Improving clinical access to mental health services in the NHS – the application of Lean thinking

This paper serves to disseminate findings from implementing Lean in a clinical decision-making service function in a NHS Trust. Operational and performance disparities were identified within the Trust’s service access points, causing inconsistent processes, poor use of staff resources, and service quality variability.
An action research project was designed and research propositions were developed from the literature. We sought to understand the extent that operational performance can be improved following Lean implementation and how it impacts upon clinical decision-making. One of the authors was embedded within the organisation, allowing access to core data and appropriate staff resource. Data collection was achieved through interviews, questionnaires, in-house performance metrics analysis and observations. Lean tools were considered and adapted, then applied with the aim of removing wasteful processes, standardisation and consolidate gate-keeping processes. The effectiveness of Lean implementation was evaluated to determine operational/performance improvements and to capture defined cost/financial benefits and savings.