The 10 High Impact Changes

There are 10 changes that mental health services can make to achieve the biggest impact in improving service delivery. The changes were originally developed by the NHS Modernisation Agency in 2004, and adapted for mental health services in 2006, drawing on quantitative data, case studies and a literature review.

The 10 high impact changes for services are relevant across the range of health and social care statutory and non-statutory mental health organisations, including CAMHS.

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The 10 changes recommended are:

  1. Treat day surgery (rather than inpatient surgery) as the norm for elective surgery
  2. Improve patient flow across the whole NHS system by improving access to key diagnostic tests
  3. Manage variation in patient discharge, thereby reducing length of stay
  4. Manage variation in the patient admission process
  5. Avoid unnecessary follow-ups for patients and provide necessary follow-ups in the right care setting
  6. Increase the reliability of performing therapeutic interventions through a Care Bundle approach
  7. Apply a systematic approach to care for people with long-term conditions
  8. Improve patient access by reducing the number of queues
  9. Optimise patient flow through service bottlenecks using process templates
  10. Redesign and extend roles in line with efficient patient pathways to attract and retain an effective workforce