Quality in Mental Health Services: Is Accreditation the Answer? Dr Adrian Worrall
|
|
- Aleesha Garrett
- 8 years ago
- Views:
Transcription
1 Quality in Mental Health Services: Is Accreditation the Answer? Dr Adrian Worrall
2 Overview Background to mental disorder, mental health services and policy Elements of clinical service accreditation Does accreditation work? How does accreditation work? Critique Is accreditation the answer?
3 Mental disorders Mental disorders are prevalent and disabling Depression is the second highest cause of disability in Europe fatigue, decreased ability to work, and suicide Anxiety is one of the top 10 causes Schizophrenia, bipolar disorder, drug and alcohol use disorders, and dementia are all in the top 20 causes Others: personality disorder; learning disability; eating disorder
4 Mental Health Services Primary care (GP) Secondary care services Community Mental Health Services; acute psychiatrist ward; home treatment team; memory clinic; child and adolescent service; forensic ward...
5 Background International Classification of Diseases (WHO) Many measures of mental, physical, social health and functioning Large evidence base for what works drugs and psychological therapies
6 What is healthcare trying to achieve? Health: a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1948) Ageing with long term conditions is now he norm. the ability to adapt and to self manage Diabetes, heart problems, liver disease, respiratory problems; most mental disorders New role for health services and clinicians coach versus a miracle healer
7 Quality in Healthcare Care Quality Commission safe effective caring responsive to patients needs well-led
8
9 Is the health service a special case? Very big The NHS costs about 100 billion p.a. and is the UK s biggest employer Unusually high levels of policy changes including major structural changes Large number of interconnected systems Large number of safety critical systems Complex ownership and management structures Professional autonomy and professional supervision run in parallel to managerial supervision
10 Landscape for Quality Healthcare Providers internal governance systems Commissioners Regulators Care Quality Commission (safety versus excellence) Professional regulation (General Medical Council) Other national organisations Professional Bodies (Royal College of Psychiatrists) NICE (Clinical standards) NHS Trust Development Authority National Quality Board
11 Policy Appointment of general managers Lead health services, to be set targets (Griffiths, 1983) Purchaser/ provider split, 1989 Competition would drive up standards New Labour (NICE, Regulator and clinical governance) Choice and Payment by Results
12 Top Down Targets and directives National campaigns Payment mechanisms National clinical guidelines Regulatory & legal Inspection, accreditation
13 Bottom Up Industrial approaches (PDSA, LEAN, process mapping, etc) Local clinical audit Local action plans addressing deficits identified in national initiatives Good governance and leadership Clinicians excellence versus system excellence
14 Blend of Top Down and Bottom Up National initiatives (top down) to create a stable and harmonious context for clinical excellence National One size fits all interventions fail because they do not anticipate context and do not make the most of local expertise Local managers and clinical teams should create excellence (bottom up) They know the issues and solutions
15 Elements of Accreditation of Clinical Services
16 A Definition of Accreditation Self-review and external peer review of clinical services against standards in order to (i) inform a decision about their level of performance and (ii)identify areas for improvement Adapted from ISQua, 1999
17 Standards 1. Environment and Facilities 2. Staff and training 3. Access, Admission and Discharge 4. Care and Treatment 5. Information, Consent and Confidentiality 6. Safety and Security Some minimum standards, but in general are aspirational To promote excellence rather than to assure safety
18 Example of a Standard 38.6 Essential: At least one staff member delivers one basic, low intensity psychological intervention 38.5 Expected: All patients are offered specific psychosocial interventions appropriate to their needs 38.8 Desirable: At least one staff member delivers two or more problem- specific, high intensity psychological interventions
19 Accreditation Cycle Agree Standards Accreditation Decision Self Review Local Report Peer Review Method: Clinical audit within a peer support network
20 What Level? Hospitals Services (adult mental health) Clinical teams * Individual practitioners Pathways
21 Involvement of Stakeholders Standards Workshops: HIGH Patients, carers, commissioners, service providers, clinical staff (all relevant professions) NHS and Independently-funded services Project Team: MEDIUM Designing methods and tools: LOW Writing reports: LOW Advisory Group: HIGH Self review and external peer review: : HIGH Accreditation decision: HIGH and LOW
22 The Accreditation Decision Accreditation Commitee reviews a report and makes a recommendation A separate senior committee checks and formally accredits Not Accredited, Deferred, Accredited, Accredited with Excellence Accreditation is prospective for 3 years
23 Accreditation is More Top Down and Bottom up Top down Centrally driven National standards Common process Bottom up External peer review involves local staff Support through the network Local staff find solutions and make action plans
24 College Centre for Quality Improvement Work with nearly all mental health trusts in UK Cover most specialised mental health services, n = 17, started in 2000 About 1000 peer reviews in 2013 Services pay about 2000 per annum Networking function with groups and forums 2013: Cross College Accreditation Alliance Care Quality Commission will use accreditation info Frameworks: UKAS/ISO versus ISQua
25 Does Accreditation Work? Typically compliance increases Ask participants to attribute reasons for improvement Controlled trial David Greenfield UNSW: Accreditation improves organisations in some circumstances Accreditation uses clinical audit which has an evidence base
26 ECT Clinics Performance against 10 standards 3 Clinical audits: 1981; 1992; 1998 Accreditation:
27 Can Accreditation Prevent Large Scale Tragedies?
28 Winterbourne View and Mid Staffordshire External peer review brings light Standards and norm group offer a benchmark Reports amplify voices and empower staff Record patient views Good processes cannot guarantee no bad outcomes, but should reduce the likelihood
29 Critique Gains are not sustained Too much focus on process and not outcome Tyranny of the trivial versus a focus on the quality critical Standards do not get to the heart of the issues (construct validity) Shallow intervention Tell people what they already know vs. help them improve
30 Performance Time
31 Accreditation
32 Process or Outcomes?
33 Is accreditation just part of the endless growth of quality in healthcare? Torrent of quality initiatives and policies result in redisorganisation (Walshe) Services need resilience to survive What is driving this growth? Desire to improve? Desire to be seen to making changes? The big business of quality? Our anxiety?
34 Sheldon: Juggernaut of Quality (2005) Computers are driving an obsession with measurement to find deviant behaviour Quality is used in a normative, coercive way Can annihilate the worst and best of services Need more trust promoting approaches rather than trust eroding ones combination of oversight and active professional selfregulation is probably the best way forward
35 Measurement without meaning We need a deep understanding of problems Shared understanding with the service concerned Long term relationships versus short term policy Critical friend A blend of large scale scanning initiatives (scanning) Small scale more intense initiatives (trouble shooting)
36 Don t try and understand em, just round em up and brand em We need to a deep understanding of problems through measuring the right things well and forming long term relationships with services
37 Isabel Menzies Lyth: Social Structures as a Defence Against Anxiety (1960) Are we using accreditation as a defence against anxiety? Psychoanalysis of nursing in a London hospital Healthcare is inherently difficult, risky, demanding, distressing, disgusting We need defence mechanisms, but should choose them carefully. Some can diminish performance Accreditation can help contain and reduce anxiety Could lead to complacency and lack of engagement with patients complaints
38 How Does Accreditation Work?
39 Themes 1. Local ownership and leadership It was our project. We signed up; decided who attends reviews of other services; planned review; saw it through; acted on feedback 2. Other people s suggestions and recommendations were very, very useful, we came away with a lot of ideas that we have adopted. SU feedback was very helpful. We gained ideas, about increasing SU involvement and timely recording of assessments. (sharing good practice)
40 Themes 3. Exposure of bad practice Either by external reviewers or by staff voicing their own concerns Really want accreditation (feel proud) Definitely don t want failure (feel embarrassed) 4. Don t want to be different benchmarking shows differences, raises questions and difference reduces confidence in service
41 Themes 5. Feeling connected The networking aspect has been of real value in helping to implement change we have felt quite disconnected in the past but now we feel more enthusiastic (confidence in support available). 6. Willingness of others in the network to help
42 Themes 7. Time for reflection as a team Staff found time to discuss and reflect in detail on their prescribing practice 8. Insight through discussion with reviewers liaison team realised local acute trust passes patients too often to them (they are very responsive).
43 Themes 9. Courage and realising one s limits It has helped us to feel more comfortable and honest about what we can and cannot do, and through this we have made some improvements. Need courage to say you are struggling and then trust in others to help 10. Willingness to deal with organisational constraints Staff members want to do a good job, but the systems they work within prevent them. Successful staff think about systems and how they might be changed (POMH)
44 Themes 11. Improved morale The team were quite buoyed up by it. Being accredited with excellence raised the spirits of the whole service and increased interest in Liaison Psychiatry (confidence) 12. Long term helped stop longer term goals from being buried under the shorter term ones... Some change takes years
45 Themes 13. Focus and vehicle for change...gave us the focus to initiate, accelerate and finalise improvements 14. Enabled broad engagement across the trust Reductions in prescribing of high dose antipsychotics after wide dissemination of reports.
46 Themes 15. Data used in governance Some used prescribing data as part of Trust performance management targets
47 Themes 16. Leverage after being accredited Accreditation helped the team argue to retain the clinical lead in context of cuts. Excellent accreditation raised our profile in the trust and within PCT. 17. Used tactically Team used ECTAS to show what they already knew could not provide consistent anaesthetist cover. Imminent failure gave team support to close down clinic (Later reopened in a new location)
48 Summary of Themes Staff feelings and attitude ownership, morale, pride, embarrassment, willingness to take on the system How the work is actively used in the organisation leverage, use of data, others ideas, focus, time to reflect
49 Summary Accreditation gives patients and professionals a rare opportunity to lead quality improvement Agree standards together and apply them together Gives a voice and leverage to effect improvement Colleges are well placed to maintain long term relationships with clinical teams and to be a critical friend But Need to be aware of the growing industry of quality (Sheldon) and measurement without meaning Need to build trust in professions and not build coercive normative quality systems (Sheldon) Valid need to contain anxiety, but this can bring problems (Menzies Lyth)
50 Summary Accreditation is not the sole answer to improving quality in health services, but it has a role to play in the blend of initiatives Accreditation can provide the context for quality. Real improvements should come from the bottom up Blend of top down and bottom up initiatives Bottom up: Clinicians excellence versus system excellence? Blend of large scale scanning and small scale intensive initiatives National bodies should co-ordinate their work to provide the context and the scanning Who should provide the small scale? Different initiatives to assure minimum standards (Regulation) to those that drive excellence (Accreditation + small scale work)
Executive Summary and Recommendations: National Audit of Learning Disabilities Feasibility Study
Executive Summary and Recommendations: National Audit of Learning Disabilities Feasibility Study Contents page Executive Summary 1 Rationale and potential impact of a future audit 2 Recommendations Standards
More informationCLINICAL GOVERNANCE STANDARDS for Mental Health and Learning Disability Services
Clinical Governance Support Service promoting excellence in mental health and learning disability services CLINICAL GOVERNANCE STANDARDS for Mental Health and Learning Disability Services Structures and
More informationGeneral Hospital Information
Inpatient Programs General Hospital Information General Information The Melbourne Clinic is a purpose built psychiatric hospital established in 1975, intially privately owned by a group of psychiatrists
More informationStep 4: Complex and severe depression in adults
Step 4: Complex and severe depression in adults A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive
More informationCosting statement: Depression: the treatment and management of depression in adults. (update) and
Costing statement: Depression: the treatment and management of depression in adults (update) and Depression in adults with a chronic physical health problem: treatment and management Summary It has not
More informationSymptoms of mania can include: 3
Bipolar Disorder This factsheet gives information on bipolar disorder. It explains the symptoms of bipolar disorder, treatments and ways to manage symptoms. It also covers what treatment the National Institute
More informationThe Michael Palin Centre for Stammering 13 15 Pine Street, London EC1R OJG 0203 316 8100. www.stammeringcentre.org
The Michael Palin Centre for Stammering 13 15 Pine Street, London EC1R OJG 0203 316 8100 The Michael Palin Centre has an international reputation as a centre of excellence for therapy, research and training
More informationOur Vision Optimising sustainable psychological health and emotional wellbeing for young people.
Our Mission To provide free psychological services to young people and their families. Our Vision Optimising sustainable psychological health and emotional wellbeing for young people. 1 Helping Students,
More informationThe diagnosis of dementia for people living in care homes. Frequently Asked Questions by GPs
The diagnosis of dementia for people living in care homes Frequently Asked Questions by GPs A discussion document jointly prepared by Maggie Keeble, GP with special interest in palliative care and older
More informationImproving the Rehabilitation and Recovery Service Model in Leeds
Improving the Rehabilitation and Recovery Service Model in Leeds Presenters: Emma Brown (Care Coordinator) James Byrne (Recovery Worker Leeds Mind) Nigel Whelan (Care Coordinator) Introduction Provide
More informationPrimary mental health care for the elderly
Guides to specific issues 1 This issues guide is linked to the vignette Mental health needs of the elderly. From a system perspective the elderly represent another invisible population as far as the management
More informationA MANIFESTO FOR BETTER MENTAL HEALTH
A MANIFESTO FOR BETTER MENTAL HEALTH The Mental Health Policy Group General Election 2015 THE ROAD TO 2020 The challenge and the opportunity for the next Government is clear. If we take steps to improve
More informationNICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.
bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.
More informationwww.focuspsychology.com info@focuspsychology.com
The main emphasis of our approach is to empower and enhance the environments around the children and young people we strive to support. However, we understand that direct work also has a role to play and
More informationBorderline personality disorder
Understanding NICE guidance Information for people who use NHS services Borderline personality disorder NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases
More informationMental Health and Wellbeing Statement
Mental Health and Wellbeing Statement The promotion of good mental health is a University-wide concern. In a learning environment there are many opportunities for developing positive wellbeing, and there
More informationMid Essex. Specialist Psychosis Service
Mid Essex Specialist Psychosis Service What is psychosis? Why have you been referred to us? Psychosis is general term used to describe a number of symptoms. Some of the symptoms of psychosis include: False
More informationSubstance misuse and behavioural addictions
Substance misuse and behavioural addictions Information about our services for primary healthcare professionals PROVIDING QUALITY INSPIRING INNOVATION DELIVERING VALUE Our substance misuse and behavioural
More informationCoventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement
More informationSpeaking Up Project. Resolving NHS complaints and preventing problems for recurring Alex Robinson Project Manager
Speaking Up Project Resolving NHS complaints and preventing problems for recurring Alex Robinson Project Manager Presentation to Health Scrutiny Committee 2 nd April 2012 Brief recap - background National
More informationCare plans which are individualised and person centred
The Right Care: creating dementia friendly hospitals Care plans which are individualised and person centred Good practice for better care 1 Care plans which are individualised and person centred Section
More informationEssential Career Skills
Essential Career Skills Careers and Employability Graduate Career Opportunities in Mental Health Careers & Employability Centre (Opposite The Binks Building) Chester Campus Opening Hours: Monday-Thursday:
More informationChanging health and care in West Cheshire The West Cheshire Way
Changing health and care in West Cheshire The West Cheshire Way Why does the NHS need to change? The NHS is a hugely important service to patients and is highly regarded by the public. It does however
More informationNICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.
bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.
More informationOrganising and planning services for people with a personality disorder
Organising and planning services for people with a personality disorder A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area.
More informationto a Degree in Mental Health Nursing
to a Degree in Mental Health Nursing Let s Talk About Mental Health Mental health affects us all. Why? Because the way we think and feel about ourselves and our lives affects our behaviour and our ability
More informationDoncaster Community Health Team for Learning Disabilities. Information for families and carers. RDaSH. Learning Disability Services
Doncaster Community Health Team for Learning Disabilities. Information for families and carers RDaSH Learning Disability Services Useful contact numbers General enquiries: 01302 796467 Duty nurse number:
More informationStep 2: Recognised depression in adults persistent subthreshold depressive symptoms or mild to moderate depression
Step 2: Recognised depression in adults persistent subthreshold depressive symptoms or mild to moderate depression A NICE pathway brings together all NICE guidance, quality standards and materials to support
More informationDetention under the Mental Health Act
Detention under the Mental Health Act This factsheet gives information about detention under the Mental Health Act. This is also known as being sectioned. It explains what the Mental Health Act is, why
More informationMental Health Needs Assessment Personality Disorder Prevalence and models of care
Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care (update) 1.1
More informationWHICH talking therapy for depression?
WHICH talking therapy for depression? A guide to understanding the different psychological therapies you may be offered to treat your depression 1 Contents Introduction 3 Cognitive Behavioural Therapy
More information4. Proposed changes to Mental Health Nursing Pre-Registration Nursing
Developments in nurse education in England Summary BSMHFT employs 1319 registered nurses and 641 health care assistants 53% of the total workforce. BSMHFT works in partnership with Birmingham City University
More informationWhat are Cognitive and/or Behavioural Psychotherapies?
What are Cognitive and/or Behavioural Psychotherapies? Paper prepared for a UKCP/BACP mapping psychotherapy exercise Katy Grazebrook, Anne Garland and the Board of BABCP July 2005 Overview Cognitive and
More informationThe Rivendell Young Persons Unit
THE HOSPITAL The Rivendell Young Persons Unit at the Priory Hospital Altrincham Individual care Innovative services Positive outcomes About the Rivendell Unit Our specialist team of clinicians work with
More informationWe are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.
Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Borough of Poole - Civic Centre Borough of Poole, Civic Centre,
More informationWHAT DOES THE PSYCHOLOGICAL THERAPIES HEAT TARGET MEAN TO YOU?
WHAT DOES THE PSYCHOLOGICAL THERAPIES HEAT TARGET MEAN TO YOU? NHS Boards are now half way through the first year of implementation of the HEAT target Deliver faster access to mental health services by
More informationYour local specialist mental health services
Your local specialist mental health services Primary Care Liaison Service B&NES Primary Care Mental Health Liaison service is a short-term support service to help people with mental health difficulties
More informationNorfolk Dementia Care Pathway. Zena Aldridge; Lesley-Ann Knox; Hilda Hayo
Norfolk Dementia Care Pathway Zena Aldridge; Lesley-Ann Knox; Hilda Hayo Need? Growing numbers of people with dementia. Majority live in their own homes. Family members providing care estimated to save
More informationEngaging young people in mental health care: The role of youth workers
Engaging young people in mental health care: The role of youth workers Debra Rickwood Professor of Psychology Faculty of Health University of Canberra Young people are reluctant to seek professional mental
More informationFuture hospital: Caring for medical patients. Extract: Recommendations
Future hospital: Caring for medical patients Extract: Recommendations Future hospital: caring for medical patients Achieving the future hospital vision 50 recommendations The recommendations from Future
More informationNHS Constitution The NHS belongs to the people. This Constitution principles values rights pledges responsibilities
for England 21 January 2009 2 NHS Constitution The NHS belongs to the people. It is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we
More informationCoventry and Warwickshire Repatriation Programme
NHS Arden Commissioning Support Unit Coventry and Warwickshire Repatriation Programme Large-scale service redesign and innovation to benefit patients Arden Commissioning Support Unit worked with Coventry
More informationSpecialist mental health service components
Specialist mental health service components The specialist public mental health system consists of clinical services and psychiatric disability rehabilitation and support services (PDRSS). Clinical mental
More informationSOMERSET DEMENTIA STRATEGY PRIORITIES FOR 2013 2016
SOMERSET DEMENTIA STRATEGY PRIORITIES FOR 2013 2016 October 2013 1 CONTENTS PAGE Section Contents Page Somerset Dementia Strategy Plan on a Page 3 1 Introduction 4 2 National and Local Context 5 3 Key
More informationBig Chat 4. Strategy into action. NHS Southport and Formby CCG
Big Chat 4 Strategy into action NHS Southport and Formby CCG Royal Clifton Hotel, Southport, 19 November 2014 Contents What is the Big Chat? 3 About Big Chat 4 4 How the event worked 4 Presentations 5
More informationAmbitions for Palliative and End of Life Care:
Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020 National Palliative and End of Life Care Partnership Association for Palliative Medicine; Association of Ambulance
More informationSuicidal. Caring For The Person Who Is. Why might a person be suicidal?
Caring For The Person Who Is Suicidal For further information see also the following MIND Essentials resource Conducting a suicide risk assessment. Suicidal thoughts and behaviours are not unique to mental
More informationB&NES Heath & Well-being Partnership. Local Action Plan Implementation of the National Dementia Strategy (NDS) November 2011 Update
B&NES Heath & Well-being Partnership Local Action Plan Implementation of the National Dementia Strategy (NDS) November 2011 Update Who is involved in our action plan? Alzheimer s Society Avon & Wiltshire
More informationAppendix 1 Business Case to Support the Relocation of Mental Health Inpatient Services in Manchester (Clinical Foreword and Executive Summary)
Appendix 1 Business Case to Support the Relocation of Mental Health Inpatient Services in Manchester (Clinical Foreword and Executive Summary) Together we are better Foreword by the Director of Nursing
More informationLearning Disabilities Nursing: Field Specific Competencies
Learning Disabilities Nursing: Field Specific Competencies Page 7 Learning Disabilities Nursing: Field Specific Competencies Competency (Learning disabilities) and application Domain and ESC Suitable items
More informationDeveloping The College of Social Work
Research, Policy and Planning (2010) 28(2), 129-137 Developing The College of Social Work Dorit Braun 1 and Bridget Robb 2 1 Social Care Institute for Excellence (SCIE) 2 British Association of Social
More informationImproving Services for Patients with Learning Difficulties. Jennifer Robinson, Lead Nurse Older People and Vulnerable adults
ENC 5 Meeting Trust Board Date 18 th December 2014 Title of Paper Lead Director Author Improving Services for Patients with Learning Difficulties Kathryn Halford, Director of Nursing Jennifer Robinson,
More informationA fresh start for the regulation and inspection of substance misuse services
A fresh start for the regulation and inspection of substance misuse services Working together to change how we regulate, inspect and monitor specialist substance misuse services The Care Quality Commission
More informationKey Challenges and Unmet Needs in Bipolar Disorder
Key Challenges and Unmet Needs in Bipolar Disorder Bridging the Gap Between Healthcare Professionals and Patients A Pilot Malaysian Study March and April 2010 WHAT THE REPORT WILL COVER Executive Summary
More informationReview of compliance. Florence Nightingale Hospitals Limited Capio Nightingale Hospital. London. Region: 11-19 Lisson Grove Marylebone London NW1 6SH
Review of compliance Florence Nightingale Hospitals Limited Capio Nightingale Hospital Region: Location address: Type of service: London 11-19 Lisson Grove Marylebone London NW1 6SH Diagnostic and/or screening
More informationIMPROVING YOUR EXPERIENCE
Comments trom the Aberdeen City Joint Futures Brain Injury Group The Aberdeen City Joint Futures Brain Injury Group is made up of representatives from health (acute services, rehabilitation and community),
More informationHow To Get A Clinical Psychologist
Older Adult Mental Health Clinical Psychology Service Older Adults Mental Health Services Seeing a Clinical Psychologist Your guide to psychological treatment from the WHSCT Older Adult Clinical Psychology
More informationSpecialist Module in Old Age Psychiatry
A Competency Based Curriculum for Specialist Training in Psychiatry Specialist Module in Old Age Psychiatry Royal College of Psychiatrists Royal College of Psychiatrists 2009 SPECIALIST IN THE PSYCHIATRY
More informationMental Health Services Follow-up
Mental Health Services Follow-up REGIONAL SUMMARY Performance Review Unit Department of Health, Social Services and Public Safety CONTENTS page BACKGROUND... 3 STRATEGIC DIRECTION... 6 PROVISION OF SERVICES...
More informationSeeing a Clinical Psychologist
Older Adult Mental Health Clinical Psychology Service Seeing a Clinical Psychologist Your Guide to Psychological Treatment From the WH&SCT Older Adult Clinical Psychology Team. What is a Clinical Psychologist?
More informationGetting it right for children and families Maximising the school nursing team contribution The Vision and Call to Action
Getting it right for children and families Maximising the school nursing team contribution The Vision and Call to Action Delivering a 21 st century service Supporting young carers Wendy Nicholson Professional
More informationBreaking the cycles of Borderline Personality Disorder
Breaking the cycles of Borderline Personality Disorder Borderline Personality Disorder (BPD) is a complex and difficult to treat condition affecting up to 2 % of the UK s adult population, and 50 % of
More informationJob Description. Wilson Health Centre, Cranmer Road, Mitcham, Surrey, CR4 4TP. Practice Manager / Clinical Manager (Clinical Matters)
Job Description Job Title: Job Location: Responsible to: Hours of work: Salary: Nurse Practitioner (NP) Wilson Health Centre, Cranmer Road, Mitcham, Surrey, CR4 4TP Practice Manager / Clinical Manager
More informationPublic Consultation 2009 Submission to the Second Independent Monitoring Group for A Vision for Change
Public Consultation 2009 Submission to the Second Independent Monitoring Group for A Vision for Change Response of the National Council for the Professional Development of Nursing and Midwifery The National
More informationWHERE CAN PSYCHOLOGY TAKE ME?
WHERE CAN PSYCHOLOGY TAKE ME? There are many careers in Psychology and many types of psychologist. If you are thinking of a career in Psychology, you need to go to university to study Psychology at undergraduate
More informationContents. Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started How to Find Us
Lakeside Clinic Contents Overview Treatments Inpatient Services Day Programs The Clinic What are the Costs? How to Get Started How to Find Us Overview At some point in their lives, as many as one-in-five
More informationUKCP Standards of Education and Training
UKCP Standards of Education and Training Guidelines for Section and Institutional Members for the Development of Standards of Supervision for Child Psychotherapists UKCP May 2008 This document is copyright
More informationTo achieve this aim the specific objectives of this PhD will include:
PhD Project Proposal - Living well with dementia: a PhD programme to develop a complex intervention that integrates healthcare for people with dementia 1. Background to the study There are 800,000 people
More informationCouncil Meeting, 26/27 March 2014
Council Meeting, 26/27 March 2014 HCPC response to the Final Report of A Review of the NHS Hospitals Complaint System Putting Patients Back in the Picture by Right Honourable Ann Clwyd MP and Professor
More informationGP-led services for alcohol misuse: the Fresh Start Clinic
London Journal of Primary Care 2011;4:11 15 # 2011 Royal College of General Practitioners GP Commissioning GP-led services for alcohol misuse: the Fresh Start Clinic Johannes Coetzee GP Principle, Bridge
More informationAssessment of depression in adults in primary care
Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and
More informationBOARD PAPER NHS ENGLAND
Paper 1505142 BOARD PAPER NHS ENGLAND Title: Patient and Public Voice From: Tim Kelsey, National Director for Patients and Information Purpose of paper: NHS England is committed to: promoting and upholding
More informationAnnex 5 Performance management framework
Annex 5 Performance management framework The Dumfries and Galloway Integration Joint Board (IJB) will be responsible for planning the functions given to it and for making sure it delivers them using the
More informationRole of the consultant psychiatrist in psychotherapy
Role of the consultant psychiatrist in psychotherapy Council Report CR139 May 2006 London Approved by Council: June 2005 Due for review: 2010 Contents Members of the Working Group 4 Executive summary
More informationTaking Care of Yourself and Your Family After Self-Harm or Suicidal Thoughts A Family Guide
It is devastating to have a suicidal family member and to live with the feelings that go with this kind of traumatic anxiety. That is why this guide is developed for you. It will give you some important
More informationAdvanced Nurse Practitioner Adult Specialist Palliative Care
JOB DESCRIPTION ellenor Advanced Nurse Practitioner Adult Specialist Palliative Care Responsible to Accountable to: Head of Adult Community Services Director of Patient Care General ellenor is a specialist
More informationJOB DESCRIPTION REPORTING TO:
JOB DESCRIPTION SECTION ONE DESIGNATION: REPORTING TO: SENIOR MEDICAL OFFICER: HAWERA HOSPITAL HEAD OF DEPARTMENT EMERGENCY SERVICES - FOR ALL CLINICAL MATTERS, AND AS REQUIRED THE HEADS OF DEPARTMENT
More informationThe NICE Guideline For OCD - Symptoms, Diagnosis and Treatment
Autumn 2015 Contents Welcome...1 What we are calling for...2 Background information...3 Better understanding...4 Clear treatment pathways...5 Appropriate diagnosis and reporting...6 Summary of actions
More informationSkill Levels for Delivering High Quality Asthma and COPD Respiratory Care by Nurses in Primary Care
Skill Levels for Delivering High Quality Asthma and COPD Respiratory Care by Nurses in Primary Care September 2007 Revised December 2009, April 2014 Author: Ruth McArthur In conjunction with the PCRS-UK
More informationFit for Work. Guidance for employers
Fit for Work Guidance for employers For details on when referrals to the Fit for Work assessment can be made in your area please visit: www.gov.uk/government/collections/fit-for-work-guidance Fit for
More informationGetting help for a drug problem A guide to treatment
Getting help for a drug problem A guide to treatment Who we are The National Treatment Agency for Substance Misuse is part of the National Health Service. We were set up in 2001 to increase the numbers
More informationSummary of findings. The five questions we ask about hospitals and what we found. We always ask the following five questions of services.
Barts Health NHS Trust Mile End Hospital Quality report Bancroft Road London E1 4DG Telephone: 020 8880 6493 www.bartshealth.nhs.uk Date of inspection visit: 7 November 2013 Date of publication: January
More informationWorkforce Development Pathway 8 Supervision, Mentoring & Coaching
Workforce Development Pathway 8 Supervision, Mentoring & Coaching A recovery-oriented service allows the opportunity for staff to explore and learn directly from the wisdom and experience of others. What
More informationNational Mental Health Survey of Doctors and Medical Students Executive summary
National Mental Health Survey of Doctors and Medical Students Executive summary www.beyondblue.org.au 13 22 4636 October 213 Acknowledgements The National Mental Health Survey of Doctors and Medical Students
More informationNICE guideline Published: 23 September 2015 nice.org.uk/guidance/ng21
Home care: delivering ering personal care and practical support to older people living in their own homes NICE guideline Published: 23 September 2015 nice.org.uk/guidance/ng21 NICE 2015. All rights reserved.
More informationAdult Learning Disabilities in Kent
Adult Learning Disabilities in Kent Kent and Medway NHS and Social Care Partnership Trust Kent Community Health NHS Trust We provide an integrated service to people with a learning disability in Kent.
More informationBRISTOL SPECIALIST CHILD and ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) REFERRAL GUIDELINES FOR ACCESS TO THE SPECIALIST NHS-BASED CAMHS TEAMS
BRISTOL SPECIALIST CHILD and ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) REFERRAL GUIDELINES FOR ACCESS TO THE SPECIALIST NHS-BASED CAMHS TEAMS The specialist NHS-based CAMHS teams are part of a wider Bristol
More informationHealth Professionals who Support People Living with Dementia
Clinical Access and Redesign Unit Health Professionals who Support People Living with Dementia (in alphabetical order) Health Professional Description Role in care of people with dementia Dieticians and
More informationFRAMEWORK JOB DESCRIPTION. Band 6
FRAMEWORK JOB DESCRIPTION Band 6 Framework is a registered charity, Company Limited by guarantee and Registered Social Landlord providing a variety of supported accommodation and tenancy support for homeless
More informationPolicy Brief November, 2006
Policy Brief November, 2006 The Role of Pediatricians in Children s Mental Health A Policy Brief from Philadelphia Citiz itizens for Children and Youth Introduction The number of children identified as
More informationLondon mental health models of care competency framework
London mental health models of care competency framework Foreword It is important that non-specialist mental health services and professionals do not exclude people with mental health needs. 2 London Health
More informationYOUNG PEOPLE & ALCOHOL
YOUNG PEOPLE & ALCOHOL Essential Information for Social Workers A BASW Pocket Guide Supported by: Bedford and Luton Purpose of the guide This guide seeks to support Social Workers in their practice with
More informationMental Health Crisis Care: Shropshire Summary Report
Mental Health Crisis Care: Shropshire Summary Report Date of local area inspection: 26 and 27 January 2015 Date of publication: June 2015 This inspection was carried out under section 48 of the Health
More informationAge-friendly principles and practices
Age-friendly principles and practices Managing older people in the health service environment Developed on behalf of the Australian Health Ministers Advisory Council (AHMAC) by the AHMAC Care of Older
More informationBorderline personality disorder
Issue date: January 2009 Borderline personality disorder Borderline personality disorder: treatment and management NICE clinical guideline 78 Developed by the National Collaborating Centre for Mental Health
More informationIntegrative Humanistic Counselling & Psychotherapy
Integrative Humanistic Counselling & Psychotherapy Aileen Hackett (CNS Psychotherapy, North Lee Mental Health Services) Integrative Psychotherapy embraces an attitude towards the practice of psychotherapy
More informationEmployee Wellness and Engagement
Employee Wellness and Engagement HEALTH POLICIES 01. Proactive Health Policy 02. Internal Health Relationships 03. Health Surveillance and Screening 04. Mental Health and Stress 05. Getting People Back
More informationOPERATIONAL GUIDELINES FOR THE ACCESS TO ALLIED PSYCHOLOGICAL SERVICES INITIATIVE (ATAPS) SUICIDE PREVENTION SERVICE
OPERATIONAL GUIDELINES FOR THE ACCESS TO ALLIED PSYCHOLOGICAL SERVICES INITIATIVE (ATAPS) SUICIDE PREVENTION SERVICE JANUARY 2012 Mental Health Services Branch Mental Health and Drug Treatment Division
More information