We adopt a multi-disciplinary approach to quality improvement in medium and low secure mental health services. A key component of our work is the sharing of best practice by listening to and being led by frontline staff and patients.
We serve to identify areas for improvement through a culture of openness and enquiry. The model is one of engagement rather than inspection. We aim to facilitate quality improvement through a supportive network and peer-review process.
The review cycle is structured in two stages over a two year period; the first stage is a full review and the second is a developmental phase.
At the beginning of each cycle the standards are reviewed, either by a wide consultation exercise or a minor revision, before being issued for use.
Stage 1: Full Review
As part of the full review, services complete a comprehensive self-review document. They provide a self-rated score and commentary against each standard and submit accompanying evidence. Additionally, questionnaires are distributed to service staff, patients, and family and friends.
A visiting peer-review team follows a structured timetable and meets with those working in and using the service to validate the information provided. A service tour and a check of the perimeter are also conducted as a part of an environmental check.
At the end of the peer-review visit, the team will provide preliminary findings to the host service, drawing on any key areas of achievement and challenges.
The data collected is collated in the form of a service report, summarising areas of good practice and areas in need of improvement
Stage 2: Developmental Review
Following on from the full review visit you received the year previously, you will review and expand on the outcomes from the visit. This is an opportunity for a focused self-review and reflection on the progress being made as part of action planning. A brief update document is used as a tool to structure the discussions on the developmental day.
The developmental visit takes place over a day period. It is designed to allow time for meaningful discussion and to provide services with the opportunity to maximise the knowledge and expertise within the Network to develop their practices.
Meetings are conducted with service managers, frontline staff, patients, family and friends. The day closes with a feedback session to reflect on progress since the previous full review and to offer guidance over the coming year.
A short developmental report is produced summarising the actions taken since the previous review and key discussions from the developmental day. Services engage in a further action planning phase to reflect on the feedback received.
The original action plan is reviewed and built upon to encourage continual development ahead of the next full review visit.
Since March, COVID-19 has had a huge impact on everyone’s lives and the way we work. Given the ongoing requirement to social distance and the risks associated with having reviewers travel across the country, the decision has been made to hold all peer-reviews virtually until at least July 2021.
As a team we have been working hard to recreate all the elements of an in-person review in a virtual environment. In order to do this, careful preparation is required both by the QNFMHS project team and your service to ensure the day runs as smoothly as possible.
The involvement of patients and carers on our peer-review days remains vital and is something we do not wish to let slip given the circumstances with virtual reviews. We would like to work collaboratively with our member services to find ways in which we can engage patients and carers and gather their feedback in a meaningful, confidential way.
For some recommendations on how best to involve patients and carers in your services virtual peer-review, please view this guidance document.
A key role for Patient Reviewers is to ensure that the views and experiences of patients are used to inform and guide the work we do. Similarly, Family and Friends Representatives ensure that the voices of the families and friends of patients are heard in discussions about service development.
Recruitment of Patient Reviewers has been inclusive. We have taken applications and accepted patients who are at different points in their recovery.
Some patients need to be escorted, others have been discharged from hospital and are living in the community and some have been recalled to hospital whilst being Patient Reviewers.
Take a look at which secure services are currently a member of the Quality Network for Forensic Mental Health Services.
To receive information about membership, including costs of membership, please email firstname.lastname@example.org.