UK trip highlights benefits of quality improvement approach for NZ mental health sector

15 Nov 2017 | Mental Health & Addiction Quality Improvement


Rees Tapsell

Dr Rees Tapsell is Director of Clinical Services and Director of Area Mental Health and Addiction Services for Waikato District Health Board.

Fresh off the plane from a whirlwind tour of some of the UK’s mental health and addiction service providers, Rees Tapsell, Chair of the leadership group for the mental health and addiction (MHA) quality improvement (QI) programme, shares some of the highlights from his trip and the learnings for those working in this sector in New Zealand.


Q. What was the purpose of your trip?

Having recently taken up the role of chair of the leadership group for the Commission's MHA QI programme, the trip was a great opportunity for me to see and learn from international examples of where QI science has been used to improve the safety and quality of mental health services.

Q. What health organisations did you visit with and what was the purpose of those visits?

In Scotland I spent time with the Scottish Safety and Quality Team from the National Health Service (NHS) and saw how a QI approach had been applied on a national scale across many different health organisations and services. In England I visited the East London, Exeter and Tees and Wear Valley partnership trusts where this approach had been used within and across multiple NHS boards. On each occasion the various teams were very generous with their time and their resources, universally happy to share their experiences, both of where things had gone well, but equally where things had not gone as they had expected.

Q. What excited you about what you learnt at these visits?

It was very exciting to see and experience real world examples in the use of a QI approach both at a national and an organisational level. What all of these programmes had in common was their ability to better engage staff, patients and families in a collaborative way, to improve services. It was great to see the energy and the engagement of staff who felt like they could make a real difference in their workplace, and for the patients that they serve.

Q. What were your main learnings from these visits?

The four core (and common) challenges for each programme were:

  1. the importance of having a leadership team that are both committed to, and competent in, QI science
  2. an organisational culture that promotes safe and effective practice 
  3. developing capability and capacity in QI methodologies across different health organisations
  4. the importance of measuring progress against agreed metrics, and being prepared to change an approach if it is clearly not working. 

Q. What did you discover that is relevant for the New Zealand MHA sector and the programme in general?

We know that right now the sector is under increasing public scrutiny, and providers are trying to identify gaps in services, whilst staff are under more and more pressure to put things right. We must find a way to help the sector shift away from this negative climate and bring the voices of consumers and their families together with those of staff, in identifying ways in which services might be improved.

QI science, and in particular the use of a collaborative methodology, provides an evidence-based way in which we can do this. During my international visits I saw examples of the ways in which such an approach has dramatically improved the engagement (and satisfaction) of staff, lead to demonstrable improvements in service delivery and led to significant efficiencies.

Q. How can the New Zealand MHA sector benefit from your visits to these organisations?

Each of the organisations I visited offered their support and resources to us. We are currently discussing a collaborative approach with some of them in:

  • learning from their experiences and leveraging off the resources they have developed
  • accessing their experts in terms of training and advice going forward
  • developing a locally based training programme in QI science.

Q. What are your take-home messages for those working in the sector?

If we are serious about the challenges of engaging staff, services users and families in the common aim of improving services, addressing significant service gaps and increasing the efficiency of services then we have to find an evidence-based way in which to that.

QI science offers a framework for this. It has been proven to work, both in an organisational context, as well as across multiple organisations.

Some service challenges are clearly common across all DHBs and lend themselves well to a national perspective whilst others might best be addressed with regional or local approaches. The national MHA QI programme will need to be able to accommodate for all of these and to acknowledge the time and resource required for success. Yet with a coordinated and sustainable approach we can improve the perception of MHA services and make them places that people would be happy to work in and receive care from.


Last updated 15/11/2017