National Continuous Quality Improvement Tool for Mental Health Education Joe Curran NIMHE North East & Yorks (Northern Centre for Mental Health)

Aims To develop a tool to assist Workforce Development Confederations in their commissioning of mental health courses/programmes To facilitate self-evaluation and promote inclusive discussion

Background Variation in the extent to which mental health education and training allied to national policy and local workforce agendas Variation in involvement of service users and carers in mental health education How well do capabilities acquired relate to changes in practice? – (Brooker et al 2002, Cross & Readhead 2001)

Development of the tool Phase 1 – Literature search – Focus groups & Semi-structured interviews – Steering group – Pilot evaluation – Refining Phase 2 – Supported implementation nationally – Selected commissioners of MH education – Selected programmes/courses

Results of pilot implementation Rationale and proposed implementation generally welcomed Suitable for use with a variety of programmes Difficult to involve non-statutory sector, service user representatives from CAMH, Forensic, primary care MH carers Concern over user/carer marking of assignments Reliability and validity of scoring Revisions made: – Addition of student experience – Reduced emphasis on ‘Beacon Status’ – Sections 1 and 4 rated on continuum

Aims of Phase 2 To find out how the tool works nationally To identify factors that facilitate implementation To identify barriers to implementation To develop a handbook/implementation guide (Oct 2004)

Methods of Phase 2 Targeted implementation on; – 12 PCGMW programmes – 28 pre-qualifying programmes – 44 post-qualifying programmes (to include PSI for psychosis) Supported implementation – WDC MH leads – Project Worker attends review meeting(s) – Telephone/

Data collection Process – Organisational factors – Existing networks/relationships – Experiences of those involved – Thematic piece Outcomes – Across areas, what factors aid or are barriers to implementation – Case examples of good practice – Scores used as a guide to national profile

Key Questions How does the tool work in practice? How does it link with QAA/Major review? What resources are needed? What issues are associated with user and carer involvement? How will the scores be used?

How does the tool link with QAA? As one of the ‘external reference points ’? (QAA Handbook for major review of mental health programmes, 2003, Para. 36, p.8) Contribute to Benchmarks and Quality Standards Contribute to ‘Evidence Base’

Review process Review meetings usually take hours. WDC MH Leads/ Commissioners select the courses and convene the meeting. Copies of the tool provided beforehand. Group discussion to complete items and ratings. Development of action plan (where needed).

Issues with service user and carer involvement Payment ‘Representativeness’ Capacity of user/ carer organisations to meet demand Training ‘Tokenism’ ‘Use of jargon’ Levels of involvement and resources required

How are the scores to be used? Locally – As a baseline – To identify areas to include in action plan – To give a common scale among participants In the report – To identify variation – To look for common themes – To make initial correlations

Progress to date – some impressions Recruitment of WDCs/WDD/SHA Generally good Programme Relevance Variation in service user involvement Generally limited carer involvement Mixed ‘Assessment of Impact’