• Managed by the Royal College of Psychiatrists’ Centre for Quality Improvement, and led by Dr Paul Lelliott, Director of the Centre.
  • Run through 12 national quality improvement networks managed by the Royal College of Psychiatrists to support UK mental health services to meet recognised standards.
  • Aimed to develop interventions to address current gaps in mental health services.
  • Used the Institute for Healthcare Improvement’s model for quality improvement (QI) to support collaboratives within the networks.

There are some persistent and recurring problems for UK mental health services, including lack of regular health checks, lack of access to mental health units at times of crisis, and lack of service provision for people with borderline personality disorders.

This project sought to develop interventions to address those gaps in services. It allowed the Centre for Quality Improvement to support QI collaboratives and tackle difficult to resolve problems.

Key findings

  • Improvements were made in a number of health checks; however the number of patients who had all health checks remains low.
  • Patients’ satisfaction with access to non-therapeutic activities was increased through advertising available resources and asking for patient feedback.
  • Transitions from in-patient to community care were successful and in some cases led to a significant decrease in the number of bed days used.


  • Organisational changes hampered all teams in achieving QI goals.
  • Changes in staffing reduced the teams’ ability to work effectively on QI projects.
  • Many health service staff associated ‘measurement’ with ‘performance management’ and were reluctant to collect the progress measures needed to monitor improvements.
  • Some staff struggled to adopt Plan-Do-Study-Act cycles.
  • Efforts to encourage teams to involve service users were largely unsuccessful.

Who was involved?

The project was managed by the Royal College of Psychiatrists’ Centre for Quality Improvement. It was led by Dr Paul Lelliott, Director of the Centre.

Participating national networks were: the Prescribing Observatory for Mental Health; the Quality Network for Inpatient Children and Adolescent Mental Health Services; the Quality Improvement Network for Community Child and Adolescent Mental Health Services; and the Community of Communities, which quality assures and accredits therapeutic communities.

The programme was supported by partner organisations including the Royal College of Nursing, the British Association for Psychopharmacology, the Association of Child Psychotherapists, and the charities Rethink and Mind.

Further reading

Learning report

Using clinical communities to improve quality

December 2013
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Closing the Gap through Clinical Communities


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