We hope these case studies will give you some insight into the kind of challenges our clients face and how we work with them to improve outcomes for their customers, reduce costs and make them better places to work. We believe that by sharing our knowledge and expertise we can better equip public services to meet the challenges they face.  
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Alexander worked with all the organisations in the Devon health economy – and with people who were expert by experience – to improve the system’s response to mental health crisis. The plan needed to deliver significant improvement, but it also needed to fit into a broader strategy for Devon, being designed by the emerging STP. It not only maned to do this but was held up as an exemplar approach by the national Crisis Care Concordat summit in 2016. 
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Changes to the Policing and Crime Act were about to significantly increase the pressures on a hard-pressed system. Alexander worked with 23 statutory organisations – including police forces, NHS commisonted, NHS acute trusts and mental health service providers, the ambulance service, unitary councils – to plan for improvements that were principally informed by the experience of people and professionals. The geography was huge – Bristol, North Somerset, Souh Gloucestershire, Bath and North-East Somerset, Swindon, and Wiltshire. An ambitious plan was developed – informed by a clear-minded view of what was happening – and an implementation plan was designed, to be delivered by several task-and-finish groups which drew on staff from the geography and across the professions. 
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TSWYPFT were faced with increasing pressure to deliver savings without compromising the safety and quality of service that was being provided. The Trust had already re-structured to facilitate delegated decision-making and innovation in four geographic Business Delivery Units (BDUs). With Alexander’s support SWYPFT undertook a series of reviews of pathways of care. It decided that Rehabilitation and Recovery (R&R) services wold be first, due to their its complex nature and the large number of service users it involved. This led to the development of an alternative model of care focussed on home-based treatment with in-reach into bed bases owned and run by other providers. The success of this initiative would also build security in the system and Trust stakeholders will feel more secure and confident in discussions with external stakeholders, such as commissioners.  
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Despite being a successful and solvent organisation Rother District Council was facing great financial pressure, with only small breathing space to diced how to cope and preserve its resilience and high performance for the future, on which the people of Rother would depend. Alexander worked with the Council extended leadership team to design a plan that was properly informed by the whole environment, including key partners and stakeholders. 
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Wye Valley NHS Trust was in special measures. In this urgent situation the Board need to do several things in parallel. The exacting detail of getting out of special measures needed to be addresses. At the same tie the Board needed to develop itself so that it could lead a resilient organisation in the future. It asked for Wye Valley Alexander’s help. The Trust came out of special measure and the Board took firm control of the future of the Trust. 
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