“Now we have a benchmark we can measure ourselves against”
We spoke with Simon Arday [Pictured], Mental Health Network Manager at King’s College Hospital NHS Foundation Trust (KCH), about his experience as part of the world-first King’s Health Partners (KHP) Mind & Body Quality Improvement Network (QIN).
The QIN was established, as part of KHP’s Mind & Body programme, to define what ‘best practice’ mind and body care looks like. In doing so, it aims to create impactful quality improvements at both local and national levels, and ultimately enhance patient care and outcomes, promote wellbeing, and reduce health inequalities for all.
Simon helped pioneer the adoption of this new framework at KCH during the project’s pilot. Find out about his experiences below:
What are the challenges faced by your staff and patients in the current system, and how does the QIN help address these?
The starting point is thinking about what the local population looks like. We have a very diverse population across south east London, particularly when we consider the apex between Lambeth and Southwark at Denmark Hill. At Denmark Hill we serve a high population of people from ethnic minority backgrounds who face numerous physical and mental health inequalities, so it’s important to consider how to develop an understanding of that intersectionality and then ensure our staff have the confidence and capability to work in a nuanced, culturally responsive way across these different environments. In comparison, we work with an older demographic at the Princess Royal University Hospital. It is important to recognise the unique and different challenges across the patch.
I think the QIN helps address this by providing a benchmark or measuring tool for us as an organisation and it allows our services to think about how their work is taking these varied aspects into account.
How has the quality improvement process improved your understanding of mind and body care for both patients and colleagues?
I think we already had a fairly rich understanding of mind and body care before joining the QIN. Within the organisation and within my practice, I think it's something I've worked on for a fair amount of time.
The quality improvement process certainly helped as it meant that I had to go looking for things and I found areas of the organisation that required improvement. The five themes of the QIN framework also helped me to consider integrated care in a structured and formal way, which is complex, particularly when working across a system. This includes a focus on developing robust governance, policies and processes to underpin this innovative work and create the conditions for sustainability. It’s admittedly sometimes the less exciting stuff, but without those foundations it will be difficult to build equitable services and pathways.
What are the benefits of the QIN for services, patients and staff? What have you improved or what are you going to change as a result of the process?
I think there are multiple benefits from being part of the QIN - it's about making it work for all of us, whether as an organisation, service, patient or staff. For me, coming into my new role, it gave me an opportunity to examine the conditions within the organisation in a structured format.
One of the sub themes of the QIN framework looked at whether people receive high quality, holistic assessments of mind and body, which varies a lot across different services and specialities. We will continue to assess and keep track of each clinical service and identify how it is evidencing holistic care and how the organisation is supporting this.
The process has given us a clear direction on some things that we need to improve on and we are already looking at our mental health strategy and other aspects of the organisation. We are also thinking about how we share learning, good practice and disseminate information across the organisation as there currently isn’t a mechanism for this. For example, if there are particular patient safety alerts related to mind and body care, how is this spread across the organisation? Or, if there’s one team or clinician doing a really good piece of work, how do we promote that?
What aspect of your organisation are you most proud of in terms of delivering mind and body care?
There are several services across the organisation that are doing incredible work. A couple of them were award winners at the Mind & Body celebration event and there are others which have been established for a while now including the cardiorespiratory liaison service and the psycho-social approach embedded in the renal department.
I am most proud of being part of an organisation that feels like it’s placing an emphasis on improving the mental health care of all patients. It’s important to think about how this commitment is maintained overtime however, both from an organisational perspective and from the perspective of the QIN. It is important to question how the QIN standards will evolve over time to reflect changing needs and practice, and what will be expected of an organisation to remain a member of this Network.
There’s definitely a pride in being part of the QIN and I think that pride can be maintained if it continues to have an influence that facilitates change by being an active, critical friend.
What aspect of the QIN excites you the most?
I’m excited for the QIN to review its framework and come back in a year’s time and say, ‘this is what’s expected now for an organisation to be part of the Network – can you demonstrate you are meeting this criteria or demonstrate your commitment to being part of this Network?'. Whether that’s contributing to sharing information and stories of success, or meeting another particular set of standards or themes, that will challenge us to continually raise the bar.
I’m also excited for when changes in legislation or policy, such as ‘Seni’s Law’, are reflected in the QIN, reinforcing the challenge for organisations in the Network to address such inequalities.
I also get excited by the opportunity to learn from other organisations and see what others are doing. It is nice to be able to share stories and borrow a few things here and there as well, particularly if they’re shown to be effective. Ultimately, what we’re trying to do is create parity in terms of mental and physical health, but also parity in access. There shouldn’t be a reason why I get a different service whether I turn up to KCH or another hospital elsewhere
Why should others consider joining the QIN?
It’s the first of its kind in terms of making a legitimate attempt to outline what organisations and services should be aiming for in order to provide integrated mind and body care. That journey can often be quite challenging, exhausting and isolating.
Having a network to draw from, whether for resource or support, is therefore invaluable. It allows you to reflect on what you’re doing, sense check things and be amongst similar thinkers who are crucial for maintaining energy and enthusiasm.