Quality Improvement in Newham

Dr Dudley Manns – Clinical Director for Adult Mental Health, Newham

Dr Dudley Manns, Clinical Director for Newham Adult Mental Health Services, and a QI Sponsor, writes about the journey his Directorate have been on with quality improvement over the last few years.

The Quality Improvement journey in adult mental health services began in Newham in 2014 with three of our Directorate Management Team completing Wave 1 Improvement Science in Action training. The training was very well-received, leaving our colleagues inspired and energised. The first of a series of highly effective psychology/access QI projects was launched and an important project addressing healthy eating and lifestyle commenced on our inpatient unit.

As a directorate we made substantial gains in relation to the food on offer in our inpatient canteen, a range of physical health activities for inpatients was developed and waiting times for psychological therapies began to stabilise. Early learnings for the directorate were that QI projects underpinned by regular project team meetings and with strong leadership have the potential to enthuse teams to innovate in relation to the care they deliver. We were constrained by having so few QI-trained individuals and directorate infrastructure around our QI work was fragile. Unfortunately our healthy eating and lifestyle project faltered when the project lead moved on to a new post; it must be said that one ongoing challenge which we face is how to keep up project momentum when our clinical teams are so busy. Active project coaching and sponsorship have been key and it is notable that projects with actively engaged service users and carers tend to thrive, retaining their focus and energy.

Quality Improvement in Newham has substantially developed over the past three years. Individuals from all of our inpatient and community teams have accessed QI training and coaches from a range of professional backgrounds have played a pivotal role in the development of QI work in the directorate. Projects addressing patient experience, recovery pathways, violence reduction, managing demand and capacity, service configuration have blossomed in the directorate. Our directorate QI forum has evolved and now offers rotating slots for the regular showcasing and review of our projects in addition to space for discussion of new QI ideas. The forum is well attended by our DMT and provides a strong foundation for our QI work.

The way in which we have involved service users and carers in our QI work continues to evolve; service user representation at our monthly QI forum has given an alternate perspective and generated new ideas, which has assisted us in our planning of a QI strategy within the directorate.

Over and above the gains in quality achieved through individual projects, QI now underpins our strategy and approach as a Directorate Management Team and has given us a an extremely helpful framework for approaching our performance and quality challenges alongside wider strategy. Our Psychology Lead and QI coach led on the innovative incorporation of QI into Trainee Clinical Psychologists’ Service Related Research Projects and this is another example of how QI has become an integral part of our work within the Directorate.

Our award-winning Newham Quality Improvement Wall, completed earlier this year by our service users & carers in collaboration with a local artist, is a powerful visual representation of the pride that is felt by our directorate and QI team and the achievements made over the past three years.

Newham Quality Improvement wall