Summary of the new National Quality Framework: Driving Excellence in Mental Health Services
Introduction
In April 2023, the Mental Health Commission (MHC) published the National Quality Framework: Driving Excellence in Mental Health Services. The National Quality Framework sets out the themes, standards and associated criteria considered essential for delivering quality and recovery oriented mental health services in Ireland.
This guidance applies to all Mental Health Services including services for children and adolescents, adults, older persons, persons with an intellectual disability and a mental illness, and forensic mental health services.
The framework aims to provide a mechanism for services to move beyond compliance with minimum standards, and instead strive for continuous improvement and better outcomes for service users. It offers clear guidance for people using mental health services, their families and representatives, service providers and the public as to what to expect in terms of best practice from a mental health service in the public, voluntary and independent sectors in Ireland.
The Themes of the National Quality Framework
There are eight themes in The National Quality Framework, these are:
- Theme 1: Ensuring quality through clinical and corporate leadership and governance within mental health services to deliver evidence-based care and quality improvement.
- Theme 2: Ensuring quality through a compassionate, holistic, non-discriminatory, and person-centred service responsive to the needs of the service user (including their families, carers, and representatives).
- Theme 3: Ensuring quality through a visible and accessible holistic mental health system and service that prioritises prevention and promotes recovery.
- Theme 4: Ensuring quality through an equal, socially inclusive and diverse mental health care service that recognises and responds to traumatic events and circumstances in peoples’ lives.
- Theme 5: Ensuring quality through a mental health service that understands recovery and supports the service user towards recovery.
- Theme 6: Ensuring quality through co-produced care planning, which is underpinned by rights-based mental health care, confidentiality, and regard for an individual’s will and preferences.
- Theme 7: Ensuring quality through the provision of adequately resourced, well led, and governed mental health care services.
- Theme 8: Ensuring quality through an internally and externally connected mental health service.
Key Points to Note from the National Quality Framework
- Leadership and Governance: The mental health service is required to have strong clinical and corporate leadership and governance arrangements in place to ensure the delivery of evidence-based care and quality improvement. There must be Key Performance Indicators (KPIs) defined and regularly reviewed to monitor performance. The service must have clear, evidence-based Policies, procedures, protocols, and guidelines are in place that relate to the standards and criteria of the National Quality Framework. The service should have an up-to-date repository of policies, procedures, protocols, and guidelines that is accessible by service providers. The mental health service must also seek feedback from services users and staff to help improve the delivery of services.
- Needs of the Service Users: The mental health service is required to focus on the needs of the services users, their families and carers. It must ensure responsiveness to the needs of the individuals and social groups and adopt a multidisciplinary approach across the continuum of care from acute to continuing.
- Holistic Services: The mental health service shall ensure equality throughout the mental health system with a focus on prioritising prevention and promoting recovery of service users. This requires the mental health service to provide an integrated service across the continuum of care in conjunction with its partners, to be responsive and accessible to all at the point of need and to ensure optimisation of the access, discharge, and transition through mental health service.
- Equal, Inclusive and Diverse Services: The mental health service shall demonstrate recognition and responsiveness to traumatic events and circumstances in people’s lives. The service must be responsive to the diverse needs of the community and promote social inclusion and advocacy on the social determinants of health. The service shall also utilise a trauma-informed approach to mental health care and treatment, recognising that service may have suffered trauma in their lives and acknowledging the impact of events or circumstances.
- Recovery: The mental health service shall promote autonomy and self-determination and include the service user as an active participant in their care. The service must also focus on the service user’s strengths to achieve a shared vision for recovery.
- Care Planning: The mental health service shall ensure that the service user is actively involved in the planning and delivery of their care. The service must ensure the privacy and confidentiality of service users is respected and they must adopt a rights-based approach to care.
- Provision of Services: The mental health service shall have the appropriate level of staff to deliver a high quality, efficient and effective service. The staff must have the appropriate knowledge and skill to deliver efficient, effective, person-centred and recovery-oriented care. The service shall maintain a schedule of mandatory education and training and monitor compliance with mandatory education and training requirements. The service must also support the professional development of staff and ensure that physical environments and facilities are conducive to recovery-oriented care.
- Connected Service: The mental health service should have standards in place for information and communication technology infrastructure and usage. They must provide education to staff on the use of the technology and monitor its effectiveness. The mental health service must also have clear standards for communicating with key external stakeholders and partners.
How can HCI help?
HCI has been working with health and social care organisations for over 18 years, supporting them in building Quality and Safety Management Systems that fulfil regulatory requirements and drive improvement in their services.
Gap Analysis
HCI can support Mental Health Services by conducting a Gap Analysis against the standards set out in the National Quality Framework (MHC, 2023a). We use our knowledge and understanding of regulatory inspections to develop a comprehensive report that will detail areas of good practice and areas of non-compliance against the best practice guidance.
This report can be used to support the development of a Quality Improvement Plan that will support you in implementing a best practice, comprehensive Quality and Safety Management System.
HCI PPG LibraryTM
HCI also offer a number of digital health transformation solutions that can support the mental health service in meeting the requirements set out in the framework. For example, Standard 1.2.7 requires “The mental health service has an up-to-date repository of policies, procedures, protocols, and guidelines that is accessible by service providers”.
HCI’s PPG LibraryTM is an online portal that acts as a central repository for all policies, procedures and guidelines held within the Quality Management Information System (QMIS). It offers simplified access for staff and removes the barriers to accessing policies and procedures.
TrainScanTM
Standard 7.2.4 states that “The mental health service maintains a schedule of mandatory education and training and monitors compliance with mandatory education and training requirements.”
HCI’s TrainScanTM is another digital health solution designed by HCI to reducing the administrative burden of managing training records and events. TrainScanTM is an intuitive, user-friendly system that allows for easy recording of staff attendance at training events through scanning of their staff I.D. badge. It links with the QMIS and automatically updates staff members’ training records in real time.
TrainScanTM also offers a training analysis interface designed to allow trainers, HR managers and line managers to quickly analyse all training activities undertaken by staff within their organisation/department. Managers can easily identify what training is scheduled, completed or remains outstanding. This is a very useful tool to have during a regulatory inspection.
For more information on HCI’s professional services or digital health transformation solutions contact HCI at 01 629 2559 or info@hci.care.
References
MHC, 2023a. The National Quality Framework: Driving Excellence in Mental Health Services. Available: https://www.mhcirl.ie/sites/default/files/2023-04/MHC_The%20National%20Quality%20Framework.pdf
MHC, 2023b. The National Quality Framework: Implementation Guide. Available: https://www.mhcirl.ie/sites/default/files/2023-04/Quality%20framework%20Implementation%20Guide.pdf