Category: High-impact changes in mental health

Winner: People using specialist eating disorders service by improving flow

Contact: Ruth Carson, tel 0151 4717751

E-mail: Ruth.Carson@merseycare.nhs.uk

A year ago at theLiverpooland Sefton Eating Disorders Service, part of the Merseycare trust Eating Disorder Clinic, clients could expect to wait 33 weeks or more for an appointment.

Clients and staff were keen to decrease this wait time and increase the efficiency of the clinics. The unit has up to 400 clients on its books at any one time.

Ruth Carson, who heads up the unit, says: "People have often had an eating disorder for a considerable length of time before they seek help. They have often reached a crisis point or are at a stage when they are motivated to make change. To then wait a year was unacceptable."

The unit could not find out why waiting times were so long. Ruth explains that the unit then responded to the Be Responsive regional programme run by CSIP North West. This programme was developed to improve choice and access in mental health services. Julie Clark, CSIP service improvement lead for theNorth West,became involved and, as Ruth puts it, "reined us in".

Improving processes

Together, Julie and the team looked at their administrative processes, how clinics were being run and organised and came up with simple changes that could be made to reduce waiting times for clients and increase clinic efficiency.

Therapists who had always worked autonomously centralised paperwork and the team now employs a secretary to handle administration. Ruth says: "We also meet people's needs better for maintenance (shorter sessions) and group therapy interventions."

Despite the simplicity of the changes, Ruth acknowledges they have not been easy for staff to make. "It's difficult to let go of things sometimes," she says.

But now the eating disorders unit has reduced its waiting time and a new obesity clinic has been set up.

"It's made such a difference," continues Ruth. "The trust has supported the work and has pledged to take some of the changes on board at a wider level."

Ruth says the team will use the Positive Practice Awards money to target problem areas that this work has helped identify, rather than offering more of the same.

Julie Clark says: "It's been wonderful to see the difference this work has made. The staff had been trying really hard to sort out their waiting lists, but sometimes it is hard to know what to do next. I helped them to take a step back, look at the whole picture, and then used their detailed knowledge to work out what could be done differently."