- IMPACT, The East Midlands Provider Collaborative (IMPACT) has been responsible for the commissioning of adult secure care mental health services across Derbyshire, Nottinghamshire, Lincolnshire, Leicestershire and Northamptonshire since October 2020.
- The collaborative embarked on agreeing a set of shared values, co-produced with service users, as well as focusing on redesigning and implementing a shared clinical model, developed by clinicians from across the partner organisations.
- Clinical leadership and clinical networks form a fundamental aspect of the governance structure of the collaborative, and all strategies and plans are discussed and signed off by clinicians in their clinical reference and governance group before being taken to the board and implemented.
- Clinicians representing all nine partner trusts meet weekly to consider the bed state across all providers for each service line and there is now a shared understanding and awareness of the needs of patients across the region.
- The partners have also signed a risk and incentive agreement outlining that efficiency savings created by reducing the amount of bed occupancy days across organisations will be reinvested into transformation schemes which will have benefits to all, incentivising collaborative working.
- Alongside clinical leadership, IMPACT considers the experiences of service users in all the work that they do and includes co-production as an integral part of their overriding vision and strategy.
- As part of this co-production work, lived experience facilitators engage with service users from groups whose voices are less widely heard. These findings have been included in their collaborative strategy and are now being implemented into their commissioning intentions for the next three-year period.
- Service users are now starting to see improvements in outcomes and experience. Since the formalisation of the collaborative in 2020, out of area placements have reduced from 21% to 6% in a period of three years. Incidents of seclusion have reduced from five to two per 100 patients, and restrictive practices have been cut by a fifth, whilst bed occupancy has increased from 85% to 90%.