Tomorrow, the winners of the NHS Excellence Awards will be announced at ConfedExpo and ahead of the event, we’re shining a spotlight on one of CNWL’s regional champions: the Harrow Psychotropic and Physical Health Clinics team.

We’re looking forward to cheering on all our CNWL colleagues and seeing who takes home the awards. We’re also proud to see CNWL’s Community Paediatrics Team in Milton Keynes recognised as a regional champion, for their work using ambient voice technology to reduce report writing time on the autism spectrum disorder pathway.

People living with severe mental illness often rely on specialist medication to stay well and live safely in the community. One of the most effective treatments for people with treatment‑resistant schizophrenia is clozapine, while many others are prescribed long‑acting (depot) antipsychotic injections to support stability. These medications are vital, but they also require careful monitoring and regular clinic visits.

Missing clozapine for even 48 hours can mean restarting treatment and, in many cases, avoidable inpatient admission. Ensuring clinics run safely and reliably is therefore essential - not just for patient outcomes, but for staff confidence and wellbeing too.

Why this work matters

The clinics in Harrow serve hundreds of patients who depend on these specialist treatments. Harrow is one of London’s most diverse boroughs, and the clinics support a particularly complex and often stigmatised group of people using mental health services.

Antipsychotic medication plays a crucial role within wider care and treatment plans, but medication alone is not enough. Safe systems, health monitoring and therapeutic support are essential to help patients remain well and continue their recovery in the community.

Redesigning clinics, driven by learning and feedback

Prompted by patient feedback, colleagues led a quality improvement project to redesign how the depot injection and clozapine clinics operate in Harrow. Importantly, the work was delivered within existing resources and without additional funding.

The aim was to make clinics safer, more consistent and more therapeutic for both patients and staff.

Key changes included:

• Protected clinic capacity to reduce disruption
• Clearer roles and responsibilities across the team
• Simplified and standardised documentation
• Daily safety huddles
• Stronger psychosocial support alongside medication

Benefits for patients and staff

The service is delivered by a team of specialists, including mental health and general nurses, healthcare support workers, an advanced clinical practitioner, psychiatrist, team manager and admin colleagues. The clinics are also supported by employment services and occupational therapy colleagues, helping ensure care goes beyond medication alone.

The impact of the redesign has been significant. More patients are now getting the checks and support they need. Health monitoring is now up to date for 98% of patients, helping to reduce long‑term health risks. Clozapine reviews increased from 28% to 95% in just four months.

We also saw improvements in how clinicians and patients use Dialog+, helping make conversations more focused and meaningful, with completion rates rising from 58% to 76%.

Referrals to the motivational interviewing group also went up by 60%. This group supports people to talk through their thoughts and feelings about change, helping them feel more involved and confident in their care.

For staff, the changes have brought much‑needed structure and clarity. Regular supervision and better rotas have helped reduce pressure and make it easier for teams to work together. Most staff are now up to date with their training and appraisals (over 90%). There’s also been a rise in how often staff flag clinical risks, showing greater awareness and a stronger focus on safety.

What patients and clinicians are saying

“I feel in control with help.”

“There isn’t any pressure.”

Clinicians describe being able to focus more on therapeutic practice:

“My practice has transformed. I feel I’m making a difference rather than just giving injections.”

Karise Graham, Team Manager, said:

“We are truly honoured to be shortlisted. This recognition reflects the dedication and compassion of our team, who work hard to engage and support some of our most vulnerable patients living with mental illness. We are incredibly proud of what we have achieved together and remain committed to delivering safe, meaningful improvements that keep patient care at the heart of everything we do.”