took a very clear approach, from the outset emphasising a partnership covering specific services and programmes.

Walsh said: “A culture of collaboration has been vital. From the CEOs to clinicians across services, operational staff and corporate functions, people have embraced a shared commitment to patient-centred planning and clinically-led change.” 

SLP work is delivering benefits in many other areas. Fewer children and young people are now placed in inpatient facilities outside the partnership area, and teams are developing innovative new community crisis care services and support for children and young people.  The SLP Nursing Development Programme has introduced consistent and standardised career pathways for more than 4,000 nursing staff across the trusts. Many are taking up on new learning and development opportunities, such as the 70 staff, previously Band 3 level, on the new Band 4 Nursing Associate programme.

Top image: David Anstiss 


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