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We recommend setting up a "Service Improvement Group" (SIG) at the start of the work with your team. Once again if there is already group that delivers the functions described above then there is no need to duplicate. It does not matter what it is called as long as there is clarity as to what it does!
The SIG will be a group of key people who can oversee, support and coordinate the CRT service improvement activity. The make-up and function of this group can be flexible and develop as the service improvement work unfolds. However, we suggest it should meet regularly, at least every two months, while your team is using the going through the process and using this resource pack. Who and how many people are involved, and how often the group meets, will depend on your team's local context. We suggest that your SIG should include up to 6-8 people and could include: the CRT manager; the local facilitator; other clinical leads in the CRT (e.g. a Consultant Psychiatrist, a Senior Practitioner), the local acute care manager and a representation from local service users.
Key functions of the SIG will be:
• Scheduling and planning the initial scoping event.
• Establishing whose support is needed to achieve meaningful improvements, and working to engage them successfully in the work.
• Where is the interdependence among players in the local system to achieve better outcomes?
• Who holds the resources needed in terms of influence, authority, access, money, etc?
• Is there a risk that key players will be alienated if they are not included?
• Are we covering the whole pathway from primary care, voluntary and community sector involvement, CRT members and in-patient staff?
• How are users and their supports going to be involved right from the outset?
• The continuum of commitment analysis is a resource that will help address these questions. We also recommend that the SIG explore the notion of "host leadership" in considering how they can most effectively host the process described here to ensure maximum participation.
• Developing, reviewing and updating your team's service improvement plan. This plan will list the key actions for achieving service improvement goals in your team, who will lead each piece of work and the timescale.
• Supporting your team's Focused Working Groups through a framework for coordination and communication, and ensuring their plans and actions have management support in the team and can be implemented.
• Making sure that the project is realistically planned, ensuring that the best use is made of existing resources including local time and talent that can be dedicated to service improvement. This includes making use of existing meeting structures rather than adding to the burden of meetings experienced by staff unnecessarily.
• Ensuring that all relevant stakeholders, including those not directly involved, are aware of the project and it's progress.
• Thinking ahead to plan for the sustainability and spread of service improvements achievements.