Background
Faced with rising service demand and ongoing cost improvement pressures, an East Midlands NHS Trust commissioned Meridian Productivity to support transformation across its Mental Health Services for Older People (MHSOP) directorate. The objective was clear: deliver a £180,000 CIP target by improving workforce productivity in community mental health teams and reducing lengths of stay across inpatient wards.
The project followed two previous successful collaborations between the Trust and Meridian in physical health services. With a remit spanning 14 Community Mental Health Teams (CMHTs) and 5 inpatient wards, the Trust sought to strengthen patient flow, standardise working practices, and enhance overall efficiency in older people’s mental health care.
Analysis
Meridian began with a comprehensive diagnostic across both community and inpatient settings. Key challenges were identified:
Productivity inconsistencies, with CMHTs averaging just 2.2 contacts per WTE per day and IRIS (Intensive Recovery and Intervention Service) teams at 3.2.
Delayed discharges driven by limited communication between inpatient and community teams.
Lack of standardised discharge planning, resulting in lengthened inpatient stays.
Poor visibility of workload, making it difficult to allocate resources effectively.
Fragmented care pathways, with little parity across teams in planning or activity tracking.
The findings made a compelling case for the implementation of structured management controls and behavioural change to realign resources to patient need.
Implementation
Over a 20-week period, Meridian worked in close partnership with Trust managers, clinical leads, and frontline staff to embed operational excellence through:
Standardised planning and work allocation systems to ensure consistent caseload distribution.
Daily and weekly review meetings across CMHTs, IRIS teams, and inpatient units to enhance cross-service communication and accelerate patient transitions.
Bespoke dashboards and tracking tools, enabling managers to monitor contacts, capacity, and workflow in real time.
Escalation protocols to support timely discharge planning and address external bottlenecks.
Leadership and behavioural coaching for service managers and supervisors to embed sustainable change.
In the inpatient setting, Meridian worked closely with matrons, ward managers, and consultants to implement a unified approach to care planning and discharge readiness—ensuring that every patient had a clear intended discharge date.
Results
The programme exceeded all expectations—delivering not only financial savings but also improved service delivery and patient outcomes:
Community Services:
45% increase in CMHT productivity, rising from 2.2 to 3.2 contacts per WTE per day.
31% increase in IRIS productivity, from 3.2 to 4.2 contacts.
£190K cashed saving delivered, meeting 100% of the CIP target for MHSOP, with an additional £260K opportunity identified—a 237% uplift on original expectations.
£142K future CIP opportunity identified within IRIS.
£55K reduction in bank, agency, and overtime spend.
Clearly defined performance targets and equitable workload distribution across teams.
Inpatient Services:
11% reduction in average length of stay, from 72 to 63.9 days—equating to over 2,300 fewer occupied bed nights.
£872K productivity saving from reduced bed days, based on average bed costs.
Embedded reporting and escalation processes for rapid issue resolution and discharge planning.
Conclusion
Through structured planning, cross-team collaboration, and leadership empowerment, the East Midlands NHS Trust significantly enhanced service efficiency in older adult mental health care. The work not only delivered over £1.2 million in total identified savings but also improved staff productivity, patient transitions, and resource use—offering a compelling return on investment and a sustainable pathway to ongoing performance improvement.
