Black Country Healthcare NHS Foundation Trust engaged Arden & GEM’s Clinical Support team to assure the review process for residents receiving Section 117 mental health aftercare in the community.
Three experienced, registered mental health nurses provided independent expertise and capacity to lead a process of data cleansing and case prioritisation which resulted in an assured single register of eligible patients. This will ensure patient reviews are being undertaken in a timely manner and in accordance with clinical need.
The challenge
Black Country Healthcare NHS Foundation Trust provides specialist mental health services for the population of the Black Country, including delegated responsibility for Section 117 (S117) aftercare. In 2023, the Trust commissioned Arden & GEM’s Clinical Support team to review and harmonise S117 aftercare across the system, ensuring service alignment and efficiency through an overarching system-wide policy.
As part of the Trust’s ambition to make meaningful and sustainable improvements to the long-term review process for residents receiving S117 aftercare, the Clinical Support team was re-engaged. The team was tasked with:
- Coordinating a programme of S117 reviews across the Black Country, ensuring quality outcomes for residents and a positive experience for the workforce
- Engaging partners to produce a mutually agreed cleansed list
- Enabling closer working relationships to bolster cross-organisational contributions
- Embedding cultural change within clinical teams to build sustainable local solutions and assure future reviews.
Our approach
A senior clinical manager and two clinical lead nurses – all registered mental health nurses – were assigned to deliver the project. This wealth of clinical and operational experience within mental health care ensured an objective and clinically assured perspective was brought to data cleansing and care prioritisation.
Stakeholder engagement
The CSU’s mental health nurses worked closely with the Trust’s leadership, quality, governance and IT teams throughout the project. Building these relationships enabled access to relevant systems and records to be secured while regular reporting back to stakeholders gave assurance on the project’s progress.
Accessing and managing data
With information kept on disparate systems within both mental health providers and local authorities, creating a single, clear register of patients eligible for S117 aftercare was the team’s first priority. Once data sharing agreements and data protection impact assessments had been put in place between the CSU, the Trust and the local authority, relevant S117 patient lists were shared with the Clinical Support team. Data from these multiple sources was merged to generate a single S117 register.
Cleansing records
With a single register in place, the team could now turn their attention to ensuring its accuracy. The three clinicians conducted a data cleanse exercise on 2,070 records. With IT support, the team was able to access electronic patient records (EPRs) to investigate any duplications, discrepancies or missing information.
The register has brought local authority and health data into one place so services can easily see which patients are eligible for S117 aftercare, the package of support they are receiving, the cost of the package and when this was last reviewed.
Prioritising case reviews
As well as ensuring accuracy, the Clinical Support team also prioritised the list for review using a RAG (red, amber, green) rating system. The criteria for the RAG rating were tailored for this specific project and agreed with the client to ensure they captured information aligned to their priorities. The team then used their clinical judgment and contextual understanding to prioritise cases for review.
Outcomes
The project, which began in 2023, has resulted in a robust, assured list of cases being data cleansed and prioritised. The single register will enable Black Country Healthcare NHS Foundation Trust to:
- Ensure patient reviews are undertaken according to clinical need
- Ensure patients are receiving the correct level of community support they need
- Prevent future unnecessary hospital admissions
- Identify areas for potential financial savings through aftercare reviews.
Feedback from the Trust and project stakeholders has been very positive with an appreciation for the high engagement levels, working relationships, operational insight and objectivity brought by the Arden & GEM team.
"Through the successful consolidation and cleansing of data from multiple organisational sources, a single, accurate and trusted Section 117 dataset was created. The thorough validation process improved data quality, removed inconsistencies, and provided a much higher level of assurance and confidence in the information being used for decision-making.
The Arden & GEM team's collaborative and methodical approach delivered valuable assurance and outcomes that will support ongoing clinical, operational and strategic activities."
Jonathan Ram, Head of Assurance – Lead Provider, Black Country Healthcare NHS Foundation Trust
The data cleanse and prioritisation project has been finalised for two areas within the Black Country and the approach is now being rolled out to a further two areas with completion expected in February 2026.
The assured list, combined with the harmonised policy, have ensured the system is now well positioned to take forward this important area of work.
Find out more about our Clinical Support.