SMI Project shortlisted for HSJ Patient Safety Award

A quality improvement team based in Luton have been shortlisted for a prestigious HSJ patient safety award, in the category of Improving Health Outcomes for Minority Ethnic Communities. The team have increased engagement of Black, Asian and Minority Ethnic service users with severe mental illness (SMI) in their physical health checks by 40%, over a 16-month period.  

What was the aim of the project and why is it important?

The team aimed to identify Black, Asian and Minority Ethnic service users on Hatters Health Primary Care Network (PCN) SMI register who have not engaged with primary care mental health service for the last 2 years, and improve on engagement and uptake of biopsychosocial intervention to 80%. These reviews play a crucial role in supporting the health and well-being of service users. When the team began their project, there was a low uptake within this specific demographic. 

What was the theory of change for the work, and what change ideas have been implemented?

Figure 1: The project team’s theory of change, represented as a Driver Diagram. 

The theory of change for the work can be seen in Figure 1. The team revised their health check process, using Plan Do Study Act (PDSA) cycles to test the effectiveness of onwards referrals, and created a new engagement process. The change ideas that the team have gone on to implement include providing appointment information and reminders in a variety of methods, and offering practice of preference and home visits.  

What measures did the team use to see the impact of their changes?

The team looked at the percentage of SMI Minority Ethnic Service users that have received an SMI review, that had not been seen since September 2020 (Figure 2). Figure 2: Cumulative Percentage of SMI Minority Ethnic Service Users that have received an SMI review, that had not been seen in the previous 2 years (P Chart)

They also worked with GP practices across Hatters Health PCN to analyse their complete SMI register, providing the chart seen in Figure 3. As part of the Quality Control for this work, the team aim to review this measure every six months, to ensure their results are sustained.

Figure 3: Percentage of Hatters Health SMI service users that have engaged with the service in two years

What learning did the team take away and what is next?

The team learnt that changes to processes should be specific to cultural backgrounds of service users, and leaflets and letters should be published in different languages. They also realised the importance of ensuring GP surgeries hold correct ethnicity data on service users. The team are currently spreading these interventions across other Primary Care Networks within Luton and Bedfordshire.

Figure 4: The Quality Improvement Team

For more information on the work, contact the Service Manager and Transformation Lead for Luton Community Mental Health Services, Trudy Wrake (trudy.wrake@nhs.net).

We wish the team the best of luck in the next round of judging in July, as they present to a panel comprising of experts and industry specialists within the healthcare sector.