Page 24 - QARANC Vol 18 No 2 2020

22 The Gazette QARANC Association
To quote the phrase ‘Governance is everyone’s responsibility’ the attitude of shared responsibility has been spread across the whole team. This has created a working environment that is very team focused; with everyone having an active role, which feels empowering and part of the change. Management are no longer solely responsible but instead are the overarching support for staff to develop and assure the work is being completed as required.
In addition to the change in organisational culture, the DCMH worked with the Regional Clinical Director (RCD), Colonel Geoff Hall, to create a new model and way of working. The whole team was involved in this process, with group discussions and collating feedback part of the plan. The new model (Table 2) splits the team into assessment or treatment focused clinicians. The aim of this is to enable a clinician’s focus to switch to meet the nature of the fluctuating demand. Clinicians in the assessment team, overseen by Captain Stone, triage new referrals, complete initial assessments, provide stabilisation and complete Low Intensity Psychological Therapy (LIPT). This increases capacity for the treatment team to work on reviewing patients on waiting lists, which is largely done by Sergeant Strickland, group therapy interventions and delivering High Intensity Psychological Therapy (HIPT) to complex patients.
Previously, clinicians would take on a mix of roles and responsibilities across assessment and treatment. This made oversight of staff caseloads more complex, which could at times become confusing and increase the possibility of errors being made. Patients placed on waiting lists would be monitored by Medical Officers (MOs) rather than the DCMH, until allocated to a clinician so oversight of any changing need or risk was not clear. The new model allows for a more streamlined care pathway in which patients on a waiting list are monitored more regularly to reduce risk and are seen for therapy much quicker - a ground-breaking quality improvement. Management have oversight of these teams and can move clinicians where necessary to meet the changing demand. The new model has been in place since March 2020 and improvements to waiting times and patient experience have already been observed.
Of course, it would be remiss of us
New working model
not to mention Covid-19. Although some of this work started prior to ‘lockdown’ much of it has happened whilst staff were also adjusting to new ways of working under rapidly changing government guidelines. During this period, we did not see a reduction in referrals but there was a noticeable change from emphasis on routine to crisis work being conducted. This meant it was ‘business as usual’ with the addition of designated rooms for seeing patients face to face, switching to using telephones to triage new assessments and monitor those on waiting lists for therapy, groups moved to 1:1 work to ensure any treatment that had been started continued and staff provided treatment over a new technology platform, ‘Attend Anywhere’. Flexibility was required to manage those staff who had to work remotely in order to continue meeting the needs of the referrals. At times it has felt like operational tempo working but overall many staff are citing that they are more productive with flexible
working as it further increases their autonomy and morale.
So, to the future; we can’t predict what future changes and restrictions will be on our working practices due to Covid-19, however we are confident that the team we have are dedicated, hard working individuals who will continue to give all we ask of them at this difficult time. What we can predict is that in August we will move into a brand-new purpose-built building in Bulford. This will be shared with the Regional Recovery Unit (RRU) and Regional Occupational Health Team (ROHT), which will further strengthen our working relationship with them and make for a better patient experience. Despite what 2020 has delivered so far, as we look forward, we feel confident we can continue to look after our staff and that patients will continue to receive excellent care.
Sergeant K Strickland, RN(MH) Captain J Stone, RN(MH)