In this blog, our Principal Consultant, Philip Purdy, looks at why community-based mental health services need more assistance with meeting the proposed new waiting time standard.
Despite having gone under the radar compared to other new initiatives, a new waiting time standard for certain areas of mental health is set to be gradually phased in over the course of this year – although data recording and implementation issues means the new standards have not yet been introduced, with only an indicative timeline for their implementation.
The 4-week (28 days) standard will mean that all mental health service groups – adults, older adults and children and young people – presenting to community-based mental health services should begin to receive care within four weeks from when they were first referred.
But issues with the capture and recording of data makes it challenging, at present, to provide an accurate picture of the number of people who currently receive help within four weeks. This is why, to support systems in improving data quality and improve the flow of data relevant to the community waiting time standard, a phased approach to implementing the waiting time standard has been created, allowing more time for organisations to get used to the new systems.
With the new approach, the clock starts when the first request for mental health services is received and stops when the person is in receipt of a clinical assessment, either a clinical or social intervention and a completed co-produced personalised care plan.
Surprisingly, despite its obvious importance, the new waiting time standard wasn’t included in the NHS’s 2023/2024 priorities and operational planning guidance, suggesting that the challenges faced in recording and monitoring may be significant enough to prevent mandating this as a ‘must-do’ this year.
Recent data featuring in the HSJ shows the extent of the challenge, with data assembled by NHS Benchmarking unveiling the first national picture of the number of patients currently being treated in four weeks. Its aggregated figures for 2021-22 revealed that 72% of adults and 67% of children waited more than four weeks for treatment. Importantly, this must be viewed alongside the caveat that metrics may be measured across providers with differing definitions.
What’s the problem?
Access waiting times are still a new concept for community-based mental health services. While it’s true that consultant-led mental health services have (technically) been subject to the 18 weeks RTT standard for a number of years, it’s also the case that this has not been widely integrated into how mental health organisations run their services.
Consequently, and unsurprisingly, the infrastructure to collect and report on waiting times data, and utilise the intelligence provided by it, simply isn’t there at present. This means, in turn, that organisations are now involved in a game of catch-up to meet the conditions of the 4-week standard.
What are the solutions?
To allow mental health providers to monitor their performance against this new standard – and see how close or far away they are from making it a reality – a patient tracking list becomes worth its weight in gold.
Here at Acumentice, we have been working closely with two mental health organisations to design and build a patient tracking list that enables these organisations to see in transparent detail how long their waiting times currently are.
It’s important to note that this isn’t an easy process. It involves getting to grips with some complex pathways, interwoven between different teams and services. It also involves coming to terms with different sets of processes that have evolved in a way that don’t necessarily lend themselves well to easy oversight.
During our work in this area, we have quickly concluded that these types of projects are as much about culture change as they are process change – developing capability in the process of management and oversight is as important as that in the technical field.
A lesson from the past
If we cast our minds back to the first decade of this millennium and the last time the NHS was introducing waiting time standards into new territory – namely cancer waits and RTT – we will remember the sea change in practice that was needed to make a success of those standards.
This isn’t something that happens overnight, and this isn’t something that happens without the necessary support and assistance.
It wouldn’t be a stretch to say that the NHS developed an entire industry to support the effective recording, management and reporting of waiting times with these previous initiatives. The new waiting time standard isn’t something that can easily be absorbed by organisations who are experiencing unprecedented demand for their services.
This focus is going to become more high-profile as the year progresses, and we already know it’s going to be a difficult process and adjustment, but there are ways in which you can ready and prepare yourselves for it when it does come into play.
It’s important to have the right systems and processes in place to enable you to meet the standard, and that’s something we can help with to ensure waiting times for mental health patients are adequately tackled and improved. Find out more here.