Mersey Care – striving for perfect care, and supporting people in crisis

Mersey Care NHS Foundation Trust is one of the largest trusts providing physical and mental health services in the North West. Serving more than 1.4 million people across 170 clinical services sites in the region, the trust is also commissioned for services that cover the North West, North Wales, and the Midlands. As one of only three trusts in the UK that offers highly secure mental health facilities, Mersey Care is leading the way with the provision of mental health services.

The trust is currently delivering a programme of organisational and service transformation, in order to significantly improve the quality of services provided, and safely reduce costs at the same time. As part of this ‘striving for perfect care’ initiative, Mersey Care wanted to develop a dedicated 24/7 urgent mental health crisis helpline to support communities throughout Merseyside.

Although originally planned for 2021, the launch of the helpline was brought forward in 2020 due to the impact of restrictions imposed during the Covid-19 pandemic, enabling Mersey Care to respond to the rapidly increasing mental health concerns in the community and provide immediate support. An average of 3,500 people per month in the North Mersey area used the service during lockdowns. Mersey Care partnered with ITGL, a multi-award winning digital consultancy, to develop the crisis helpline for the future. Together, they ensure that the latest innovations in technology are deployed to continuously improve Mersey Care’s ability to care for people in crisis. Now in its fourth year, the crisis line project continues to evolve, with 500,000 more people known to be using the service than in 2020, and an average of 14,000 contacts per month. The integration of Calabrio (part of Cisco Webex Workforce Optimization suite) in October 2023 has further transformed the service, enabling the trust to respond more quickly, provide the correct care, and safeguard the wellbeing of clinicians so that they can continue to deliver this critical service to the highest standard. The software which we are continuing to develop is there to support our team to provide more time to care.

 

First steps

The launch of the crisis helpline in 2020 reaffirmed the growing need for such a service in the North Mersey area, with an immediate influx of users during the Covid-19 lockdowns, and call numbers only rising since. Mersey Care wanted to ensure that the crisis line is flexible and futureproof in the face of growing demand and pressure on the service. Particular aims of the first phase of the project included:

• Improving the user experience through better management of staff and queue allocations, distinguishing between urgent and non-urgent calls, and reducing the number of abandoned calls.
• Facilitating the training/onboarding of new staff and ensuring the solution had the capacity to cope with increased call volumes expected due to an ongoing merger between North Mersey and Mid Mersey services.
• Providing a wider variety of communication channels, to respond to the varied needs of the community – for example, offering text-based communication options for the hard of hearing.

The ITGL team worked with Mersey Care to design and implement a Cisco Webex Contact Center solution, completing migration to the cloud-based platform in November 2022. With Webex:

• Call routing capabilities enable urgent calls to be prioritised over lower acuity calls, ensuring that patients receive immediate support from qualified nurses and clinicians when needed – with the aim of reducing pressure on A&E and emergency services that are already managing long wait times and staff shortages, where mental health teams are trained specifically in handling mental health cases.
• Utilising text-to-speech features enables the team to be flexible and responsive to patient needs, updating recorded messages quickly and easily, and ensuring that all responses are consistent.
• A dedicated Emergency Services line enables the trust to provide a direct line to those in the field, again ensuring that patients receive the right help, that emergency service staff have the information they need, and staff who may be less experienced in dealing with mental health concerns are supported.
• Real-time and historical data and reports accessed within Webex Contact Center Analyzer allows the team to better manage calls, queue times, abandoned calls, call-backs, and agent availability.

Most importantly, the trust now had a flexible, future-proof solution upon which they could continue to build.

 

Innovation

With the initial migration complete, ITGL and Mersey Care could now look ahead on the roadmap, and plan to integrate innovative new tools to continually improve both patient and staff experience. Developments so far have included:

Successfully managing the merger with Mid Mersey and 111, onboarding new agents at various skill levels to ensure consistent quality of service.

Bespoke changes to the IVR systems, improving call flows and helping to ensure calls are handled by the appropriate clinicians.

Utilising the capabilities of the Webex platform to embed web pages that use the technology of the what3words application, which has seen 114 active rescues to date (September 2024), where the emergency service has been able to pin point exact locations of service users in crisis.

Implementation of Calabrio to provide transcription, sentiment analysis and enhanced data capture.

 

The impact of Cisco Webex Workforce Optimization (WFO)

Calabrio Contact Center Workforce Optimization technology (part of Cisco Webex Workforce Optimization Suite) was integrated into the solution in October 2023. It has provided Mersey Care with increased visibility and more detailed analytics, which can be used to deliver a better service to patients and improve support for helpline staff. Key benefits so far include:
 

Contact volume insights

• Analytics can automatically identify all Biopsychosocial questions. Mersey Care has been able to identify that only 21% of contacts handled by clinicians are ‘clinical’. By re-routing calls to the most appropriate team members, clinicians have more time to deal with critical calls.
• Non-clinicians take 16% longer to address a critical interaction. Using WFO to ensure users reach the right clinician will improve outcomes for patients.

Reduction in after-call work  

• Analytics automatically summarise contacts and identify the location of key points in a call. Transcriptions, contact navigation, and 150-word summaries are available within ten minutes. Once fully rolled out, Calabrio will significantly reduce time spent on after-call notes and reporting, increasing workforce capacity across all skill sets.

First Call Resolution

• Analytics identify repeat contact patterns, either by dialling number or indicators of repeat contact. Mersey Care has currently identified that 15.3% of contacts are repeat callers. These calls can be audited and studied to identify where the service may have been improved, or where staff may benefit from further training to ensure that the correct care can be given, and to hopefully reduce the need for repeat callers.

Focus on staff well-being

• Analytics dashboards, powered by transcription, will identify clinicians who have dealt with high volumes of contacts, or where staff have dealt with particularly challenging or abusive contacts. With 50 clinicians leaving the service every year, and 6,728 hours spent on induction and training of new staff, the ability to identify staff at risk of burnout enables more effective support for wellbeing, protecting clinicians and improving retention, saving the trust time and resources in the process.

Mersey Care has already realised significant value from the insights, analytics, and workflow optimisation WFO can provide. With the operational efficiencies gained through more accurate call routing, automated reporting, and retention of highly-skilled staff, thousands of hours can be reinvested into the service to respond to increasing demand and improve patient outcomes. Analytical insights are also shaping training plans for staff, identifying opportunities for development, further improving the quality of care Mersey Care provides.

Next steps

With such transformative progress achieved already, Mersey Care and ITGL are excited to work together to continue to enhance the crisis line capabilities, exploring how the benefits of WFO can further support the development of the project, and ensuring that the latest innovations in technology are deployed to continuously improve Mersey Care’s ability to care for people in crisis.