Maintaining and sustaining an MBCT service
What does an embedded service look like? The ASPIRE project suggests that in the journey of creating, maintaining and sustaining a service the following characteristics are commons.
Making it ‘fit’ the service you are working within
Starting out – Base service on evidence and local need (i.e., commissioning or clear service gap)
Developmental – Recognise fit/dissonance with existing and changing local pathways and look for opportunities
Sustainable – Contribute to a shift in service culture /model of care (treatment, recovery, prevention, well-being)
Developing an evaluation approach, using it and learning from it
Starting out
- Plan for evaluation (key measures and frequency, quality assurance and reporting)
Developmental
- Establish feedback loop of evaluation to service design and delivery
- Change based on feedback
- Annual reporting
Sustainable
- Evolve-based on new opportunities and feedback (e.g., establishing services in different setting, staff groups etc)
- Publish annual report
- Disseminate learning and good practice
Creating your networks and building culture
Starting out
- Find a “buddy”
- Identify where you need practical support
- Use existing networks such as those find at the British Association of Mindfulness-based Approaches.
Developmental
- Develop local networks and special interest groups
Sustainable
- Increase the visibility of your networks (local conferences, publications, newsletters, social media)
- Networks benefit users and sustain service (joint provision, shared training, sharing good practice)
Building a team to deliver
Starting out
- Train the first cohort of MBCT teachers
Developmental
- Encourage supervision and CPD
- Train the MBCT trainers
- Develop a training pathway
Sustainable
- Establish a mixed workforce of MBCT teachers / trainers
- Succession planning: ensuring there are second and third generation implementers
- Maintain and quality assure training provision
- Develop and innovate new training approaches
Getting top-down buy in
Starting out
- Create key messages for buy-in (who is it for, evidence, value it brings to people, benefits to the system)
- Establish who are the key gatekeepers for starting out
Developmental
- Increase reach of the message (public / external messaging)
- Communicating, from evaluation (above) with gatekeepers (people with power and influence)
- Mindfulness offered to gatekeepers and staff
Sustainable
- Empower gatekeepers as champions
- Patients and carers as champions
- Staff engaged and as champions
- Engagement with critical friends
Creating a fit for purpose structure / governance
Starting out
- Be accountable (keep records, talk to immediate network); work within professional and UK Network GPG which can be found by visiting Mindfulness Teachers
Developmental
- Develop clearer lines of accountability into existing service structures
- Establish your governance structure (e.g. finance, training, quality, risk)
Sustainable
- Make available your documentation and link it to stakeholders expectations (e.g., commissioners, patients, etc)
Nourishing and sustaining yourselves and your colleagues
Starting out
- Establishing personal mindfulness practice within the service
Developmental
- Capture, celebrate and spread to colleagues successes
- Reflecting and challenging (supervision, culture of mindfulness practice)
Sustainable
- Celebrate successes widely
A Case Study