Celebrating 2 years of Improving Access to Services Collaboration!

The improving access to services learning system was formed in March 2015. The aim of the learning system has been to bring together quality improvement projects from across the trust working on:

• Reducing Wait Times – Average days from referral accepted to first face-to-face contact
• Reducing DNA Rates – DNAs (Did Not Attend) before first face-to-face contact / total number of appointments booked (excluding cancellations)
• Increasing New Referrals – Total number of referrals received from external referrers (non-ELFT)

Over the past two years, the teams have tested out a variety of different change ideas with the aim to develop a change bundle that can be shared across the wider trust. The learning system has incorporated teams from two different Child & Adolescent Mental Health Services (CAMHS), Adult Community Mental Health Teams, services from Community Health Newham, Memory services and services from Children’s Community Health.

(This graphic shows all teams in the collaborative. Blue are current teams. Green previously involved in the learning system)

Initially these teams came together to meet every six weeks for a learning set, which later transitioned to a six weekly WebEx (web conference), both joined by the learning system’s executive sponsor. All teams would be represented on the WebEx and a couple of projects were asked to present their learning during the calls. The learning sets often focused on specific topics for example; process mapping, text message reminders and implementation. The primary focus was to provide opportunities for teams to connect, share ideas and support each other with overcoming challenges and potential barriers.

Outside of these six weekly learning sets the teams committed to meeting regularly as a project team to focus on their project with support from the QI Lead and tested a variety of change ideas. In addition the learning system developed a bundle of measures and developed an ‘access to services’ dashboard. This dashboard is shared with the services and project teams on a monthly basis and included control charts on the three measures listed above. This provided the teams with an easy way to observe and understand variation in their system and see whether the changes resulted in improvements.

To date the teams have achieved some remarkable results. Across the aggregated teams within the learning system we have seen a 19% reduction in average wait times despite an increase in demand and a 26% increase in the number of new referrals (see figure 1). In addition the teams have achieved an incredible 40% reduction in first face to face DNAs (see figure 1). Almost all of the teams have seen an improvement in one or more of the three measures. (see figure 2)

Figure 1

Figure 2