A caseload management and supervision tool for community mental health services

Mersey Care NHS Foundation Trust used a digital solution to analyse mental health data from multiple sources to support decision-making based on service user needs and to determine the likely resources required to provide safe and effective care.

Situation

Community Mental Health Teams (CMHTs) in Mersey Care Trust were experiencing rising caseloads, increasing numbers of service users with complex mental health problems and practitioners prioritising managing risk and keeping people safe with limited time to deliver recovery based care.

Aspiration

The Trust wanted to address the issues they faced by using the wealth of health data held in their clinical systems, and understand how they could deliver intelligence based healthcare by optimising existing data.

Solution and impact

MaST (Management and Supervision Tool), is a decision support tool which uses predictive analytics to help mental health staff make better decisions about the resources they use to provide safer and higher quality care. It is powered by a Risk of Crisis algorithm which uses retrospective data from mental health electronic health records.

MaST determines the likelihood of any given service user using crisis services within the following 28 days. By using these insights, service users can be grouped into cohorts to understand the resources required to support their care.

Using predictive analytics presented in an innovative dashboard, practitioners can now, at a glance, identify which service users might be at greatest risk of using crisis services and which might be ready to continue their recovery in the primary care sector. MaST allows the practitioner to prioritise their interventions and move to a preventative rather than treatment focused model of care.

MaST has had benefits for working methods and caseload management in the following areas:

• improved identification of people at high risk of crisis
• improved identification of people who are lower risk and less complex who may require a different level of care
• improved number of people stepped down from CMHTs to a more appropriate service for their needs such as primary care, voluntary sector services or other community support
• enabled proactive contact with people who are vulnerable and may otherwise be lost to follow up
• improved staff engagement with technology to support better clinical decisions day to day

It was important that certain technical prerequisites were in place for this work prior to implementation, including an electronic patient record capturing the clinical and non-clinical factors required by the MaST algorithms and dashboards.

Functionality

MaST is a software platform, which analyses data and information from multiple sources to inform decision-making based on service user needs and the likely resource required to provide safe and effective care.

Capabilities

• MaST can help healthcare professionals track and manage:
  • team and individual caseloads
  • allocation of resources
  • patient flow through services
  • safe care through the easy monitoring of key performance indicators
• MaST can be used in multi-disciplinary team meetings, during supervision, or when staff are planning the allocation of resources
• At a system, team or individual caseload level, MaST allows frontline staff, managers and clinicians to identify any risks, issues or potential blocks in patient flow through mental health services
• MaST uses risk and complexity profiling to enable planning decisions and allocation of resources to be made based on the needs of populations and cohorts of individuals
• It helps predict which subgroups of high-risk or crisis patients will benefit most from different resources and levels of preventive care

Scope

MaST is devised to be used within a clinical setting.

Key learning points

Governance

Establishing information governance and controlled security arrangements that allowed mental health data from multiple sources to operate and process data within the Trust’s own environments.

Integration

After an initial period with a separate login for MaST, the Trust implemented the Single Sign On solution. This makes access easier for users, and also allows the tool to appear integrated with the internal business intelligence portal.

Service user engagement

MaST has been developed in full collaboration with NHS staff and service users so that it reflects the workflow and requirements of Community Mental Health Services.

Using the team’s own data in engagement sessions was also found to be valuable. Allowing staff to see the value of MaST for decisions to be made in their own teams is critical and often overcomes any mistrust of the analytics before formal MaST training takes place. This feedback mechanism enabled the team to see that the role of MaST was critical in supporting a change in how people recorded data, seeing how adding information accurately and diligently meant the insights generated could work for them.

Key figures/quotes

“[MaST] helps us to see the huge volume of information that's in our own record systems and use that to reach quicker clinical decisions by making sense of that data and presenting it back in a really simple to use and understand dashboard.”
Adam Drage, clinical change manager

Find out more

Read the Global Digital Exemplar (GDE) blueprint here (requires login)

Learn more about the MaST products

Find out more about MaST from NHS accelerator

Key contact

Adam Drage, service lead / business development manager, Mersey Care NHS Foundation Trust

Adam.Drage@merseycare.nhs.uk

Caroline Gadd, director of healthcare solutions, Holmusk

Caroline.gadd@holmusk.co.uk