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Saving the NHS money & reducing stress

Flexible Minds has been working with Portsmouth NHS Trust to manage heroin addicts more effectively throughout 2010. Portsmouth NHS asked Mark Webster, psychotherapist and director of Flexible Minds, to help them to increase the attendance at monitoring appointments. As a result, attendance was increased from approximately 27% to 95%.

Heroin addicts are prescribed methadone to enable them to manage the withdrawal from heroin. But methadone is a dangerous drug and, particularly if taken in a cocktail with other drugs, can lead to overdoses. So the prescribing consultants have a duty of care to monitor addicts being prescribed methadone, but chaotic lives mean that they often forget to attend their monitoring appointments.

Portsmouth NHS was concerned about both the level of resources spent simply chasing people to attend these clinics and the stress that this caused staff.

Flexible Minds set up a series of workshops with addicts and clinicians over a period of a month to analyse the situation and design an intervention. Once approval was given, a six months pilot study of 20 addicts tested the new process. The original clinic attendance rate was about 27%: During the pilot study this increased to 95% and this level was maintained when the NHS Trust gave the go ahead for the new process to roll out to all heroin addiction monitoring clinics.

There was also a dramatic increase in addicts' satisfaction with their treatment, further reducing stress levels for everyone.

As well as rolling out the new practice throughout Portsmouth NHS, there are now initiatives to roll out the practice in other NHS Trusts.

Mark: "We used performance methodology to identify precisely some small changes that have made an enormous improvement to Portsmouth NHS' ability to treat heroin addicts.

Barry Dickinson, Integrated Commissioning Unit, Portsmouth City Council & NHS Portsmouth: "Many people were surprised because Flexible Minds had such a different way of working. Mark ensured that everyone understood and bought into his principles. As a result, the ideas for improving the process came from case-workers: they identified the specific problem that had to be solved, and found a solution."

Barry: The training process has engaged staff and helped them to work together very effectively.  On the ground, the process is now organic: staff continue to meet and look at how to improve processes where appropriate, without direction from senior managers.