Winner: South Staffordshire Healthcare trust Towards Effective Mental Health Day Services Contact: Theresa Moyes, tel: 01785-272560 A three-year project to transform a mental health day unit. Audit found the traditional, hospital-based unit had no focus. Attendance was high, but it had few referrals and many attenders had no definable continuing mental health needs.

Staff experienced poor morale and high sickness rates. The aim was to create a modern, community-based unit within a strategic framework to ensure it delivered effective therapeutic services, to put clinical governance at the heart of the new service and address staff morale.

Management

The new role of clinical development manager was identified to take the overall lead. An early strategy grew out of service audits in consultation with a multi-agency steering group. This was tied to operations - support staff, clinical staff and senior managers were all involved in setting and achieving objectives.

Innovations and successes

This project aimed to develop clinical pathways based on clear clinical reasoning, provide a team support worker to work with all clinical staff so they could develop audit and evaluation skills and encourage a team culture. Nonevidenced interventions have been phased out and new interventions added. Costs have been kept down by down-sizing the team, planning service needs on an individual basis and moving into a quality community location. Sickness was reduced by 24 per cent by the end of year one and an 800 per cent increase in referrals was achieved by year three.

The judges said: We were particularly struck by the way this project has made a real impact on the nature and quality of care provided to patients and service users. In the three years since it was formed, the team has turned around the culture and practice of a traditional mental health day unit, which is no mean feat. Having achieved these improvements, the team is continuing to develop its services, focusing now on providing services for inpatient wards in the trust.

Runner-up: Hammersmith Hospitals trust

Project: Cyber-cafe development Contact: Eleanor Murray, tel: 020-8383 3377 To provide free and easy access to the intranet and Internet for patients and staff at Hammersmith Hospitals trust, complementing plans to meet targets set in the Information Strategy for the Modern NHS 1998-2005. Two cyber cafes have been set up in the staff/public canteens at Charing Cross and Hammersmith hospitals. Further cafes are planned for other units and public areas.

Management

The trust has appointed a trainer to ensure the cyber cafe is always functioning correctly.

Special software has been used to analyse which sites are visited and how long people spend on them. Kiosk Manager software also prevents access to offensive sites.

Innovations and successes

Unlike similar projects, the cyber cafes provide free access to the Internet and do not limit this to particular sites.

Staff are encouraged to use their breaks to 'surf ' as this develops useful skills. Feedback forms indicate staff are able to find answers to questions quickly and efficiently over the net.

Cancer patients have used email and chat rooms to make contact with other patients. Visitors from overseas have been able to find accommodation and hire cars.

The judges said: An exciting and innovative project that is spreading fast through the local health economy. Meticulous attention has been paid to the detailed needs of users. We were particularly impressed by the flexibility of the trainer. Our only reservation was our uncertainty about the impact of the project on clinical behaviour and outcomes.

Runner-up: North Mersey Community trust

Project: Fundamentally Modern - Radically Different: a centrally integrated, one-stop clinical governance facility Contact: Ian Porter, tel: 0151-250 6174 The 'Radical' department and resource centre is a central, onestop clinical governance facility.

It provides a 'gateway to governance' for mental health and primary and community services within the trust.

Management

An open and transformational leadership style has been adopted. There are fortnightly Radical surgeries, which are a single-access point for project proposals and requests for assistance. A whole-team approach is taken to considering proposals and a project management pathway has been developed to ensure high-quality support is given throughout the stages of the project cycle.

Innovations and successes

This may be the only integrated clinical governance facility of its kind in the UK. The centre produces the trust's clinical governance development plans and coordinates its clinical governance committee structure. It has designed and conducted a number of development, evaluation and implementation projects, including the Questioning Quality project in mental health, commended by the national Clinical Governance Support Team. It has also developed toolkits to enable appraisal of its own work, and been successfully assessed by Investors In People.

Awareness of its work is spread through trust induction days, road shows and newsletters.

The judges said: The enthusiasm and energy of the Radical team have clearly made a huge contribution to the implementation of clinical governance across the trust. We were impressed by the balance they have achieved between national quality improvement priorities and encouraging and supporting smaller projects that motivate enthusiastic individuals.