Local implementation of the crisis model: The Buckinghamshire community acute service

Abstract

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 ref errers ahead of old demarcations and practices has enabled a more flexible and responsive service to develop and grow.