Successful initiative to reduce waiting lists to be rolled out in the North East

The Waiting List Initiative, a programme offering non-clinical support to patients on mental health waiting lists, is to be rolled out in the North East of England after a successful pilot.

The programme was co-created by Everyturn Mental Health, a charity offering mental health services, and two community treatment teams (CTTs) at Cumbria, Northumberland, Tyne and Wear (CNTW) NHS Trust.

The Sunderland and South Tyneside CTTs faced significant increased demand, with their waiting lists increasing by 37% between January 2019 and September 2021. Their total caseload size increased by 34% during the same period, and they were operating with 34 vacancies across their teams. As a result, patients with serious mental illness (SMI) were having to wait a long time for treatment.

The trust needed an innovative solution to improve patient access to treatment. An analysis of historic caseloads suggested that many people were presenting with SMI because of practical and social problems. For these people, clinical treatment might not be the best approach.

CNTW asked Everyturn for help because of the charity’s success in developing crisis link worker services. The trust asked Everyturn to help develop a programme that could address their patients’ social and practical needs, which are often largely responsible for the deterioration in the patients’ mental health.

Three-to-six months of practical support

The resulting programme, the Waiting List Initiative, aimed to offer help to a specific cohort identified by CTTs – those who could be safely supported by the non-clinical workforce – during the period from referral to treatment. The goal was to contact patients within 48 hours of their referral, reduce the CTT caseload and reduce the number of patients waiting for clinical treatment. The programme was also intended to improve the mental health of patients, and to signpost them to other services that could support them with mental health resilience.

Everyturn and CNTW reviewed existing tools from other service models and adapted them to develop an assessment and treatment approach. The resulting pathway offered three-to-six months of person-centred emotional and practical support.

The support enabled people to engage with community assets, and the methods of communication and intervention were chosen by the service users.

Everyturn hired six new members of staff, including people with lived experience of mental ill health, who were then trained by experienced link workers with a range of backgrounds, including psychiatric nursing; social workers; psychology graduates; people who have worked in drug and alcohol services; and people with lived experience of mental health conditions.

Before launch, and in collaboration with partners in the local area, Everyturn created a signposting directory of community organisations and services, enabling the link workers to know where they could direct patients outside the CTT.

Waiting times slashed

The service uses the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) to measure its impact, reporting quarterly to its commissioners. The outcomes show that:

• 64 % of people (384 in total) who accessed the service were safely discharged from the CTT waiting list
• 84% of service users supported showed an increased WEMWBS score following intervention
• Sunderland North CTT has reduced its waiting list from 200 people (waiting up to two years) to 86 people (waiting six months)
• During the first 12 months of the Waiting List Initiative (Oct 2021 – September 2022), the CTTs’ waiting lists increased by only 1%, compared to 34% the year before

Once the programme is rolled out more widely, the team anticipates that within 12 months, one caseworker will be able to help up to 100 people, with up to 500 people being supported by the programme each year. Julie Lawlor, associate director of partnerships and improvement at CNTW, said she was pleased that, following the successful pilot, the programme would now be offered more widely: “The demand on our services is very real. This programme will help many people waiting to see us and will bring our waiting times for specialist support down.”

Adam Crampsie, chief executive of Everyturn Mental Health said he was delighted to continue the partnership, adding: “We understand the increasing pressures community treatment teams face, especially in such a unique rural area. By offering this additional support, we can ensure that no one in North Cumbria struggles alone.

“I am looking forward to working with our local partners to get this programme off the ground and make a real difference to the mental health and wellbeing of the communities in North Cumbria.”