Below you can view all the entries that made it into the Big Book of Best Practice 2022-23 which span multiple care groups.
Contact details for each project can be found within the entries below. For more information about the Big Book of Best Practice, email cwp.
Team: SORT-IT leadership team
Contact: jean.
What did we want to achieve?
The SORT-IT project had three key objectives:
- Use operational research methodologies within CWP to bring about service improvement and better delivery of care.
- Build multidisciplinary research and evaluation capacity by upskilling front-line staff, in line with the CWP research strategy.
CWP are the first NHS organisation to host the programme - share learning from CWP research with an international audience through publication in peer review journals.
What we did
An initial cohort of six colleagues from the children, young people and families and learning disabilities (LD), neuro-development disorder (NDD) and acquired brain injury (ABI) care groups was undertaken. This was supported by three senior CWP researchers and three experienced international SORT-IT academic clinicians. The papers covered topics relating to children and young people’s mental health services, physical health services and LD and NDD services. All studies have been submitted for publication, some are published, and results of the initial projects were fed back into the two care groups.
Results
The cohort papers were successfully submitted and published. Study findings have been used to make improvements in:
- Quality of children and young people’s autism assessments.
- Transitions for children and young people with learning disabilities to adult services.
- Pathways of care for children, young people and adults with learning disabilities.
- Development of novel therapeutic interventions for people with intellectual disability.
In addition:
- 18 CWP colleagues have been trained in operational research and writing for publication.
- 9 CWP colleagues have been trained to be SORT-IT faculty, to ensure sustainability.
Feedback from participants on the current cohort praised the value of being given the time and headspace to work through problems from the real world, as well as the quality of the programme.
Next steps
Results from the studies will be shared across research forums and services within CWP and the wider health and social care system, as well as publication in international research journals and presentation at conferences. The vision for the programme is to expand and grow the CWP research community, in line with research strategy. The internal faculty will continue to grow and work closely with research colleagues to promote and support operational research.
Team: Fitness and Wellbeing team
Contact: donna.
What did we want to achieve?
The aim of the outdoor cycling initiative has been to increase the activities on offer for service users during their time at Bowmere Hospital. It has allowed inpatient service users to access cycling outdoors with support from trained fitness staff to help improve their physical and mental health. The initiative is accessible to all inpatient services users, including acute adult mental health, rehabilitation, children and young people, and those with learning disabilities.
What we did
The fitness and wellbeing team worked alongside occupational therapy colleagues and wider teams to identify service users who were interested in cycling to improve their physical health and mental wellbeing. The fitness and wellbeing team has scheduled outdoor cycling group sessions, where service users can be trained by, or alongside, a qualified fitness instructor. Service users are required to complete an initial cycling assessment, which looks at road safety, how to use the equipment correctly, set up and personal safety. There is also an introduction to cycling, focused on increasing distance and time, and planning safe routes of travel within the area close to the inpatient hospital grounds. The fitness and wellbeing team has also created a cycling resource pack highlighting possible routes, risk assessments and the benefits of cycling.
Results
The outdoor cycling initiative has provided an excellent form of cardiovascular exercise, improving physical and mental health, as well as cognitive function. Service users have improved their stability, balance and coordination. Cycling outdoors has supported a sensory experience, has built confidence and promoted socialisation. One of the many benefits of cycling is that it is low impact and the fluid motion involved while supported by pedals is joint-friendly, and can reduce pain and stiffness. Some service users have gained more confidence cycling and some have been cycling on the road, which has helped develop concentration, awareness, and safety skills.
One patient further developed their learning and attended a free local BikeRight course.
Feedback received to date has included:
“I really enjoyed that - it was just what I needed!” - Service user, Beech Ward
“Service users who have taken part in the cycling group have really enjoyed it, and have been pleasantly surprised that it is something on offer for them to participate in.” - Occupational Therapist, Maple Ward
Next steps
The plan is to create greater partnership links within the community so that service users can continue to enjoy cycling when discharged from hospital, as well as learning “how to look after your bike” with possible workshops on basic bike maintenance. The team also wants to introduce service users to local cycling events where they can enter for enjoyment or as a competitive hobby.
Team: Clinical Education Team
Contact: amanda.
What did we want to achieve?
The team wanted to successfully apply to become a nationally certified training provider with the British Institute of Learning Disabilities (BILDACT) and to develop a brand-new staff education training programme called Proactive Approach Training (PAT) in line with the Restraint Reduction Network training standards. The PAT programme will reflect CWP’s 6Cs values, including using a positive behavioural support (PBS) framework, Human Rights Act, trauma informed care, person centred thinking, and therapeutic physical restraint skills.
The aim of the new four-day training programme is to reduce incidents of restrictive practices, including physical restraint, intra-muscular medication and seclusion, and to strengthen relationships between patients and staff through coproduced learning.
What we did
- CWP’s Clinical Education Team worked closely with mental health partners across the CWP footprint to develop a physical skills restraint programme.
- Engaged collaboratively with people with lived experience to appraise the training each step of the way and to co-deliver the programme to CWP staff.
- Worked alongside ward staff and managers to support them to understand the new PAT programme and techniques.
- A new Restraint Reduction Policy was developed based on the values of the PAT programme.
- Patient and carer involvement was used to develop restraint information leaflets.
- Post-incident support frameworks were developed for patients and staff.
Results
- CWP became one of the first mental health trusts in the North West to gain national certification.
- Increased focus on patient and carer engagement and involvement.
- Promotion of lived experience role within staff education has helped embed staff learning.
- Creating a paid role for people with lived experience to co-deliver the PAT training has provided an opportunity to step into employment.
- All staff who completed a course evaluation form welcomed the new programme, especially the emphasis on non-physical skills and the contributions of people with lived experience.
- Patient safety incidents and prone restraint incidents have significantly reduced.
- Post incident support framework has been established.
Next steps
The Proactive Approach Training is intended to be responsive to organisational need, patient-centred, evidence-based and relevant to everyone within CWP. The plan going forward is to:
- Annually evaluate the programme using incident data, patient and staff testimonies and in line with national and local guidance.
- Increase the involvement of people with lived experience in the PAT programme, eg video testimonies and course delivery.
Team: Provider collaboratives – EmpowerED and Level Up
Contact: fiona.
What did we want to achieve?
EmpowerED Adult Eating Disorders North West and Level Up Cheshire and Merseyside Young People and Families provider collaboratives (PCs) are committed to driving improvements across patient pathways for eating disorders services and tier 4 children and young people’s specialist mental health services. To meet this aim, the PCs have been working with third sector providers to support the establishment of the Experts by Experience (EBE) Programme. The programme has been designed to ensure people with lived experience can play a full and active role in the development and delivery of these services and help the PCs focus on commissioning for quality, clinical outcomes and most importantly, patient experience.
What we did
The PCs brought in third sector partner expertise – commissioning support from Beat, YoungMinds and Inspire Motivate Overcome to begin recruitment, training, and community connections. Following the recruitment, the forums have been supporting a culture of transparency, honesty and community engagement, with EBEs involved in all areas of planning and development, including playing an active role in PC groups and decision making.
Results
The EBE forums have been playing a full and active role in the development and delivery of both LPCs. Key results include:
- Influencing at the highest level - giving a voice to EBEs.
- Unique perspective – people with lived experience share how services feel in reality.
- Evidence based discussions – best practice evidence alongside the views of EBEs.
- Directly involved in the development and design of the PC names, logos and websites.
- The EBE Programme was recognised nationally at the PENNA Awards and has been asked to present and share best practice in a separate event in 2023.
Feedback from forum members has included:
“It’s a very powerful forum to give a voice back to people who had it taken away from them.”
“EmpowerED has taught me that our stories and experiences have the ability to influence real change.”
Next steps
Over the next 12 months the EBE Forums will:
- Review referral processes for both PCs.
- Support with the training of professionals across all partners across the North West.
- Continue to engage with communities and influence at a regional and national level.
- Continue to review what good inpatient and community treatment looks like.
- Begin the recruitment of community champions to volunteer their time to promote services across the North West. The champions will play a vital role in engaging with the wider community to feed into the Expert by Experience Forums.