Improving personality disorder care across mental health services: a system-wide approach

Abstract

Improving personality disorder (PD) care across a healthcare system is an important but complex task and one that has been endeavoured by many organisations. Oxford Health National Health Service (NHS) Foundation Trust recently received funding from the NHS Long Term Plan's Community Mental Health Framework to improve PD care across Buckinghamshire mental health services. Therefore, Oxford Healthcare Improvement performed a system-wide diagnostic assessment of gaps in the provision of care for patients with PD and produced a list of recommendations to aid future improvement work. We used a robust and systematic approach that included, a range of quality improvement methods, the mapping of patient pathways, collection of quantitative data on the utilisation of these pathways and focus groups with staff, patients and carers. This paper summarises our mixed-method approach to show how the first stage of improving a complex mental health system could be approached. It also outlines potential areas for improvement associated with the care and treatment of patients with PD and change ideas to address these areas. These include, ensuring a specialised approach to triage and assessment for patients with PD, upskilling the workforce across the system and utilising a variety of evidence-based practices to best support the range of patient needs. As well as introducing a leadership structure to ensure and support improvement work associated with PD care and treatment. We believe our methodological approach could be used beyond improving PD care and we hope that sharing our methods will aid organisations when approaching system-wide improvement work.