Is a plan developed by the local Devon system. The things we need to do have been identified locally through a dialogue between users and professionals from all agencies. They have been informed by inspection reports of our local system and reinforced by our own findings. In addressing Devon’s issues we have built the national ‘must dos’ into our local plan. This is shown in the plan highlighted in yellow in Sections 3, 9a, 9b, 9c, 9d, 9f and 10. Is informed throughout by the and ideas of those with lived experience. Is focussed on improving care, outcomes and experience for people in Devon who are facing MH crisis. Is jointly owned by the public service organisations in Devon. While it is submitted by NEW Devon CCG on behalf of the Devon public service system, seeks to cover the whole of geographical Devon and those people who live on the geographical margins of Devon (recognising local reality). Will be continuously updated and improved. Covers principally those actions that can only be taken forward on a multi-agency basis. It does, however, refer to other work. Follows on from the Peninsula Declaration Statement of December 2014. ACTION TIMESCALE LED BY OUTCOMES / MEASURES / NOTES Essential pathway context for our work on MH Crisis The following pathway context was chosen for MH crisis, so that was a shared approach to action planning: Governance and guidance
Allocation of beds at times of crisis reflects people’s needs, not geography. Where conveyance is required it is in a non-stigmatising appropriate vehicle. Sound whole system improvement process and method 4 Map the crucial elements of the MH Crisis ‘As Is’ pathway, that requires multi-agency collaboration and delivery. Feb 15 to Mar 15 Gavin Thistlethwaite NEW Devon CCG MA MHACP WG A shared and clear understanding of the ‘As Is’ so that everyone knows what happens now, in order that improvement can be planned from a position of evidence. Populated with volume data and information so that priorities for quality improvement / cost reduction can be clearly seen. Illustrated with patient journey narratives. The diagram below shows the latest version of the MH Crisis part of the first part of the pathway – before ED (note that data / information points and patient journey narrative has been removed so that the ‘flow’ can be seen): 5 Develop the MH Crisis ‘To Be’ pathway (focussed on delivering value and eliminating waste); plan to implement it using PDSA; review and agree options for implementation. It may be decided to pilot in a specific location / geography, having taken advice from key stakeholders, including DPT, Primary Care and the Police. Mar 15 to Jun 15 (develop ‘To Be’ pathway) Jun 15 to end 16 (PDSA implementation) Thistlethwaite NEW Devon CCG MA MHACP WG A clear person-focussed view of a good pathway that delivers value without waste in MH Crisis. Into possible solution elements can be incorporated in a coherent and efficient way, avoiding the re-creation of an inefficient patchwork of ‘point solutions’. SMART Management and Information 6 Develop a clear set of SMART outcome and process measures – drawing in the Apr 15 to Sep 15 Gavin Thistlethwaite The work of the MA MHACP WG has already produced valuable perspectives on patient experience measures. In
best from work being done in other parts of the country (including the North West) – that can inform effective management. NEW Devon CCG MA MHACP WG parallel DPT has developed 5 specific measures. It is intended that, if possible, we will develop a single experience measure. See also 10 below. 7 Develop a Devon protocol for sharing information related to MH crisis quickly, safely and efficiently. Apr 15 to Sep 15 Gavin Thistlethwaite NEW CCG MA MHACP WG A protocol that enables information to be shared swiftly and efficiently – observing regulatory and governance requirements – so that good care is facilitated. Quick Wins 8 In order to deliver early change and build confidence, look ‘forward’ into prevention. Select a number of ‘quick win’ changes that are ‘upstream’ of measures addressing MH crisis, so that we can prevent Devon becoming solely reactive in its approach to crisis. Implement those changes using PDSA. Planning Apr 15 to Jun 15 Implementation Jul 15 to Dec 15 Gavin Thistlethwaite NEW Devon CCG MA MHACP WG Early success and confidence. The following are early candidates for quick wins: Vulnerable adults. Frequent callers and attenders. A single public POC. Compassionate friends. Complimentary systemic and systematic improvement 9 Consistent with a clear view of the Devon ‘To Be’ crisis pathway (see 5 above) plan and execute six prioritised changes in Devon that will make a significant difference to people in MH crisis (see below). Build and manage a goal-directed milestone-managed plan from this high level plan. Apr 15 to Apr 17 Apr 15 to May 15 MA MHACP WG Gavin Thistlethwaite A MH Crisis pathway that is efficient – focussed on people and value, with no waste. Programme management, control and assurance.