EDITORIAL. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
The transitional discharge model (TDM) bridges hospital discharge and community living for people receiving psychiatric services. TDM, based on Peplau's theory of interpersonal relations, ensures continued support from hospital staff until a therapeutic relationship is established with community providers and formal peer support.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Sally McManus writes her debut elf blog on a recent national cohort study of multiple adverse outcomes following first discharge from psychiatric care.
BPS Blog post by Lucy Maddox. The UK population continues to grow, while nursing numbers have remained static for several decades. Compounding matters, The King’s Fund and Nuffield Trust have reported a 25 per cent increase in nurses and midwives leaving the NHS from 2012 to 2018, from 27,300 to 34,100. In short, in the UK, we now have far fewer nurses relative to the general population than we used to.
What does this mean for patients’ care experience?
Transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) can be stressful for the young person and family alike. Previous reviews have focused on specific aspects of transition or perspectives of young people, or have not used systematic approaches to data identification and analysis. The objective of this review was to develop the understanding of the transition between CAMHS and AMHS by systematically identifying and synthesising evidence regarding professionals’ and parents/carers’ perspectives.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Safe staffing and coercive practices are of pressing concern for mental health services. These are inter‐dependent and the relationship is under‐researched.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
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Developing person‐centred recovery‐oriented care is a challenge in mental health systems, particularly psychiatric hospitals.. To read the full article, log in using your MPFT NHS OpenAthens details.
The move to making NHS estates smoke-free has been enshrined in policy for a number of years. The desire to stop people smoking is clearly linked to potential health benefits, yet hospitals continue to “collude” with individuals to enable them to carry on smoking. Travelling around hospitals you often see patients being wheeled outside to smoke, or staff turning a blind eye to patients or colleagues smoking. This is not just in mental health settings.
In order to reduce the level of risk and ensure positive clinical outcomes for patients and staff it was decided to introduce a new system known as ‘Zonal Engagement and Observations’, which aimed to ensure appropriate observation of individual patients without the need to assign particular nurse to be in close proximity to the patient for long periods of time. Zonal observations and engagement aims to provide patients with increased activity and therapeutic engagement and to assess patient’s mental and physical health and document this in real time.
Valerie Provan is a Nurse Consultant on Ruskin Unit, an assessment unit in Carlisle for older adults with organic mental illnesses such as Dementia. It is the only nurse led treatment centre of its kind in the country and several other trusts have visited to see how it could be replicated elsewhere.
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Open access. Trauma-informed approaches emerged partly in response to research demonstrating that trauma is widespread across society, that it is highly correlated with mental health and that this is a costly public health issue. The fundamental shift in providing support using a trauma-informed approach is to move from thinking ‘What is wrong with you?’ to considering ‘What happened to you?’. This article, authored by trauma survivors and service providers, describes trauma-informed approaches to mental healthcare, why they are needed and how barriers can be overcome so that they can be implemented as an organisational change process.
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In collaborative care models between psychiatry and general practice, mental health nurses are used as care managers who carry out the treatment of patients with anxiety or depression in general practice and establish a collaborating relationship with the general practitioner. Although the care manager is the key person in the collaborative care model, there is little knowledge about this role and the challenges involved in it.. To read the full article, log in using your SSSFT NHS OpenAthens details. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Research shows that changing from white to blue plates enables patients with dementia to see food better as sometimes, they experience difficulties with their sight and perception. For example, chicken, mashed potatoes, porridge, white bread and other typically pale-coloured foods stand out more on blue plates and encourage individuals to eat more. In turn, this will reduce food wastage.
COMMENTARY ON: Walter F, Carr MJ, Mok PLH, et al. Premature mortality among patients recently discharged from their first inpatient psychiatric treatment. JAMA Psychiatry 2017;74:485–92.. To read the full article, log in using your NHS OpenAthens details.
The stages of change model suggests that individuals seeking treatment are in the ‘preparation’ or the ‘action’ stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems. To read the full article, log in using your SSSFT NHS OpenAthens details.
People with learning disabilities and a mental health condition are now getting more support to look after their physical health thanks to a team of specialist mental health nurses working in GP practices across Suffolk.
We’ve just heard that SSOTP will not be renewing their agreement with SSSFT LKS for library services for this financial year. Because of this we will be reviewing our Be Aware bulletins. Sadly we won’t be accepting any new sign-ups from SSOTP staff and will be withdrawing some of the physical healthcare bulletins that we…
Research and evidence from service users has consistently reported that service users are not involved in care planning, despite mental health policy that advocates a collaborative process and evidence that involvement facilitates recovery (Bee et al, 2015; Simpson et al, 2016). Service users want the care plan to go beyond being a record of clinical decisions and include aspects of their lives in which they need support, such as housing, employment and benefits.
Grundy et al (2016) looked at what ‘user-involved’ care planning might look like. They found that meaningful relationships were key to the successful involvement of service users in care planning. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Care planning and co-ordination are central to the delivery of comprehensive mental health care especially where individuals have complex health and social care needs. Although the terms are often used together they clearly imply different sets of processes, practices and ultimately experiences for individuals using and working in services. Care planning involves professionals (nurses, doctors, social workers and others) and the person needing care collaborating on goals, making shared written records and agreeing when to review progress. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The new CPA process uses Dialog + to ensure that the views and goals of service users are absolutely central to the assessment and care planning process. The new My Recovery Care Plan is intended to provide service users with an individualised and understandable care plan which reflects their concerns and priorities.
Staff on Heather ward, based at Airedale Centre for Mental Health, which supports people with complex mental health problems ‘huddle’ twice a day so they can identify any ways they can better support people on the ward in the day ahead and keep people safe.
A new initiative has been launched on Meadow Ward at Penn Hospital to encourage staff to take frequent breaks to help improve their health and wellbeing.
The ‘taking a break' initiative aims to help make staff aware that taking enough breaks can also help them to provide the highest standard of patient care, by putting them in a position to make the best decisions for patients and helping to strengthen morale and create relationships.
This article presents to implementation service evaluation/quality improvement initiative in one NHS trust which involved the implementation of the Modified Early Warning Scoring System (MEWS) that enables staff to assess, recognise and respond to the physical health needs of people with mental health problems or a learning disability in an inpatient setting.
To read the full article, log in using your NHS OpenAthens details
A caseload management tool was developed with the aim of creating a straightforward, unbiased way of assessing a clinician's caseload for the community mental health teams (CMHTs) in Aneurin Bevan University Health Board. For the first time, the tool developed allows for individual clinicians to record caseloads electronically, enabling decision makers and their teams to assess caseloads.To read the full article, log in using your NHS OpenAthens details
This essay addresses common arguments against implementing smoke-free policies in mental health facilities drawing on the international research evidence. Key arguments supporting implementation of smoke-free policies in mental health facilities are also outlined. This commentary provides policy makers, researchers, and clinicians with information to dispel myths about smoke-free policies in mental health facilities and provides arguments advocating for implementation of these policies. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Mental Health Street Triage is a partnership between the Trust, Bedfordshire Police, East of England Ambulance Trust, Bedfordshire Clinical Commissioning Group, Luton Clinical Commissioning Group and mental health charities Mind BLMK and the Samaritans.
Gail Dearing, ELFT’s Bedfordshire Mental Health Street Triage lead: “The focus of the street triage partners is to make sure people experiencing a mental health crisis get the right care at the earliest possible opportunity.
The service will provide an advice and guidance service to all health professionals, support to women already using secondary mental health services where psychiatric disorder predates pregnancy and is expected to continue beyond, plus new referrals of perinatal presentations.
In this blog Kiri Quinn a senior mental health practitioner and Charlotte Jackson an occupational therapist talk about their experiences of working in the new care models programme and the changes that have been made through working in a newly formed multi-disciplinary team.
These registered mental health nurses are working as wellbeing practitioners in teams with social workers, pharmacists, physiotherapists, care support workers, voluntary services and GPs.
Our practitioners will see people in their own homes or residential care homes, to help reduce referrals into secondary care or hospital for people with mental ill health including dementia, delirium and depression.
As well as providing mental health care, they’ll also carry out some standard wound care and physical health care checks, and support people with long term conditions. The practitioners will also help to educate other health staff in the community care teams, such as district nurses and healthcare support workers, about mental health issues.
A new model for the workforce across our secure estate is delivering both cost improvements and better career opportunities.
Typically across the NHS, band 5 nurses are supported by staff at band 3. Our trust is pioneering a new approach which sees staff at bands 2 and 4 added to the workforce, a model which is rarely seen across the NHS.
The trust’s secure mental health services are piloting the approach. They first starting establishing a workforce of ward–based staff at bands 2 and 3 in 2014. Band 4s are starting in the service for the first time this month.
Vulnerable drug users will be given additional support to access treatment services thanks to a new partnership which will see mental health staff work alongside police to take help direct into people’s homes.
From Monday (23 January), nurses from Norfolk and Suffolk NHS Foundation Trust (NSFT) and officers from Norfolk Constabulary will together visit the homes of drug users where there is a suspicion that out-of-county drug dealers have taken over the property.
Older adult patients undergoing hospital treatment for mental health problems in Lincolnshire can now take ‘time-out’ to relax and unwind in a new bespoke Mindfulness Suite.
Staff working at the Trust’s Rochford Unit, based at Pilgrim Hospital in Boston, have spent the last few months transforming a former therapy room into a brand new relaxation area for patients on the ward.
A Trust project designed to make it easier for people using our inpatient services to independently charge and monitor their mobile devices has been highly commended at this year’s HSJ Awards.
Earlier this year, bespoke mobile charging stations, called ChargeBoxes, were installed on four inpatient wards at Farnham Road Hospital to reduce the significant amount of nursing time which was being taken up by facilitating charging. It also gave people staying on the wards more autonomy when charging devices and allowed them to stay better connected with what was happening outside of the ward.
The police liaison scheme is run in Kirklees and Calderdale and involves mental health nurses working alongside officers at Halifax and Huddersfield police stations to recognise the signs of mental illness. This ensures fewer people with mental health conditions are placed on Section 136 of the Mental Health Act, held in a cell or admitted to A&E when there are more appropriate ways of providing health care for them. The scheme also enables practitioners to visit victims and witnesses at home and support police officers at the scene of an incident.
or three years Sussex Police and Sussex Partnership have operating street triage teams, which started in Eastbourne, and has expanded across East and West Sussex. This scheme sees a specially allocated police officer and a specialist mental health nurse responding to incidents where a mental health intervention is needed. It has been an enormous success meaning less people have been detained under s136 and those that have are far more likely to be taken to a hospital place of safety.
The police liaison scheme is run in Kirklees and Calderdale and involves mental health nurses working alongside officers at Halifax and Huddersfield police stations to recognise the signs of mental illness. This ensures fewer people with mental health conditions are placed on Section 136 of the Mental Health Act, held in a cell or admitted to A&E when there are more appropriate ways of providing health care for them. The scheme also enables practitioners to visit victims and witnesses at home and support police officers at the scene of an incident.
Following leading work in AWP, nurses can now administer electroconvulsive treatment across the UK.
The Royal College of Psychiatry ECT has accepted the results of an AWP led national pilot study to train experienced specialist nurses to deliver ECT treatment as well as doctors.
This new practice, which gives patients better continuity of care and gives ECT nurses a chance to expand their role, was first proposed by our own Lead ECT nurse John Leyden, who is also ECT nurse representative for England Wales and N. Ireland on the Royal College of Psychiatry ECT special interest group.
Inpatient suicide and absconding of inpatients at risk of self-endangering behaviour are important challenges for all medical disciplines, particularly psychiatry. Patients at risk are often admitted to locked wards in psychiatric hospitals to prevent absconding, suicide attempts, and death by suicide. However, there is insufficient evidence that treatment on locked wards can effectively prevent these outcomes. We did this study to compare hospitals without locked wards and hospitals with locked wards and to establish whether hospital type has an effect on these outcomes. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
The staff from Cambridgeshire and Peterborough NHS Foundation Trust, the community and mental health provider, have been advising teachers how to identify and help youngsters who are experiencing emotional difficulties.
Costing £150,000, which has been funded by Peterborough City Council, the Project For Schools Team is made up of three community psychiatric nurses who are available to all 70 primary schools in Peterborough.
In the last of our series of blogs about the Mental Health Implementation Plan launched earlier this week, nurse consultant Kate Chartres discusses how the model of liaison at Northumberland, Tyne and Wear NHS Foundation Trust supports patients through specialist clinics for people with co-morbid physical and mental health conditions
The article discusses the challenges and opportunities presented by workforce transformation in clinical care which was prompted by a Nufffield Trust report on practical guidance to those wishing to reshape their workforce. Topics covered include the areas for consideration when undertaking transformation such as increase demand and service costs and the simplification of the legal framework to enable regulators to respond to changing needs. To read the full article, log in using your NHS OpenAthens details
Come and visit our first pop-up library at Severn Fields, Shrewsbury 19th July 11.00am-3.00pm. Join the library, borrow and return books, get help finding information and evidence, set up an Athens account, find out what the library can do for you and your team.
The ReFleCT service is a recovery focused, pre-discharge intervention which has improved and supports the transfer of service users’ ongoing care from mental health services to GP services.
ReFleCT is client-led and developed primarily for people with chronic mental health difficulties to improve their transition to GP care. Frontline staff identify what matters in terms of life goals, hopes and desires and that offers invaluable support to clients and multidisciplinary team staff during the transition.
Patients that require mental health support in Furness General Hospital (FGH) can now benefit from Dedicated Mental Health Liaison Nurses on site, thanks to a partnership between University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) and Cumbria Partnership NHS Foundation Trust (CPFT).
Prior to February 2016, mental health liaison was only available by hospital staff calling the Access and Liaison Integrated Mental Health Service (ALIS). This could cause delays in patients being seen as the team are not based in FGH.
Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Mutual help meetings form part of the Safewards initiative, set up to make psychiatric wards more peaceful places, increasing safety, reducing coercion and building relationships between service users and staff.
Safewards is being embraced in many wards and is rolling out across our Trust. It creates a therapeutic nursing environment based on 10 interventions including clear and mutual expectations between staff and service users; the use of soft and positive words and offering reassurance.
Despite being 15 years old, this study remains relevant. To investigate carer involvement in care planning in the psychiatric unit of an older person’s hospital, the researchers observed multidisciplinary ward rounds and family meetings, and reviewed documentation about admissions, discharges and care plans. They also conducted interviews with 20 carers and with members of the 29-strong multidisciplinary team to explore their experiences of carer involvement. Login using your SSSFT NHS OpenAthens details for full text. SSOTP - request a copy of the article from the library http://bit.ly/1Xyazai
Best Example of Collaborative Working – NWC Research and Innovation Awards 2015 Cheshire Constabulary and mental health services are working together to provide an immediate response to police incidents that would benefit from mental health services, through Street Triage. It is supported by Cheshire and Wirral Foundation Trust and 5 Boroughs Partnership NHS Foundation Trust.
A police officer and a community psychiatric nurse work together, sharing information and expertise.
Both parties assess situations with the nurse using mental health expertise, access to diagnosis and risk history, and the officer looking at the law/crime, offending history and current situation. Together they decide the most appropriate course of action, taking into consideration customer care, illness, safeguarding and the law.
The Admiral Nurse Service, which is provided by specialist dementia nurses, will be based in the community and the nurses will work with local families to ensure they are better able to understand and cope with the changes which can occur with dementia. They will work with the family to make informed decisions about their future needs, to enable the family to stay together for as long as possible.
Admiral nurses play a unique role in care management by joining up the different parts of the health and social care system, and help address the needs of family carers and people with dementia in a coordinated way.
The Admiral Nurse Service is delivered by ourTrust and works in partnership with Dementia UK which governs and monitors the service. The service has been running in Knowsley since 2011.
A website full of ideas about inpatient mental health care. Covers areas such as activities, mindfulness, involvement, culture/atmosphere, communications ...
[Canadian article] What are the implications for practice?
Multidisciplinary outreach teams, specifically those with psychiatric and nursing support, successfully work with and house people experiencing street homeless-ness and psychosis.
Mental health nurses embedded in the community are an essential link between inpatient and outpatient care for highly vulnerable street homeless individuals. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Conclusions
The administrative elements of care co-ordination reduce opportunities for recovery-focused and personalised work. There were few shared understandings of recovery, which may limit shared goals. Conversations on risk appeared to be neglected and assessments kept from service users. A reluctance to engage in dialogue about risk management may work against opportunities for positive risk-taking as part of recovery-focused work.
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The Commission on Acute Adult Psychiatric Care has been set up by the Royal College of Psychiatrists (RCPsych) in response to widespread concerns about the provision of acute inpatient psychiatric beds and alternatives to admission available for patients.
There is evidence – some quantified, some anecdotal – of difficulties in admissions, variable services for patients in the community, long distance transfers of patients, high occupancy rates and high stress levels amongst patients, their families, carers and staff.
The Francis Inquiry (2013) focused the attention of the general public onto poor quality nursing care. As a direct result of this inquiry, NICE was asked to review the evidence base for safe nurse staffing levels in nine care settings in England. Two of these reviews focused on mental health, with reviews proposed for acute inpatient and community care. This work was halted in June 2015 by NHS England, and it was thought that the majority of this work would not be completed and published.
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