FEATURE SERVICE IMPROVEMENT
Lessons and limitations Improving understanding of the caseload was a vital part of improving flow . The caseload weighting tool enabled individual professionals to control their caseload , enabling more informed clinical supervision , which resulted in prompter discharges .
The team leader had control and understanding of a service user ’ s journey through the whole occupational therapy pathway and the tool used in clinical supervision enabled quicker identification of any blockers to care .
The strength of the project came from the caseload weighting tool quickly becoming a fundamental tool used in all core aspects of the role and the commitment the team gave to embedding it .
There were easy gains made , which increased the time for care to 26 per cent , but the tool has also better prepared the team for the more transformational changes that will come when job plans are fully incorporated .
As we begin the process of replicating the success of the project in other areas , we come across issues of generalisability , in that the tool works better for outcome focused interventions .
We are currently in a PDSA cycle , testing what thresholds could be used for community nursing , basing thresholds on mental health cohorts ’ thresholds , rather than occupational therapy process thresholds .
Despite the current restrictions of COVID-19 on community working , the tool remains current and is a useful way of monitoring caseload and changing complexity of the service user group .
The project had identified that although the team felt they were working to their maximum capacity they were not working in the most efficient and effective way .
Using the time and motion study identified and demonstrated to the team how they were spending their time and enabled them to get on board with the project and embed it into their work .
Development of the caseload weighting tool has provided a simple way to measure the complexity and management of risk of service users on the clinician ’ s caseload leading to better flow and releasing more time to care .
The team has delivered incredible improvements to their service . Service users are being seen four times quicker , the allocation list has been halved and patient contact time doubled . Impressively , this was all achieved with zero pounds of investment .
References
NHS England ( 2016 ) Releasing time for Care . Available online at : www . england . nhs . uk / gp / gpfv / redesign / gpdp / releasing-time /
Fiona Piddington , occupational therapy professional lead , Specialist Learning Disability Services , and Peter Bampton-Clare , quality improvement manager . Email :
fiona . taylor20 @ nhs . net or
p . bampton-clare @ nhs . net . The authors would like to thank the Buckinghamshire learning disability occupational therapy team , the service line leads and the CQI team at Hertfordshire Partnership NHS University Foundation Trust for their support and commitment to this project
36 OTnews December 2020