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Case Study Barnet, Enfield and Haringey Mental Health NHS Trust

Barnet, Enfield and Haringey goes digital to measure quality improvement across their estate

Case Study
Nurses at Barnet Enfield and Haringey Mental Health NHS Trust

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Barnet, Enfield and Haringey Mental Health NHS Trust (BEH), a large provider of integrated mental health and community services in London, has implemented Tendable’s digital technology, enabling 300 staff in 45 teams to conduct 13 quality audits using their mobile devices. In November 2020, the Trust successfully extended the implementation to 12 community teams, going live in just 4 months.

The challenge of data in large and complex organisations

Like many NHS organisations, collating meaningful quality data from the whole Trust is a significant hurdle, especially when services are delivered from a large number of locations ranging from mental health and community hospital facilities through to clinics, care homes, people's own homes and prisons.


From the beginning, we recognised that using data in a more structured way to highlight areas for improvement, refine our processes and identify key trends was a critical success factor. We kickstarted our governance journey by digitising our health and quality inspections with the help of Tendable. Two years on and the quality improvement app has totally transformed how we measure quality across our large and complex organisation.

Caroline Sweeney Deputy Director of Nursing – Quality Governance at BEH

A solution to match requirements and help gain control

Both clinical and non-clinical staff in the community and mental health teams use Tendable to conduct their own audits, with content and questions to match their specific requirements. Staff particularly praise the flexible way Tendable allows them to receive instant feedback on their smart devices, so they can track performance in real-time and act swiftly on the results. They are able to save their audits and then go back to add or review them at a time and place to suit them. Meanwhile, notifications of completed audits and associated outcomes are automatically generated and issued to divisional and corporate management, putting leaders in complete control of their quality environment.

During the pandemic, BEH used Tendable to develop a new set of audits consisting of 24 questions in 6 key areas covering visitors, hand hygiene, COVID cases, PPE, general staff awareness and managing IPC on the wards. The results pinpointed two key problem areas of staff confidence and PPE that were quickly addressed through training.

The benefits of faster digital inspections and audits

Since automating health and quality inspections, BEH has noticed a series of benefits. The flexibility and efficiency of the Tendable app has vastly reduced the number of hours spent auditing, allowing more time for people to care for patients. In addition, the technology is fast becoming a valuable strategic tool. Dynamic data held in the Tendable system empowers staff to actively contribute to national programmes such as the Mental Health Act or meet the unique challenges of a global pandemic as Caroline Sweeney explained:

Infection control has become a prominent issue over the past year and Tendable has really helped us to become COVID secure. As the pandemic has changed, we’ve been able to adapt and update our audits in line with changing national guidelines. At a glance, we were able to understand where the gaps lay and how we were learning from the challenges of dealing with COVID-19.

The more BEH has used the Tendable solution, the more creatively it has applied technology to launch new Quality Improvement (QI) initiatives. One of the most inspirational is the recent introduction of ‘Clinical Fridays’. On this day, everyone from the Chief Nurse down, works on the frontline, focuses on one specialist area such as safeguarding or resuscitation and gathers data in the Tendable solution to identify areas of improvement and agree a meaningful QI plan for their chosen theme. BEH is leading the way but it’s an approach that could equally be applied in multiple health and social care settings.

Effective staff engagement is essential

Caroline Sweeney offers one final word of advice.

“The Tendable solution is very intuitive but we found good training was crucial to boosting user acceptance, as was involving staff in the design of the audits. We also had to reverse the traditional ‘checklist versus audit’ mentality where displaying a sea of green scores is not particularly helpful when it omits the key obstacles that have to be overcome to arrive at the perfect green result. To change the mindset, we turned conventional thinking on its head, showing how Tendable is not a tool to chastise, rather it presents a complete journey of learning to help improvement.”

Future plans

BEH plans to roll-out the Tendable solution to more community teams where the majority of patients receive their care. Other plans involve peer-to-peer auditing to boost transparency and cross-functional learning along with the launch of a new and bespoke CAMHS (Children and Adolescent Mental Health Service).

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