MENTAL HEALTH Access to Psychological Therapies DCAQ in NHS Ayrshire & Arran PROJECT INITIATION DOCUMENT Revised Draft 6 24th August 2011
CONTENTS Section Title Page 1. Purpose of the Project Initiation Document 3 2. Introduction, Aims and Objectives 3 3. Scope 4 4. Exclusions 4 5. Project Deliverables 5 6. Interfaces 5 7. Governance 6 8. Key Stakeholders and Contact Details 6 9. Risks and Mitigation 7 10. Project Resource 8 11. Roles and Responsibilities 9 12. Project Plan 10 VERSION AND CONFIGURATION MANAGEMENT Configuration History Sheet Version No. Date Details of Changes included in Update Draft 1 29/11/10 Outline Draft Document Draft 2 10/12/10 Working Draft Document Draft 3 07/01/11 Final Draft Draft 4 26/07/11 Revised objectives, scope and deliverables Draft 5 08/08/11 Minor revisions/updates Draft 6 24/08/11 Update to Key Stakeholders and Project Resource table 2
1. Purpose of the Project Initiation Document The purpose of the Project Initiation Document (PID) is to define the project, in order to form the basis for its management and an assessment of its overall success. The Project Initiation Document has two main purposes: To ensure a sound basis for the Project Team to progress and; To provide a single source of reference about the project so that information can be placed in context and easily found. 2. Introduction, Aims and Objectives The Scottish Government introduced a HEAT target in relation to current provision of Psychological Therapies in Scotland in Autumn 2010. Although the scope, definition and measurement of this HEAT target is yet to be finalised, it will set a maximum waiting time for access to Psychological Therapies. This target is being set at a time when the NHS in Scotland is facing significant financial constraints. Therefore, the challenge is to deliver improved access to psychological therapies within the existing resource constraints whilst not impacting negatively on clinical outcomes. The Quality and Efficiency Support Team (QuEST), formerly the national Mental Health Collaborative (MHC), has a lead role in developing the capacity and skills of Mental Health services across Scotland to use service improvement techniques to support the delivery of this key HEAT target. The QuEST will work with two NHS Boards across Scotland as early implementer sites to support the application of Demand, Activity, Capacity and Queue (DCAQ) techniques to improve access times for psychological therapies. The aim of this project is to improve access times for psychological therapies for two of the six adult community mental health teams (one Primary Care Mental Health Team and one Community Mental Health Team) providing Psychological Therapies in NHS Ayrshire & Arran, within their existing resourcing frameworks and without impacting negatively on clinical outcomes. 3
The objectives of this project are to: carry out DCAQ analysis and related service improvement work for two of the adult community mental health teams (one Primary Care Mental Health Team and one Community Mental Health Team) providing Psychological Therapies in NHS Ayrshire & Arran with the aim of reducing access times for existing therapies; share learning from this project across NHS Ayrshire & Arran and with other NHS Boards and; provide an early implementer site that enables the National team to: o develop further the existing tools to support DCAQ work in mental health; o identify and develop further tailored tools and guidance to support local and other NHS Boards to use service improvement techniques to deliver the target; o identify what external inputs might be required to support NHS Boards to deliver the target. 3. Scope The scope of this project is to: 1. Undertake DCAQ analysis and related Service Improvement work primarily for the South Ayrshire Community Mental Health Team and the South Ayrshire Primary Care Mental Health Team. 2. Undertake pre specified components of DCAQ analysis for the North Ayrshire and East Ayrshire Adult Community Mental Health and Primary Care Mental Health Teams and the Ayrshire Out of Hours/Weekend Service as appropriate. 4. Exclusions 1. This project will not extend to other teams providing psychological therapies within NHS Ayrshire & Arran with the exception of point 2. in Scope above. 4
5. Project Deliverables The project deliverables will be: 1. An analysis of DCAQ for the South Ayrshire Community Mental Health and Primary Care Mental Health Teams which identifies key opportunities for more effective management of both demand and existing capacity. The level of analysis will be determined by the quality of the data available. 2. Identification of any gaps in routine data collection that need to be addressed to effectively manage demand and capacity on an ongoing basis. These data gaps will be addressed as appropriate via two mechanisms: 1) implementation of a quick fix to current systems and processes, or 2) incorporating into the Mental Health PMS Specification. 3. Service improvements for each of the services undertaking DCAQ work have been implemented and their effectiveness evaluated. 4. Guidance for other services and NHS Boards looking at access to Psychological Therapies. 5. To support the refinement of the QuEST DCAQ tool. 6. An analysis of the non recurrent costs of the project versus the recurrent efficiency gains delivered. 6. Interfaces The project will be aligned with work being carried out in relation to this target by NHS Education for Scotland and Information Services Division, and the local 18 Weeks RTT Workstream. The QuEST will work with one other early implementer site and will ensure that mechanisms are in place to share learning across both sites. The project will feed into NHS Ayrshire & Arran s Adult Psychological Therapies Programme Board, and the Adult Psychology Development and Training Group in addition to the respective joint planning groups in each geographical area covered by the project, for information and shared learning across the organisation. 5
7. Governance The project sponsor will be Jim Crichton, Director of Primary Care and Mental Health Services NHS Ayrshire & Arran. The Project Management will be an integral part of NHS Ayrshire & Arran s Psychological Therapies Programme Board, using the MSP Managing Successful Programmes approach. The Programme Board meets regularly and will review key milestones. The Project Management Team will report to the Programme Board through the Joint Project Managers. The Project Management Team will meet at agreed intervals. 8. Key Stakeholders & Contact Details Name Job Title Contact Jim Crichton Director of Primary Care and Mental Health Services NHS Ayrshire & Arran, Jim.Crichton@aapct.scot.nhs.uk 01563 826345 MH&WB Strategic Programme Manager Linda Boyd Healthcare Manager NHS Ayrshire & Arran, Programme Manager Linda.Boyd@aapct.scot.nhs.uk 01563 826346 Dr Malcolm Cameron Clinical Director Adult Community NHS Ayrshire & Arran Malcolm.Cameron@aapct.scot.nhs.uk 01563 577775 Gail Sabbatini Service Manager, Adult Mental Health Community NHS Ayrshire & Arran, Project Manager Lesley Sinclair Senior Information Analyst NHS Ayrshire & Arran, Project Manager Catherine Kyle Director Psychological Services NHS Ayrshire & Arran Janet Davies Head of Psychological Specialty: Adult Mental Health Services NHS Ayrshire & Arran Gail.Sabbatini@aapct.scot.nhs.uk 01563 826381 Lesley.Sinclair2@aapct.scot.nhs.uk 01563 826370 Catherine.Kyle@aapct.scot.nhs.uk 01292 559749 Janet.Davies@aapct.scot.nhs.uk 01292 559748 Craig Stewart Locality Manager North Ayrshire Craig.Stewart@aapct.scot.nhs.uk 01294 470010 Stuart McGregor Locality Manager South Ayrshire Stuart.McGregor@aapct.scot.nhs.uk 01292 613776 Karen McDowall Senior Nurse, NHS Ayrshire & Arran Karen.McDowall@aapct.scot.nhs.uk 01563 826381 Aileen Fyfe Head Occupational Therapist, NHS Aileen.Fyfe@aapct.scot.nhs.uk Ayrshire & Arran Mark Fleming Programme Manager Mental Health/eHealth, NHS Ayrshire & Arran mark.fleming@nhs.net 01294 323479 Ruth Glassborow National Programme Manager Mental Health, QuEST Ruth.Glassborow@scotland.gsi.gov.uk 07500 066722 Dr Mike Henderson Psychology Lead for National QueST mike.henderson@borders.scot.nhs.uk 6
9. Risks and Mitigation Risk Risk Control Lack of good quality data from internal IT Use manual data collection exercises where systems to carry out the analysis necessary Data collected in different ways to different Develop standard list of definitions at outset of definitions may impact on integrity of analysis project Identify clearly assumptions made in analysis and report findings with clarity on error margins Caution with cross team comparisons unless clear that using similar definitions Developmental time to get data to standard Assess availability and quality of data at beginning may be longer than project lifespan allows of project so can quickly identify if need to adjust timescales of project Use manual data collection exercises where necessary Lack of engagement of key clinical staff Appoint a clinical lead for the project Ensure that the clinical team are involved in agreeing key changes for testing Use external senior clinicians as appropriate to reenforce case for change and benefits of change Seek to understand reasons for any resistance and then respond appropriately Current management structures or split lines of accountability between different professional groups result in barriers to progressing agreed actions Key members of project team leave during the project Project steering group takes overall accountability and will ensure decisions are made where there are differing viewpoints between key stakeholders Ensure clear mechanisms in place for sharing information and skills across project team Develop capacity of project team in key skills (ie DCAQ) as an early priority Lack of capacity to progress project locally due to competing priorities Delays in appointing clinical lead and data analysis support roles Regular 1:1 meetings between programme manager and key postholders to agree priorities and adjust workload accordingly Commence appointment process immediately following approval by programme board Flexible use of project resource (outlined below) to initiate work 7
10. Project Resource A collaborative approach will be taken in running this project. The project will by run jointly by the National QuEST and NHS Ayrshire & Arran Adult Mental Health Services utilising existing lean methods and tools to manage the work. The following resources will be invested to enable delivery of the project outcomes: Resource Who Amount Resource Investment from National Programme External clinical advice Dr Mike Henderson, Psychology Lead for QuEST External General Management advice/support Ruth Glassborow, National Programme Manager Mental Health, QuEST Approx 1 day per month Resource Investment of 40K for NHS Ayrshire & Arran will include the following Service Leads Who Amount Programme Manager Linda Boyd Health Care Manager Business Change Gail Sabbatini Manager/Project Manager (Improvement Implementation) Service Manager Adult Mental Health Project Manager (Information Lesley Sinclair Approx 3 4 days per week Analysis) Senior Information Analyst Local Clinical Lead Janet Davies Business Change Manager Consultant Psychologist Business Change Manager Stuart McGregor Locality Manager South Ayrshire Administrative Support Ann Murphy Personal Secretary Budget to be held centrally by Jim Crichton, Director of Primary Care and Mental Health Services, who will ensure the funding is used in its entirety for the purposes described. 8
11. Roles and Responsibilities Project Board The Project Board is NHS Ayrshire & Arran Mental Health Services Psychological Therapies Programme Board. The Project Board: is accountable for success of the project and has the authority to direct the project; provides overall guidance and direction; agrees the Project Initiation document; meet at key milestones and at any other time required; authorise exception plan; review Risks and Issues; close project. Project Management Team The Project Team reports to the Programme Board. Specifically the Project Team: reports to the Programme Board; manages the progress of the day to day work; reports the progress to the Team; identifies any risks and issues; assesses deviation from plan and produces options. Membership of the project management team: Gail Sabbatini, Service Manager Adult Mental Health, NHS Ayrshire & Arran (Joint Project Manager) Lesley Sinclair, Senior Information Analyst, NHS Ayrshire & Arran (Joint Project Manager) Janet Davies, Lead Psychologist, NHS Ayrshire & Arran Psychological Therapies Service; Stuart McGregor, Locality Manager South Ayrshire Dorothy Lynch, Team Leader South Ayrshire Community Mental Health Team John Leighton, Team Leader South Ayrshire Primary Care Mental Health Team Ann Murphy, Administrative Assistant, NHS Ayrshire & Arran Jacqui Russell, Administration Co ordinator, NHS Ayrshire & Arran 9
Project Management The project will be jointly managed by Gail Sabbatini and Lesley Sinclair. Together, they will provide hands on project management and actively manage the project plan and deliverables, to ensure that the project goals and objectives are achieved within the project timeframe and guidelines established by the Programme Board. In addition to the above, specific duties include: chairing the Project Management Team meetings; manage the risks, including the development of contingency plans; prepare and report to the Programme Board through Highlight Reports. Service Leads The role of the Service Lead is to: progress the day to day work as per the project plan for the workstream; discuss progress with the Project Managers; report any risks or issues to the relevant Project Manager. 12. Project Plan The overall project will be managed by Gail Sabbatini and Lesley Sinclair from NHS Ayrshire & Arran and will focus on: Identifying and implementing immediate service improvement opportunities; Gathering appropriate data to undertake a detailed DCAQ analysis; Completing the DCAQ analysis and agreeing further areas for service improvement activity; Undertaking the specific improvement activities identified and associated work to the agreed timescales; Evaluating the outcomes of the work. Throughout the project, both the effectiveness of changes made and the financial impacts of those changes will be evaluated. 10
Key Milestones Revised project plan to be inserted 11