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SSA Toolkit

Section 136: Manage phase


Section 136: Manage phase

Section 136: Manage phase

The Manage phase of the Section 136 case study involved planning next steps, refining the goals, engaging the stakeholders and monitoring the system, as follows:

Guidance on how to Manage the SSA process in general can be found in the Guide section of this website.

Diagram showing the Manage phase as part of the overall SSA process. This phase involves Plan next steps, Refine goals, Engage stakeholders and Monitor system.

The Manage phase of the Section 136 case study

Plan next steps

The Section 136 SSA was triggered by the planning of a new secure mental health unit for adolescents which would include a Section 136 suite (see Monitor system below). Given the breadth of the planned changes in the new build compared with the existing facility, there were many different areas that could be examined. Several telephone discussions took place between the Project Manager and the facilitator for the SSA, to identify a number of candidate topics for SSA. One of these was to consider the impact of the design of the 136 Suite. There were several SSAs examining different aspects of this. The SSA described on these pages was one of these, focusing on the process of admitting a young person to the unit.

During the SSA process, it can be important to revisit earlier activities in the SSA. However, this particular case study was a fairly simple assessment which took place over a short space of time. As a result, there were no major system changes that took place during the SSA, and significant reviews were not deemed necessary in this case. Perhaps the most significant activity that could have been repeated was to reconsider who was present in the SSA, especially after completing the Identify stakeholders activity, and perhaps again at the Identify risk stage. In the case of this SSA, it was felt that the stakeholders already present were sufficient to provide an accurate picture of risk.

Information about how to plan next steps in an SSA is provided in the Guide section: Plan next steps.


Refine goals

In the Section 136 SSA, the goals were quite varied and broad, but because it took place over a short space of time, the goals did not change. However, due to time restrictions in the SSA meeting, some further assessments were scheduled: one to consider two remaining risks in further detail, and one to focus on risks around smoking cessation.

Information about how to refine the goals in an SSA is provided in the Guide section: Refine goals.

Screenshot of the Outline goals page from the Section 136 case study. The goals are circled. They are to examine the risks involved in the opening of a new unit and address them as far as is practical, to determine how to improve the service, and to address the unit's capacity issues, with the increase in number of patients, now that patients aged 17 are included. The full form in pdf is available from the Resources page.

The refined goals were recorded on the ‘Outline goals’ page.
(Click image to enlarge)

Engage stakeholders

The Section 136 SSA started with a series of initial telephone discussions with the Project Manager. These identified a number of possible stakeholders for the SSA. In particular, the discussions were invaluable for considering who to invite to the first SSA meeting, especially to ensure that a sufficient understanding of the system and its risks could be established during the meeting. Care was given to select members of staff who would be likely to engage with the SSA process and the case study, and who were sufficiently connected into the organisation to help carry out changes. The Project Manager then set up the first SSA meeting, and a follow-on meeting a few weeks later, giving the stakeholders several weeks' notice to help ensure their attendance.

Since this was a relatively simple SSA, only five stakeholders took part, led by one facilitator. The SSA was given the blessing of the Director of Nursing, who was able to engage the interests of the Trust's Board and to email nursing staff to encourage them to engage with the process. In between the two meetings, additional discussions took place between the nursing stakeholders and colleagues, to solicit wider opinion.

Information about how to engage the stakeholders is provided in the Guide section: Engage stakeholders.

Monitor system

The main trigger for the Section 136 SSA was that a new mental health unit was being planned, and that this was an excellent opportunity to consider new ways of working and to assess risks in the proposed plans. This case study was actually one of a series of SSAs.

Further monitoring and evaluation were planned to take place after the SSA, particularly in the light of any emergent capacity issues and any adverse effects of introducing the new actions.

Information about how to monitor the system is provided in the Guide section: Monitor system.