The purposeful and productive community services (PPCS) programme is a challenging and large scale change.

Why we needed to change

TEWV is committed to supporting and working with service users (and their carers) to achieve the goals they have set themselves (recovery focussed care). Changing the way we work in community services is helping us fulfil that commitment and continue to improve the quality of the care we provide.

We also have a duty to make the most of tax payers’ money and to use our resources to get the best outcomes for people. The best way to do this is through focussing on improving quality.


What is PPCS

PPCS is the largest and most significant initiative the Trust has attempted in recent years.

Key to its success is the use of our quality improvement system (TEWV QIS) which empowers and supports staff to improve services. It helps teams remove waste so that clinical staff can focus on what’s important – improving the lives of the people who need our services.

TEWV QIS also challenges us to see the service through the eyes of patients and carers.


Phase one

Phase one of PPCS was launched in February 2016. This included introducing a number of different ways of working in community teams including:


Creating cells and introducing daily huddles

Smaller groups (called cells) have been created within larger teams. The cells meet on a daily basis (huddles) for around 15 – 30 minutes. The cell members (usually around five to seven people) review the previous day’s appointments and highlight any problems or challenges they are facing. This gives them an opportunity to discuss issues and get support from colleagues to identify solutions. Feedback from staff has been very positive. They say communications has improved, problems are addressed early and staff feel more supported.


Caseload management

The aim is to make sure that clinical staff have manageable caseloads and that they are providing the level of care and support that individual service users need. We have introduced tools that assist with this and have introduced standard processes that help staff manage their diaries. Again, feedback has been positive with staff saying they feel contact with service users is more purposeful and they’re able to manage their caseloads more effectively.

Of course, there have been challenges along the way and we continue to support teams to embed these new ways of working. Nonetheless, we are starting to see the benefits, including a reduction in waiting times (particularly in children and young people’s services).

You can learn more by watching the videos of staff telling their personal experiences on TEWV’s YouTube page:


Phase two

Phase one focussed on the way teams work. Phase two, which is now underway, will focus in much more detail on the clinical services we provide and the systems we have in place across the organisation to support them. Much of this work will focus on


Developing clinical pathways and developing our workforce (clinical pathways are standard, evidenced-based assessment and treatment plans)

Work is now underway to develop clinical pathways for every clinical community team. We have a number of pilot teams that are testing our new pathways which will then be rolled out to all similar teams.

Once the pathways have been developed we will then need to make sure that we have the right staff with the right skills in the right place to deliver these pathways.


Improving Information technology

Information technology (IT) has a key role to play in supporting staff to do the job they need to do. We recognise that there are things we can do to improve our use of IT.

We need to make sure that we are using the correct technology and that it is supporting staff to work effectively and efficiently. We need to make sure that staff have the skills they need to use the technology so that it saves them time and reduces waste.


How we are involving service users and carers

The involvement of service users and carers is crucial to this programme. This has already started (see examples below) although we recognise there is still work to do to increase the level and type of involvement.


  • Two service users and a carer were involved in developing the adult mental health pathway in York and Selby.
  • We’ve held focus groups in older people’s services for both service users and carers to find out what adds value to their experiences of services and what can lead to improved outcomes. We plan to use this feedback to improve and develop services.
  • Experts by experience have been helping us refine our approach to developing our workforce. Our goal is to enable staff to ‘problem solve’ with the support of skilled and supportive colleagues.


We hope this briefing provides a useful overview of PPCS but if you have any additional questions, would like more information or would like to get involved please contact Maureen Raine, head of Kaizen Promotion Office (email or call 0191 3333096).


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