Psychiatric Bulletin (2009) 33: 252-254. doi: 10.1192/pb.bp.107.018499
© 2009 The Royal College of Psychiatrists
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Local implementation of the crisis model: the Buckinghamshire community acute service

Danny Allen, Consultant Psychiatrist

*Oxfordshire & Buckinghamshire Mental Health Partnership NHS Trust, Harlow House, Harlow Road, High Wycombe HP13 6AA, email: danny.allen{at}obmh.nhs.uk

Wendy Blaylock, Service Manager

Community Acute Service, Oxfordshire & Buckinghamshire Mental Health Partnership NHS Trust

Stefan Mieczkowski, Operations Management Consultant

Archipelago Healthcare Ltd, Sutton Scotney, Winchester

Declaration of interest

S.M. runs his own company, which works specifically with mental health services to improve their performance.

AIMS AND METHOD

Buckinghamshire crisis and home treatment team was struggling to meet its commissioned care episodes and found itself detached from community mental health teams (CMHTs) and acute day hospitals. An operations management consultant, using ‘lean’ principles developed in industry, worked alongside staff to redesign the service.

RESULTS

Improvements in staff capacity and ability contributed to more care episodes and reduced ward-stay times, compensating for the impact of a ward closure. Re-examination of individuals needs through case-review led to the development of ‘patient typing’, facilitating clear care pathways according to need. Finally, two proven modalities of community-based service were fused together.

CLINICAL IMPLICATIONS

Placing value to patients, carers and referrers ahead of old demarcations and practices has enabled a more flexible and responsive service to develop and grow.