scholarly journals Payment by results in mental health: the current state of play in England

2007 ◽  
Vol 13 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Andrew Fairbairn
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Healthcare ◽  
Healthcare Sector ◽  
Department Of Health ◽  
Current State ◽  
The Uk ◽  
Acute Healthcare

The Department of Health is introducing a ‘payment by results’ system for mental health services in the UK. The system is already being used in the acute healthcare sector, but is still under development for application in mental healthcare. This article outlines the concept of payment by results, briefly reports on its use in other countries and describes the pilot study underway in England to define currencies to be used in a payment by results system planned for NHS mental healthcare throughout England and Wales.

scholarly journals Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme

BJPsych Open ◽  
2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siobhan Reilly ◽  
Catherine McCabe ◽  
Natalie Marchevsky ◽  
Maria Green ◽  
Linda Davies ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Medical Records ◽  
Secondary Care ◽  
Mental Healthcare ◽  
The Uk

Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

scholarly journals Inpatient mental healthcare in England and Wales: patterns in NHS and independent healthcare providers

2008 ◽  
Vol 101 (11) ◽  
pp. 544-551 ◽  
Author(s):  
Veena S Raleigh ◽  
Giovanna M Polato ◽  
Stephen A Bremner ◽  
Sunderjit Dhillon ◽  
Anthony Deery
Keyword(s):  
Mental Health ◽  
Information Systems ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
England And Wales ◽  
Current Information ◽  
Health And Social Care ◽  
The Uk

Summary Objectives Independent healthcare, most of it NHS-funded, provides a significant and growing proportion of inpatient mental healthcare in the UK, but information about patients in these providers is limited. This paper examines differences in the profiles of mental health inpatients in NHS and independent providers in England and Wales, and assesses whether current information systems are adequate for monitoring patient flows and care, given the plurality of service provision. Design Data from the national censuses of inpatients in mental health services in England and Wales in 2006 and 2007 were analysed to examine differences in demographic and other characteristics between inpatients in NHS and independent providers. Setting All NHS and independent providers of inpatient mental health services in England and Wales in 2006 and 2007. Main outcome measures Patients in independent providers were younger, 60% were on low/medium secure wards (compared with 16% in the NHS), they were 44% more likely to be detained and referrals were predominantly from NHS inpatient services. For all ethnic groups, ratios of detention on admission were higher in independent providers. Conclusions This analysis highlights differences between inpatients in NHS and independent providers of mental health services. We also highlight the inadequacy of current information systems for monitoring care, and the urgent need for standardized data across all NHS-commissioned mental healthcare, irrespective of whether it is publicly or privately provided. This is especially important in view of the increases in independent sector provision, and the specialist nature of their services. Such information is critical for commissioners, regulators of health and social care, and other audiences for monitoring patient flows, the quality of care provided, usage of the Mental Health Act 2007 and compliance with equality legislation.

scholarly journals Mental healthcare for asylum-seekers and refugees residing in the United Kingdom: a scoping review of policies, barriers, and enablers

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Teresa Pollard ◽  
Natasha Howard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
National Health ◽  
Scoping Review ◽  
Asylum Seekers ◽  
Mental Healthcare ◽  
Barriers And Enablers ◽  
The Uk ◽  
Asylum Seekers And Refugees

Abstract Background Since 2011, a large influx of asylum-seekers and refugees has put pressure on the UK’s under-resourced national health services and mental health services. Asylum-seekers and refugees (ASR) may experience traumatic events pre-departure, life-threating circumstances on their journeys, and difficulties integrating into host countries related to immigration policies, social isolation, poor living conditions, and unemployment, all of which can significantly affect their mental health. This topic is increasingly important due to the numbers of people seeking asylum and growing concern for their mental health on resettlement. This study examined UK-wide policies and guidance, healthcare practices, barriers, and enablers of mental healthcare for ASR residing in the UK. Methods We conducted a scoping review using Arksey and O’Malley’s 2005 framework, which included semi-structured interviews with stakeholders from non-governmental organisations, academia, UK National Health Service, and community groups. We synthesised and analysed literature and interview data thematically to examine current barriers and potential enablers of ASR mental health support in the UK. Results We included 39 literature sources, of 1,638 identified, and 10 stakeholder interviews. Sources, most published in 2019 (n = 13), included data from England (n = 13), Scotland (n = 3), Wales (n = 3), and Northern Ireland (n = 2) and covered access to care (n = 16), mental health disorders (n = 7), impacts on health (n = 7), barriers to care (n = 13), policies and plans (n = 4), and clinical recommendations (n = 3). Synthesised themes from literature and interviews included existing barriers (i.e. communication difficulties and lack of funding, resources, and political will) and potential enablers (i.e. proposed provision practices, social needs of ASR, and policy changes). Conclusions There is a gap in the literature regarding UK-wide assessment of access and delivery of mental healthcare for ASR in the UK. Time sensitive and culturally appropriate approaches are needed, with greater funding and resource support from the UK Government. This study provides justification for a call to relax hostile environment policies, and for ASR-specific mental health services and support to be considered within the UK. Further research is needed to assess implementation of guidelines across the UK.

scholarly journals Interprofessional education in mental health services: learning together for better team working

2014 ◽  
Vol 20 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Daniel Kinnair ◽  
Elizabeth Anderson ◽  
Henderikus van Diepen ◽  
Cath Poyser
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interprofessional Education ◽  
Mental Health Policy ◽  
Mental Healthcare ◽  
Team Working ◽  
Postgraduate Level ◽  
Training Programmes ◽  
The Uk

SummaryInterprofessional education, learning which brings together different professional groups, helps to prepare practitioners for effective team-based collaborative practice and is now included in all undergraduate training programmes in the health professions. We explore the merits of team-based interprofessional learning, drawing on learning theory and mental health policy. We endorse the use of a practice-based interprofessional education model involving patients in which students experience the complexity of team working and the clinical team gain a more detailed analysis of team processes, which can enhance the quality of patient care. The model has been replicated for undergraduate education in mental healthcare and could easily be used for postgraduate staff. Interprofessional education at postgraduate level could foster the ongoing team-based reflective learning needed to enable mental health services in the UK to adapt to the dramatic changes both in their organisation and in the roles and responsibilities of individual professions.

Adolescent inpatient mental health services in the UK

2021 ◽  
pp. archdischild-2020-321442
Author(s):  
Daniel Hayes ◽  
Jemma Thievendran ◽  
Marinos Kyriakopoulos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Treatment Plan ◽  
Mental Healthcare ◽  
Inpatient Mental Health ◽  
Adolescent Inpatient ◽  
The Uk ◽  
High Level

Inpatient mental health services are an indispensable part of the mental healthcare for adolescents. They provide comprehensive assessment and treatment for young people severely affected by mental health difficulties whose presentation is associated with high level of risk or where diagnostic clarity and effective intervention cannot be achieved with less intensive community input. In the UK, a range of different mental health units have been developed with the aim to meet the needs of young people requiring admission with the appropriate expertise and in the least restrictive way possible. Although an inpatient admission is necessary and helpful for a number of adolescents, it may also be linked to some adverse effects that need to be carefully assessed and managed when such an option is considered or pursued. Collaborative working between inpatient units, community teams and young people and their families is paramount in ensuring that inpatient interventions form part of a wider treatment plan, are as efficient and effective as possible and are used in a way that fosters engagement, independence and optimal outcomes.

Fundamental skills of mental health nursing

2009 ◽  
Author(s):  
Chapman Jim ◽  
Cheryl Chessum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service User ◽  
Code Of Conduct ◽  
Mental Health Nursing ◽  
Department Of Health ◽  
Health Nursing ◽  
The Uk ◽  
Nursing Department

A mental health nurse practises the skill and craft of their role in a variety of different settings to reflect the varied range of services provided in today’s mental health services. Whatever the setting or nature of the mental health problem, a set of adaptable mental health nursing skills will be required to enable the nurse to facilitate the safe and effective care of the service user. This care is expected to be individually tailored to the needs of the service user, developed (with only occasional exceptions) collaboratively with the service user, and evaluated with the service user and key partners in care. The principles of the nurse’s practice have to be underpinned and informed by the policies and guidelines that shape contemporary and future services. In the UK, nurses must respond to the essential capabilities (Department of Health 2006a) and the Chief Nursing Officer’s review of mental health nursing (Department of Health 2006b) in order to deliver a service that reflects the reform and quality improvements expected in modern mental health services. Practical skills have to be backed up by a strong knowledge base, with nurses knowing why they do what they do and being able to explain their actions whenever called upon to do so. Where possible and available, what mental health nurses do needs to be done on the basis of the most up-to-date evidence or guidance, which comes in many forms (Sainsbury Centre for Mental Health 2004, National Institute for Clinical Health and Excellence 2004a, Nursing and Midwifery Council 2008a and 2008b). As not all the scenarios that nurses encounter have a textbook answer, it is important that other complementary skills are developed to help them make decisions and deal with scenarios for which there is no clear and obvious answer available. These skills include: • Reasoning using principles and frameworks to weigh up a situation, e.g. ‘To adhere to the NMC Code of Conduct, what do I need to be aware of in this case?’ • Reflecting in or on practice (Schön 1987, Rolfe and Freshwater 2001, Johns 2004) to get a deeper understanding of situations and your own reactions and judgements, especially those values and attitudes you hold that may cause conflict with service users and significant others.

scholarly journals Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK

2013 ◽  
Vol 202 (s54) ◽  
pp. s30-s35 ◽  
Author(s):  
Patrick McGorry ◽  
Tony Bates ◽  
Max Birchwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Disorder ◽  
Age Groups ◽  
Mental Healthcare ◽  
Population Group ◽  
The Uk ◽  
The Impact

SummaryDespite the evidence showing that young people aged 12-25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people, if we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Here, we present three recent and rapidly evolving service structures from Australia, Ireland and the UK that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people.

The EPA Guidance Project: Guidance for Mental Healthcare in Europe

2015 ◽  
Vol 12 (01) ◽  
pp. 5-11
Author(s):  
I. Großimlinghaus ◽  
J. Zielasek ◽  
W. Gaebel
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Graduate Training ◽  
Action Plan ◽  
Stakeholder Involvement ◽  
Mental Healthcare ◽  
World Health ◽  
Post Graduate Training ◽  
Health Organization

Summary Background: The development of guidelines is an important and common method to assure and improve quality in mental healthcare in European countries. While guidelines have to fulfill predefined criteria such as methodological accuracy of evidence retrieval and assessment, and stakeholder involvement, the development of guidance was not standardized yet. Aim: In 2008, the European Psychiatric Association (EPA) initiated the EPA Guidance project in order to provide guidance in the field of European psychiatry and related fields for topics that are not dealt with by guideline developers – for instance due to lack of evidence or lack of funding. The first three series of EPA Guidance deal with diverse topics that are relevant to European mental healthcare, such as quality assurance for mental health services, post-graduate training in mental healthcare, trust in mental health services and mental health promotion. Results: EPA Guidance recommendations address current and future challenges for European psychiatry. They are developed in accordance with the World Health Organization (WHO) European Mental Health Action Plan.

scholarly journals Service innovations

2003 ◽  
Vol 27 (09) ◽  
pp. 346-348
Author(s):  
Chris Simpson ◽  
Prasanna De Silva
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
High Quality ◽  
The Uk ◽  
Multi Disciplinary Team

The increase in older people in the UK will increase the need for mental health services to run efficient, high-quality services. Multi-disciplinary team assessments, although not new, provide a method of increasing the capacity to see referrals. Two similar systems of multi-disciplinary team assessments from North Yorkshire are reported with evidence of improvement in quality.

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