Hampshire Partnership NHS Foundation Trust
To improve awareness and compliance across the Trust for historical guidelines, and new guidelines within more strictly managed timescales, with a view to being ready for PbR tariffs being introduced into Mental Health.
Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?
Aims and objectives
The Hampshire Partnership NHS Trust gained Foundation Trust status in April 2009. Its services are provided via Adult Mental Health, Older Persons Mental Health, Specialised Services (including CAMHS and Forensic services), Learning Disabilities and Social Care directorates. Indications are that PbR tariffs will be introduced in mental health trusts in the relatively near future, and that NICE will feature heavily in the commissioner's criteria for selecting and commissioning services. With this in mind, we decided to focus on improving the system by which the NICE guidelines were implemented and disseminated across the trust. Thus, helping clinical champions and steering groups to influence change at directorate level. 1. To increase the number of guidelines implemented trust-wide, increasing each localities awareness of their own compliance and progress. 2. To help the clinical champions and steering groups influence change that has a positive effect on trust staff working with patients, therefore improving service user and carer experience. 3. To improve the monitoring and feedback system to enable the trust management team to be better informed of the trusts progress of implementing NICE guidance.
Reasons for implementing your project
We reviewed current practice, systems and approach to implementation. We found that implementation and compliance were patchy dependant on the directorate or areas the clinical champion worked in and the cross directorate membership of the steering groups. (The Clinical Champion is a prominent figure who leads on an individual piece of NICE guidance. They develop an implementation framework for the guidance outlining the key requirements for the Trust, with support from the trust NICE Lead, identifying where the Trust complies with the recommendations outlined in the guidance and where actions are needed. The actions taken to implement the recommendations may include; a guideline specific workshop, self assessment tools, clinical audit, or the establishment of a Steering Group.) In order to effect change across such a wide geographical area it was evident that a multi-tiered approach would be required. This would need to include discussion and buy-in from each directorate and each locality, getting them to focus on the guidelines which were key to the services that they were commissioned to provide.
How did you implement the project
1. Each directorate clinical governance group has highlighted the key guidelines for their directorate. 2. Each locality/service has identified the top 5 guidelines that they feel they must focus on first within their services to best meet their service users needs. 3. A database of recommendations has been compiled to assist localities in assessing their compliance and areas requiring attention. 4. Increased awareness of NICE guidelines and implementation amongst trust staff across all areas. 5. Clinical Champions have an improved system to gather information, monitor implementation progress and a platform form from which to disseminate information.
A Trust reporting format has been developed, which enables the NICE Lead to more easily track and influence the progress of implementation. A report format has been used to inform various committees (trust's management team, clinical governance and risk, and NICE) of implementation progress, exception reports and costings, etc.. The Trust's Clinical audit programme is used to monitor compliance against NICE recommendations. The NICE Lead meets regularly with clinical champions and attends steering groups to assist in influencing change. Directorate clinical governance and locality/service management teams now monitor NICE implementation regularly.
Key learning points
- Use a multi-tiered approach to best increase the profile and awareness therefore increasing buy-in. - Inform everyone of upcoming initiatives which will impact on their services and help develop buy-in; e.g. PbR - Ensure monitoring and feedback systems are in place to track improvements, and consistently promote advancement. - Do all this in manageable chunks rather than a whole cake approach, breaking things down. This helps everyone focus better.
Trust NICE Lead, Medical Device Lead, Project Manager
Hampshire Partnership NHS Foundation Trust
Is the example industry-sponsored in any way?