Psychiatric Out-Patients in Plymouth—An Area Service Analysed

1965 ◽  
Vol 111 (470) ◽  
pp. 10-17 ◽  
Author(s):  
Neil Kessel ◽  
Christine Hassall ◽  
Robert Blair ◽  
John M. Gilroy ◽  
Francis Pilkington ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Community Care ◽  
Psychiatric Patients ◽  
Patient Department

Out-patient services in Britain for psychiatric patients have expanded enormously under the National Health Service. Well over half a million patients are seen at clinics annually. Concomitant with this increase the out-patient department has changed in function. No longer is it principally concerned with providing follow up and support for discharged mental hospital in-patients; instead, because of the greatly increased demand for psychiatric care for less severe disorders and under the influence of the movement for community care it now should play a part not at all subservient to the in-patient department. The clinic, properly run, should be an arena of treatment in its own right.

scholarly journals Scottish rehabilitation services: eight year follow-up

1993 ◽  
Vol 17 (6) ◽  
pp. 341-344
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson ◽  
Lesley J. Robertson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mentally Ill ◽  
Support Services ◽  
Psychiatric Rehabilitation ◽  
Rehabilitation Services ◽  
Local Authorities

A survey of Scottish psychiatric rehabilitation and support services, carried out in 1983 (McCreadie et al, 1985), found that although there were wide between-hospital differences, the National Health Service in Scotland was making considerable efforts to provide services for the long-term mentally ill. However, services provided by local authorities were seriously deficient.

scholarly journals Translating the Strengthening and Stretching for Rheumatoid Arthritis of the Hand Programme from clinical trial to clinical practice: An effectiveness–implementation study

Hand Therapy ◽  
2020 ◽  
Vol 25 (3) ◽  
pp. 87-97
Author(s):  
Esther Williamson ◽  
Cynthia Srikesavan ◽  
Jacqueline Thompson ◽  
Eda Tonga ◽  
Lucy Eldridge ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Routine Care ◽  
Service Organizations ◽  
Implementation Study ◽  
Health Service Organizations

Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand programme is a hand exercise programme for people with rheumatoid arthritis. It was clinically effective when delivered during a clinical trial but there was a need to evaluate translation into routine care. Methods We conducted an effectiveness–implementation study. We adapted the trial training into an online format for National Health Service hand therapists. Educational outcomes included confidence and capability to deliver the programme. Implementation outcomes included training reach and adoption. Therapists were invited to collect clinical outcomes. Patients receiving the programme provided data on function (Michigan Hand Questionnaire function scale), pain and grip strength at baseline, treatment discharge and four-month follow-up. Results A total of 790 therapists (188 National Health Service organizations) enrolled in the training; 584/790 (74%) therapists (162 National Health Service organizations) completed the training; 448/790 therapists (145 National Health Service organizations) (57%) evaluated the training and were confident (447/448, 99.8%) and capable (443/448, 99%) to deliver the programme with 85% intending to adopt it (379/448). Follow-up data were provided by 116/448 (26%) therapists. Two-thirds (77/116; 51 National Health Service organizations) reported adopting the programme. One hundred and eighteen patients (15 National Health Service trusts) participated. Patients reported improved function (mean change Michigan Hand Questionnaire scores: 10 (95% CI 6.5–13.6) treatment discharge; 7 (95% CI 3.8–10.2) 4-month follow-up). Grip strength increased 24.5% (left) and 31% (right). Pain was stable. Discussion Online training was an effective way to train therapists with good reach. Clinical outcomes were similar to the clinical trial providing preliminary evidence of successful translation into routine care.

Validation of the Security Needs Assessment Profile (SNAP) by a national survey of secure units in England

2012 ◽  
Vol 36 (10) ◽  
pp. 366-371 ◽  
Author(s):  
Steffan Davies ◽  
Mick Collins ◽  
Chris Ashwell
Keyword(s):  
Clinical Practice ◽  
National Health Service ◽  
Health Service ◽  
Needs Assessment ◽  
National Health ◽  
National Survey ◽  
Content Validity ◽  
Security Requirements ◽  
Clinical Implications

Aims and methodThe Security Needs Assessment Profile (SNAP) was developed to provide a detailed description of individual patient's security requirements in the then Trent Region of England. A national survey of secure units was undertaken to examine the content validity of the item structure of SNAP and revise the item definitions to reflect more broadly based clinical practice. A follow-up survey sought views on the usefulness of SNAP in clinical practice.ResultsThirty-five secure units from National Health Service and independent sector providers participated. No new security items were generated. All the item definitions were reviewed, many amended, and a small number revised extensively. Units' security profiles were rated on the original and revised instruments.Clinical implicationsThe revised SNAP has been shown to be generalisable across secure services in England; 92% of respondents agreed or strongly agreed that SNAP would be useful in providing a structured security needs assessment.

Competition in the Mixed Economy of Care

1996 ◽  
Vol 25 (2) ◽  
pp. 201-221 ◽  
Author(s):  
Julien Forder ◽  
Martin Knapp ◽  
Gerald Wistow
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Social Welfare ◽  
National Health ◽  
Market Failure ◽  
Social Care ◽  
Community Care ◽  
Economic Framework ◽  
Social Welfare Services ◽  
Basic Understanding

ABSTRACTThe 1990 National Health Service and Community Care Act introduced sweeping changes to health and social welfare services. The reforms to community care were dominated by the introduction of markets for social care. We argue that the new markets cannot be guaranteed to deliver the range of services required to meet community care objectives. When they began to assume their new responsibilities, few key purchasers had a basic understanding of the functioning and imperfections of markets. Consequently, they were poorly equipped to anticipate or ameliorate the sources of market failure that we identify. Like any other relatively ill-informed purchaser, local authorities risk being unable to buy what they want on behalf of their residents and at an appropriate volume, cost and quality. We discuss where and how market imperfections are likely to occur. In this context, we offer an economic framework to help in the shaping and managing of social care markets.

scholarly journals A state of insubordination and mutiny

1990 ◽  
Vol 14 (5) ◽  
pp. 302-305
Author(s):  
A. D. M. Douglas ◽  
E. G. Oram
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Nursing Staff ◽  
National Health ◽  
Mental Hospital

A strike involving nursing staff prior to the 1948 National Health Service Act was almost an unheard of event. In 1922 nurses at Saxondale, an 800 bedded mental hospital at Radcliffe-on-Trent near Nottingham, staged what was termed a “sit in strike” lasting four days for refusing to work a 66 hour week and accept a wage reduction as ordered by the employing authority.

Learning Clinical Psychiatry in a Provincial Mental Hospital

1974 ◽  
Vol 125 (586) ◽  
pp. 303-309 ◽  
Author(s):  
Brian Barraclough ◽  
Godfrey Wace
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Clinical Psychiatry ◽  
National Health ◽  
Mental Hospital ◽  
Clinical Skills ◽  
Educational Experience ◽  
Postgraduate Teaching ◽  
The Past ◽  
Mental Hospitals

Postgraduate teaching in psychiatry has always been a function of the provincial mental hospitals, but nothing before has equalled the expansion of theoretical teaching which has taken place over the past ten years. At the heart of the training of a psychiatrist, however, there is the National Health Service job with its own demands, where the practical clinical skills are acquired. The job has not changed much, even though the arrangements for theoretical instruction have improved. Yet changes may be possible which will make the registrar's job more efficient as an educational experience by removing the unsystematic and random elements.

The future of services for the chronically mentally ill: a priority case?

1993 ◽  
Vol 17 (10) ◽  
pp. 582-585 ◽  
Author(s):  
Som D. Soni ◽  
Rafeek F. Mahmood ◽  
Anant Shah
Keyword(s):  
Mental Illness ◽  
National Health Service ◽  
Health Service ◽  
Royal College ◽  
Mentally Ill ◽  
Psychiatric Care ◽  
Economic Cost ◽  
High Quality ◽  
High Prevalence

Research into delivery of psychiatric care has shown that the chronic mentally ill (CMI) patients continue to pose major difficulties not only in terms of economic cost to patients, their families and the state but also in the ability of authorities to provide adequate facilities in the community. The latter is especially important now because of rapid discharge of patients into the community from long-stay wards of mental hospitals, often with little rehabilitative preparation and even less consideration of the effects of the environment into which they are relocated. Although follow-up in some cases has been of exceptionally high quality, a majority have filtered through the network into inadequate residence; this surely is unacceptable. The high prevalence of mental illness among the homeless and the difficulties of providing care for them by an inflexible health service have been highlighted by a recent report of the Royal College of Psychiatrists (Bhugra et al, 1991). This paper attempts to define the possible adverse consequences of the recent reorganisation of National Health Service (NHS) on the care of the chronic mentally ill.

scholarly journals Pre-Exposure Prophylaxis Counseling in a Community Sexual Health Clinic for Men Who Have Sex with Men in Lisbon, Portugal

2019 ◽  
Vol 32 (6) ◽  
pp. 441 ◽  
Author(s):  
Sofia Ribeiro ◽  
Miguel Rocha
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sexual Health ◽  
National Health ◽  
Antiretroviral Drugs ◽  
Health Clinic ◽  
Eligibility Criteria ◽  
Sex With Men ◽  
Exposure Prophylaxis

Introduction: Pre-exposure prophylaxis is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal pre-exposure prophylaxis in Portugal, CheckpointLX, a community clinic targeted to men who have sex with men in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize pre-exposure prophylaxis users attending CheckpointLX before formal pre-exposure prophylaxis introduction in Portugal, and those who were referred to pre-exposure prophylaxis in the National Health Service following formal approval of pre-exposure prophylaxis.Material and Methods: Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed the European AIDS Clinical Society recommendations for pre-exposure prophylaxis eligibility, initiation and follow-up. For formal pre-exposure prophylaxis, the General-Directorate for Health’s Pre-exposure Prophylaxis guidelines checklist was used.Results: Until the end of May 2018, CheckpointLX had a total of 90 appointments for wild pre-exposure prophylaxis, of which 64 (71%) were first time visits. As for the 380 service users referred to the National Health Service, most were Portuguese (n = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (n = 59, 83%).Discussion: Pre-exposure prophylaxis delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care.Conclusion: Much remains to be done in Portugal to ensure that pre-exposure prophylaxis is available to those who need it the most. Offering pre-exposure prophylaxis at community clinics could be a first step.

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