Risk assessment and the Care Programme Approach: an independent sector initiative

The epidemic of formarrhoea blighting adult mental health services is spreading to child and adolescent mental health. Threatening to arrive all about the same time are forms to do with risk assessment, care programme approach, outcome and activity recording, Commission for Health Improvement, child protection, assessment of trainees … and more. They will likely cause an avalanche when added to the mountain of existing forms and Government circulars already piled up on my desk. Forms are increasingly governing all aspects of clinical practice. They threaten to get in the way of doing the job.

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Outcomes of care programme approach, dual diagnosis, carer support and psychological therapy inductions

Psychiatric Bulletin ◽

10.1192/pb.bp.113.045526 ◽

2014 ◽

Vol 38 (4) ◽

pp. 172-174 ◽

Cited By ~ 1

Author(s):

Caroline Kamau

Keyword(s):

Risk Assessment ◽

Dual Diagnosis ◽

Ad Hoc ◽

Job Design ◽

Psychological Therapy ◽

Care Programme ◽

Outcomes Of Care ◽

Carer Support ◽

The Uk ◽

Univariate Analyses

Aims and methodFor many trainees, an obstacle into psychiatry is the challenge of an imprecise job design and uncertainty about the psychiatrist's job design across many complex, often ad hoc care situations involving multiple professions and organisations. The UK's National Health Service (NHS) has introduced inductions for trainee psychiatrists geared towards improving that. Are the induction programmes effective? This article presents an analysis of the outcomes (n= 1115) of inductions about the care programme approach, dual diagnosis, carer support, mental health risk assessment, psychological therapy and suicide risk assessment.ResultsUnivariate analyses of variance revealed a consistent interaction of care programme approach, dual diagnosis, carer support and psychological therapy inductions. Psychiatrists who attend all four inductions have the best perceptions about their job design, strongest teamwork approach, and highest motivation.Clinical implicationsThe NHS and hospitals outside the UK should note these results when prioritising inductions for trainee psychiatrists.

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Delivering the Transforming Care programme: a case of smoke and mirrors?

BJPsych Bulletin ◽

10.1192/bjb.2019.3 ◽

2019 ◽

Vol 43 (5) ◽

pp. 201-203 ◽

Cited By ~ 4

Author(s):

John L. Taylor

Keyword(s):

At Risk ◽

Intellectual Disabilities ◽

Community Services ◽

National Plan ◽

Care Programme ◽

Number Of Patients ◽

Hospital Beds ◽

People With Intellectual Disabilities ◽

Independent Sector

SummaryThe Transforming Care national plan for England to develop community services and close hospital beds for people with intellectual disabilities and/or autism was published in October 2015 and is due to finish in March 2019. In this editorial the key plan objectives are evaluated, with particular reference to people with intellectual disabilities and/or autism who offend or are at risk of offending. The conclusion is that, to date, the plan has failed to meet its targets to reduce the number of in-patients with intellectual disabilities and/or autism and to invest in community services, and the number of patients in independent sector beds is increasing.

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Service innovations: risk assessment in learning disability

Psychiatric Bulletin ◽

10.1192/pb.29.1.28 ◽

2005 ◽

Vol 29 (1) ◽

pp. 28-31 ◽

Cited By ~ 1

Author(s):

S. Bhaumik ◽

S. S. Nadkarni ◽

A. B. Biswas ◽

J. M. Watson

Keyword(s):

Risk Assessment ◽

Information Sharing ◽

Management Plan ◽

Treatment Unit ◽

Care Programme ◽

Perceptions Of Risk ◽

After Care ◽

Planning Meeting ◽

Adults With Learning Disabilities ◽

Specialist Treatment

Aims and MethodThe aim of the study was to evaluate the effectiveness of the care programme approach (CPA) in adults with learning disabilities in a specialist treatment unit by auditing all in-patient records over a 6-month period. A multidisciplinary team set CPA standards. Staff on the unit completed questionnaires about patients, including CPA screening and risk assessment/management, and carers completed questionnaires about their perceptions of risk and information sharing.ResultsOf the 15 patients whose records were reviewed, 13 had CPA screening on admission and 12 on discharge. Before discharge, 9 patients had a CPA planning meeting and only 4 patients had a demonstrable risk management plan. Carers of 9 patients perceived that information was shared.Clinical ImplicationsMajor deficiencies identified in risk assessment and management and in information sharing may potentially jeopardise successful treatment and after-care.

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Weapon carrying: an important part of risk assessment

Psychiatric Bulletin ◽

10.1192/pb.22.2.92 ◽

1998 ◽

Vol 22 (2) ◽

pp. 92-93 ◽

Cited By ~ 2

Author(s):

David W. Perry ◽

Irene D. Cormack ◽

Colin Campbell ◽

Alison Reed

Keyword(s):

Risk Assessment ◽

Mentally Ill ◽

Psychiatric Patients ◽

Psychiatric Hospitals ◽

Community Supervision ◽

Public Concern ◽

Care Programme ◽

Weapon Carrying ◽

The Past ◽

Seriously Mentally Ill

Over the past 20 years, with the closure of psychiatric hospitals, there has been a greater emphasis on treatment of the seriously mentally ill in the community. Recently, there have been untoward incidents involving psychiatric patients leading to increasing public concern over this policy. Steps to reduce this concern have included the care programme approach, the supervision register and the community supervision order. Each requires some form of risk assessment to be carried out prior to their implementation, although there is little guidance on what areas should be covered.

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Formarrhoea

Psychiatric Bulletin ◽

10.1192/pb.27.10.388 ◽

2003 ◽

Vol 27 (10) ◽

pp. 388-389 ◽

Cited By ~ 3

Author(s):

Peter Hardwick

Keyword(s):

Mental Health ◽

Risk Assessment ◽

Clinical Practice ◽

Mental Health Services ◽

Health Services ◽

Child Protection ◽

Child And Adolescent ◽

Health Improvement ◽

Care Programme ◽

Adult Mental Health

The epidemic of formarrhoea blighting adult mental health services is spreading to child and adolescent mental health. Threatening to arrive all about the same time are forms to do with risk assessment, care programme approach, outcome and activity recording, Commission for Health Improvement, child protection, assessment of trainees … and more. They will likely cause an avalanche when added to the mountain of existing forms and Government circulars already piled up on my desk. Forms are increasingly governing all aspects of clinical practice. They threaten to get in the way of doing the job.

Download Full-text

Searching for Programme Theories for a realist evaluation: A case study comparing an academic database search and a simple Google search

10.21203/rs.3.rs-25988/v1 ◽

2020 ◽

Author(s):

Susanne Coleman ◽

Judith M WRIGHT ◽

Jane NIXON ◽

Lisette SCHOONHOVEN ◽

Maureen TWIDDY ◽

...

Keyword(s):

Risk Assessment ◽

Pressure Ulcer ◽

Database Search ◽

Cochrane Library ◽

Striking Difference ◽

Assessment Instruments ◽

Programme Theory ◽

Care Programme ◽

Health And Social Care ◽

Google Search

Abstract Background Realist methodologies are increasingly being used to evaluate complex interventions in health and social care. Programme theory development (ideas and assumptions of how a particular intervention works) is a key initial step in realist methodology, with literature reviews providing important evidence to support this. Deciding how to search for programme theories is challenging and there is limited guidance available. Using an example of identifying programme theories associated with the use of Pressure Ulcer Risk Assessment Instruments in clinical practice, the authors explore and compare several different approaches to literature searching and highlight important methodological considerations for those embarking on similar reviews. Methods We compared the performance of an academic database search with a simple Google search and developed an optimised search strategy for the identification primary references (i.e. documents providing the clearest examples of programme theories) associated with the use of Pressure Ulcer Risk Assessment Instruments (PU-RAIs). We identified the number of primary references and the total number of references retrieved per source. We then calculated the number needed to read (NNR) expressed as the total number of titles and abstracts screened to identify one relevant reference from each source. Results The academic database search (comprising CINAHL, The Cochrane Library, EMBASE, HMIC, Medline) identified 2 /10 primary references with a NNR of 1395.The Google search identified 7/10 primary references with a NNR of 10.1. The combined NNR was 286.3. The optimised search combining Google and CINAHL identified 10/10 primary references with a NNR of 40.2. Conclusion The striking difference between the efficiency of the review’s academic database and Google searches in finding relevant references prompted an in-depth comparison of the two types of search. The findings indicate the importance of including grey literature sources such as Google in this programme theory search, while acknowledging the need for transparency of methods. Further research is needed to facilitate improved guidance for programme theory searches to enhance practice in the realist field and to save researcher time and therefore resource.

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