Change and Transformation in the Public Sector Finalist 2022: Moorhouse Consulting with Oxleas

Change and Transformation in the Public Sector

The pandemic has placed huge tolls on our nation’s mental wellbeing, causing a significant rise of people presenting at A&E requiring specialist mental health care.

By June 2021 the pressure on Oxleas NHS Foundation Trust had become critical. The rise in demand of adults requiring admission outstripped the number of beds available.

Moorhouse undertook an in-depth diagnostic to help understand factors that could improve the situation. Spending time on wards, listening to staff and reviewing data, we uncovered significant differences in cultural and operational practices across their three hospital sites.

Patients were being kept in hospital beyond the dates when they were clinically ready for discharge due to planning and team working challenges. Aligning to best practice offered the opportunity to release an additional 30% bed capacity.

Our understanding of the underlying cultural and operational issues helped us to reframe the problem with the leadership teams and gave them the confidence to allow us to design and deliver a bespoke ten-week improvement project with their frontline staff.

Our approach of embedding our team with NHS staff on the wards, combined with a blended team approach with one-to-one buddying and development of clinician change-agents, allowed us to build trust and energy to deliver substantial improvement at pace.

Measurable outcomes included a reduction in average length-of-stay by 25% (9-days). For patients this meant fewer non-clinical delays, allowing them to get home quicker to continue their recovery.

More timely discharge also released capacity meaning the Trust needed to rely less on beds purchased from private hospitals outside of Southeast London. The average number of patients staying in private beds fell from 35 to 20 per month keeping patients closer to their homes and support networks. The indicative saving to the Trust was £212k each month.

The new working practices have given NHS staff more time to focus on patient care. The improvement journey has delivered a growth in capability and confidence to deliver sustainable and continual improvement.

Client feedback:

“It speeds up the discharge of patients…we are getting the support needed from the other teams that are not on the ward with us because they are aware of what is going on” – Staff Nurse

“I like the way we are working together across the different sites with different teams. We are seeing progress and we now have a system that works… together as a whole Trust” – Matron

“The benefits are there for all to see…it gives us more time to spend on the wards with our patients” – Charge Nurse

“They displayed an intellect and interpersonal warmth which meant they were able to rapidly engage and motivate colleagues. They fired colleagues’ imagination and desire to strive for ongoing continuous improvement. They have set us off on a journey which we feel very confident we will be able to build upon.”

– Ify Okocha, CEO and Iain Dimond, COO

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