Mental Health Act Administration Rapid Process Improvement Workshop

Mental Health Act Administration Rapid Process Improvement Workshop Final Report Our Process Owner verandern

Purpose of the RPIW Objective • To improve the and in the delivery of the MHA Admin process to assist the Service User on their recovery journey

Purpose of the RPIW Targets • To continue to ensure service users are being lawfully detained under the act and lawfully treated • Ensuring service users/nearest relative receive information on their rights and the support required in understanding them • Carers have easy access to MHA information • To reduce burden and stress levels within the MHA Admin team and to improve team wellbeing • Improving working relationships with clinical colleagues and other stakeholders

Current State View Demand • Service users don’t always understand their rights • Carers don’t have easy access to MHA information and 132 rights

Current State View Themes • Over processing • 44+ versions of checklists including locally edited checklists • Letters manually created Swim lane diagram showing process for S 2 and S 3 • High level of interruptions • Increase in the use of the MHA

Mental Health Act Administrator Network SOADS Solicitors Ministry of Justice Tribunal Service CQC Carers Mental Health Act Administrators Clinicians Others Community Teams Nurses MHARMS Care Co-ordinators Inpatient Units Social Workers Pharmacists Advocacy GP’s Service Users Clinical Commissioning Group

Current State View • Burden • Manual processes • Overworked and frustrated • Working in isolation/local silos • Reluctant to ask wider MHA team for help with workload • Good collaboration with local clinical staff and other stakeholders • Felt valued by clinical staff

Ideas and key themes for improvement The ideas: • Patient and Carers • Technology • Team structure/development

Ideas and key themes for improvement Service users and Carers • Adding questions to the agenda of service user meetings to identify who would like support around detention • Review the leaflet content for informal service users, of all ages, on admission to an inpatient unit • Identify carer forums to provide resource and information regarding the MHA • Identify if HCC will share their nearest relative rights leaflet with SHFT, to allow SHFT to pass them onto carers who were not available at the time of detention

Service users and Carers • To organise a steering group including service users and carers to review the Trust website and agree improvements to provide easy access to MHA information • Monitor usage of MHA page on the Trust website with the view to understand demand with the potential to install kiosks into inpatient units • To review the effectiveness of the Trust’s S 132 rights policy: • including the intervals for the different types of sections • review the checklist used by staff

Technology & RIO Within 30 days: • Clarification if documents can be uploaded onto RIO e. g correspondence, clinical reports - complete • All MHA admin staff to have access to all generic NHS. net accounts in progress • Review, reduce and minimise current checklists (44+) • Content in the MHA page of the staff intranet to be reviewed and updated to include an FAQ for staff and templates etc • Review the content within the patient information leaflets • Continue discussions with Thalamos and other suppliers • To make contact with other Trusts

Technology & RIO 60 – 90 days: • All MHA team letters to be added to RIO to become Editable letters • Create Mental Health service panel on RIO (within case record) • S 132 & S 17 leave to be added to RIO • KP 90 National return to be pulled from RIO and not manually • To identify potential IT solutions for the checklist process • Electronic systems in place to populate weekly spreadsheets which are currently completed manually by staff • Report proforma added to Rio for (tribunal, manager and court reports)

Technology & RIO 90 + Days • To liaise with RIO Development team to identify the options for statutory papers to be added to RIO • To explore the use of tableau to disseminate information to teams to reduce the use of spreadsheets and to also share information to allow teams to self serve • Review Standard Operating Procedure to incorporate technological changes

Team structure/development • One corporate team locally based • Shared responsibility - Protected admin time + quality • Greater focus on knowledge sharing for staff, patients and carers • Subject experts – support through education – MH diploma • Career path • New leadership structure • MHA link to legal team

Team structure/development 30 days • To arrange and hold a extraordinary QI meeting for the whole MHA Admin team • Reviewing all job descriptions • Review team structure • Review team name • Out of hours cover • To identify centres of excellence and team members to visit • To commence dialog to have MHA team to be directly linked to SHFT legal team – In progress • Funding authorising for MHA Diploma for band 5 and optional for band 4 – In progress • Develop apprenticeship role with HR • New daily work flow process • Create a timetable for all team members to walk a day in each others shoes

Team structure/development 60 – 90 days • Commence training with nurses and doctors • To review geographical work allocations • To have visited with other Trusts

Outline Implementation Plan Key aspects of plan • To gain Sponsors/process owner support to explore technology options and accredited training • Support from the MHA team to implement and carry forward our new way of working • Work with Service User and Carers in order to improve and enhance patient experience with better access to MHA related information

Elmleigh Parklands QA hospital Melbury Lodge Antelope House Ravenswood Western Community Hospital One corporate team locally based Gosport War Memorial Tatchbury HHFT Corporate office

Reflections Andrew Jackman MHA Team Lesley Valerie

The RPIW Team

• Clare • Nathan • Valerie, Andrew & Lesley • Thalamos • The whole MHA team • Russell • QI Facilitators • Siven and Mayura • Emma Louise & Tom To: • And finally to the wider team holding the fort back in our teams and trusting us to take this forward

Sponsor Comments / Conclusions