1.  Conducting a diagnostic to create ‘one version of the truth’:

• Creating the baseline: Conducted quantitative analysis of mental health admissions, referrals, and assessment data; generating qualitative insights from immersion with operational and clinical teams to map out assessment process and identify bottlenecks
• Establishing the common narrative: ‘Busting myths’ and building a shared case for change. For example, long wait times for one Community Mental Health Team created the false perception that all teams had similarly long wait times

2. Co-creating transformation initiatives, including:

• Systems and processes: Reducing rota overlap, streamlining discharge processes, simplifying forms, improving interfaces with other trusts, and designing a new KPI reporting mechanism
• Resources: Recruiting Approved Mental Health Professionals in response to increasing mental health assessment referrals, and training ED consultants to complete mental health assessment alongside certified mental health consultant
• People and mindsets: Introducing weekly touch points to create a culture of effective communication and information sharing between mental health, rapid response, Child and Adolescent Mental Health Services (CAMHS), ED and inpatient teams

3. Establishing the delivery mechanism:

• Governance: Agreed and set up forums to manage programme delivery
• Reporting: Defined KPIs, including when and how they will be tracked
• Accountability: Established incentives for delivery and escalations for areas which were not progressing