Background
Dudley and Walsall Mental Health Partnership NHS Trust serves a population of over 470,000 people across the West Midlands, providing a wide range of community and inpatient mental health services. By mid-2015, the Trust’s Adult Recovery Services, Older Adult Mental Health Teams, Early Intervention Services, and Early Access Service were under growing pressure.
Persistent inefficiencies in workforce utilisation, high numbers of joint assessments, and lengthy waiting times were impacting both patient experience and staff morale. The Trust commissioned Meridian Productivity to analyse the root causes and implement sustainable change.
Analysis:
Meridian began with a diagnostic assessment across the Trust’s community mental health services. The study uncovered critical performance challenges:
Community teams were allocating caseloads without sufficient alignment to risk or frequency of contact.
Clinical activity lacked standardisation, with minimal oversight of face-to-face contact ratios.
In the Early Access Service, 68% of assessments involved both a clinician and a medic, often duplicating effort.
Waiting times averaged 12.5 weeks, with some patients waiting up to 20 weeks for initial intervention.
There was an urgent need to introduce a consistent management control system, better workload planning, and improved tracking of clinical activity.
Implementation:
Over a 12-week improvement programme, Meridian worked closely with team managers, clinical leads, and the Associate Director of Operations to deliver change that stuck.
Key changes included:
Introduction of workload-driven allocation models, replacing outdated caseload metrics.
A targeted increase in face-to-face clinical time, improving service responsiveness.
A redesign of joint assessment processes, reducing unnecessary duplication.
Implementation of performance dashboards to monitor KPIs such as contact frequency, wait times, and staffing efficiency.
Importantly, Meridian ensured that these systems were not imposed from outside but co-developed with staff, allowing team leaders to take ownership and embed new behaviours.
Results:
The impact of the programme was both immediate and long-lasting:
Waiting times in the Early Access Service were reduced by 57%, from 12.5 weeks to just 5.4 weeks.
The longest recorded wait time dropped from 20 to 8 weeks — a 60% improvement in timely access to care.
Joint assessments fell from 68% to 29%, freeing up clinical time for direct patient care.
Across community teams, a clear workload-based allocation model was adopted, improving fairness and resource efficiency.
The project identified £898,890 in annualised savings, representing a 6:1 return on investment.
Conclusion
By shifting the focus from caseload to workload, and from oversight to ownership, Dudley and Walsall Mental Health Partnership NHS Trust successfully embedded a new culture of accountability, efficiency, and patient-focused care. This programme not only enhanced productivity but laid the foundation for sustainable, data-driven decision-making across community mental health services.
