In Phase 1, local sites will form a comprehensive picture of their current system of services for children and young people’s mental health, understand the problems that the system faces and assess the particular needs of their local population of children and young people.
This will include three types of information: qualitative (what service users, the public and staff think about existing services), quantitative (data that demonstrates demand, capacity, flow, identifies bottlenecks, efficiencies and inefficiencies) and pathway mapping (a full description of the pathways across a whole system, including how services are working and interacting together or not). Local areas will develop an idea of how ‘THRIVE-like’ services are currently, create a baseline prior to the start of implementation and prioritise the changes they want to make.
Sites will also decide who will lead on implementation, identify i-THRIVE champions and create a robust implementation plan, as well as developing jointly owned outcome frameworks.
Phase one of implementing the THRIVE Framework for system change (Wolpert et al., 2019) involves:
- Understanding Your System
- THRIVE Assessment
- Prioritising Improvement
- Redesign and implementation planning
2. Understanding Your System
The system of services for supporting children and young people’s mental health and general wellbeing is often complex. There is a need to understand how the system is working first, before making changes. This section talks through one method of building an understanding of your system including what is already working well, and the elements that would benefit from improvement.
Mapping the current pathways within and between services, and reviewing qualitative and quantitative data can help to build an understanding of your current services.
3. THRIVE Assessment
Once you have formed an understanding of your local services for children and young people’s mental health, you can start to assess how ‘THRIVE-like’ it is and start to identify opportunities to work in a more ‘THRIVE-like’ way. A THRIVE Assessment Tool has been developed to support sites with this.
4. Prioritising Improvement and Gap Analysis
In this session, you bring together the THRIVE Assessment analysis and the opportunities for improvement in your system. You will re-establish with the group what they are looking to achieve through their transformation. What, out of everything discussed, are we looking to improve? (e.g. patient experience, access, waiting times, costs). The gap analysis will then support you to think about what is missing.
5. Redesign and implementation planning
This is the final step of the phase – determining as a group what your new services will look like. This will focus on your identified priority areas, and working with examples of best practice and evidenced based models of care you will work out a plan for delivery of each of the THRIVE Framework needs based groupings. From this there will be a clear description of how each service will look at the end of implementation, as well as provide a stepwise plan to approaching this. From here, a clear plan for implementation can be drawn up, including any requirements for up-skilling the workforce and capacity building.