scholarly journals Management of psychiatric in-patient violence in the Anglia region

1999 ◽  
Vol 23 (8) ◽  
pp. 486-489 ◽  
Author(s):  
J. H. Dowson ◽  
J. Butler ◽  
O. Williams
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Learning Disability ◽  
National Health ◽  
Staff Training ◽  
Physical Restraint ◽  
Clinical Implications ◽  
Patient Violence ◽  
Victim Support ◽  
Psychiatric Units

Aims and methodA total of 384 incidents of violence against the person (six ‘serious' and 378 ‘mild’), by adult in-patients in general psychiatric units (GPUs) and learning disability units (LDUs) in 10 National Health Service trusts in the Anglia region, were evaluated by Interviews with staff and examination of records.ResultsThe findings, when compared with standards derived from previous recommendations, showed deficiencies in the documentation of incidents (there was no satisfactory written record of physical restraint for 97% of incidents in GPUs and 86% in LDUs), in the training of staff in ‘control and restraint’ procedures (If two or more staff were involved In physical restraint, for 3% of incidents in GPUs and 100% in LDUs, the staff had received no training within the previous 12 months) and in policies for victim support (there was no written policy that included procedures for victim support in relation to 84% of incidents in GPUs and 44% in LDUs).Clinical implicationsTrusts should consider reviewing their policies on the prevention and management of violence, particularly in relation to staff training.

scholarly journals Research productivity of staff in NHS mental health trusts: comparison using the Leiden method

2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Research Productivity ◽  
Social Care ◽  
Clinical Implications ◽  
Clinical Services ◽  
Health And Social Care

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

scholarly journals Postcode lottery? Hospital transfers from one London prison and responsible catchment area

2010 ◽  
Vol 34 (4) ◽  
pp. 140-142 ◽  
Author(s):  
Simon Wilson ◽  
Katrina Chiu ◽  
Janet Parrott ◽  
Andrew Forrester
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Catchment Area ◽  
Clinical Implications ◽  
Hospital Unit ◽  
Transfer Data ◽  
Hospital Transfer

Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.

Crisis in Admission Beds

1995 ◽  
Vol 167 (6) ◽  
pp. 765-769 ◽  
Author(s):  
Robin B. Powell ◽  
Doris Hollander ◽  
Robert I. Tobiansky
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Corrective Action ◽  
Clear Correlation ◽  
Bed Occupancy ◽  
Careful Monitoring ◽  
Psychiatric Units ◽  
The Mean ◽  
Occupancy Rates

BackgroundThis study was carried out to measure bed occupancy in Greater London's psychiatric units, in response to the apparent shortage of admission beds.MethodThe bed occupancy of London's 54 National Health Service (NHS) acute psychiatric units within 29 districts was ascertained by telephone on 16 bank holidays covering the period 1990–93.ResultsThe mean occupancy level for all London over the 4 years was 97.54% (95% CI = ±0.94%). The number of beds occupied in inner London was significantly greater (99.79 ± 1.11%) than in outer London (95.1 ± 1.49%) (t = 3.85, d.f. = 462, P < 0.001). Bed occupancy for inner London units was ≥ 100% on over 49% of occasions. There has been a steady decline in the number of beds over the four-year period. There was a clear correlation between occupancy levels and the Jarman UPA8 Underprivilege Score (r = 0.504) and between bed provision and the UPA8 (r = 0.67).ConclusionOccupancy rates have become unacceptably high and require careful monitoring. Corrective action may be required in order to prevent a breakdown in services.

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.

scholarly journals Uncertainty among Scottish psychiatrists over NHS continuing care guidance

2009 ◽  
Vol 33 (10) ◽  
pp. 381-383
Author(s):  
Gary S. Stevenson ◽  
Agnieszka Philipson ◽  
Gordon McLaren
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Strong Association ◽  
Postal Questionnaire ◽  
Previous Experience ◽  
Continuing Care ◽  
Clinical Implications ◽  
The South

Aims and MethodTo examine knowledge among Scottish psychiatrists of the 1996 guidance on National Health Service (NHS) responsibility for continuing healthcare, a postal questionnaire was devised and sent to the 132 consultants and specialist registrars in the South-East Scotland Deanery in May 2007.ResultsTwo-thirds of the clinicians (67%, n= 88) responded, 88% of whom had in-patient responsibilities. Only 24% responded positively to an awareness of the current Scottish guidance. There was a strong association between awareness of the guidance and psychiatric speciality, and greater awareness among clinicians with previous experience of a relevant complaint or appeal.Clinical ImplicationsUncertainty about NHS continuing healthcare guidance among practising psychiatrists suggests a need for increased awareness of the issues, with training implications for the new guidance on NHS continuing healthcare in Scotland which became effective in February 2008.

scholarly journals Trainees' views of portfolios in psychiatry

2012 ◽  
Vol 36 (11) ◽  
pp. 427-433 ◽  
Author(s):  
Neel Halder ◽  
Ganesh Subramanian ◽  
Damien Longson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Reflective Practice ◽  
National Health ◽  
Annual Review ◽  
Clinical Implications ◽  
Weekly Basis ◽  
Careful Planning ◽  
Educational Tools ◽  
And Training

Aims and methodPortfolios are now used extensively within the field of psychiatry and our aim was to obtain trainees' feedback on their value. We used a questionnaire to evaluated trainees' priorities, what educational tools they found most helpful, how much time trainees spent on preparing their portfolios and the best and worst aspects of the portfolios.ResultsThe survey was completed by 207 out of 228 trainees (90.8%). The majority (58.4%) rated ‘Passing the ARCP [Annual Review of Competence Progression]’ as their top priority. More trainees found benefit from the feedback of workplace-based assessments (33.3%) than the ratings given (24.1%). Time spent on portfolios on a weekly basis ranged from 5 min to 12 h (the most common answer was 1–2 h). A total of 50.7% felt they did not have enough time to spend on their portfolios. Many found it encouraged reflective practice, but wanted more training for both trainees and trainers on how to use them properly.Clinical implicationsThe expansion of portfolios within the changing National Health Service requires careful planning and training, and perhaps some allocated time to complete them, so that trainees can derive the maximum benefits from the portfolio's intended purpose.

scholarly journals A suitable waiting room? Hospital transfer outcomes and delays from two London prisons

2009 ◽  
Vol 33 (11) ◽  
pp. 409-412 ◽  
Author(s):  
Andrew Forrester ◽  
Christopher Henderson ◽  
Simon Wilson ◽  
Ian Cumming ◽  
Miriam Spyrou ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Clinical Implications ◽  
Waiting Room ◽  
Total Saving ◽  
Hospital Transfer ◽  
Clinical Records ◽  
Timely Treatment

Aims and MethodTo describe a group of prisoners who required transfer to mental health units from two London prisons. Data were collected from prison clinical records.ResultsOverall, 149 patient-prisoners were transferred over a 17-month period. Around a quarter were not previously known to services. the aggregate wait was 36.5 years (averaging between 93 and 102 days per prisoner) and the total saving to the National Health Service (NHS) has been estimated at £6.759 million.Clinical ImplicationsBoth prisons manage a large number of prisoners with untreated psychosis. While in prison, they save the NHS considerable sums of money, but transfer delays prevent timely treatment and could now be legally challenged.

scholarly journals Copying letters to patients: a study of patients' views

2005 ◽  
Vol 29 (2) ◽  
pp. 56-58 ◽  
Author(s):  
Marek Marzanski ◽  
Padmapriya Musunuri ◽  
Tim Coupe
Keyword(s):  
General Practitioner ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Healthcare Professionals ◽  
Clinical Implications ◽  
Family Work ◽  
The Cost ◽  
To Receive

Aims & MethodTo investigate patients' views on receiving copies of letters sent by their healthcare professionals, 72 patients were asked about their willingness to receive a copy of the letter sent to their general practitioner and about preferences for the type of information to be included in such letters. We also asked what concerns, if any, they had about the process.ResultsThree-quarters of the respondents (n=55) said they would like to receive a copy of the letter. Patients accepted the inclusion of information about their illness but were reluctant for data about their family, work and finances to be included.Clinical ImplicationsAlthough the majority of the patients we interviewed wished to have the copy letter, many of them expressed concerns about confidentiality, the risk of distress and the cost of the process to the National Health Service. The rights of those who do not want copy letters should also be respected.

scholarly journals Experience and application of HoNOS65+

1999 ◽  
Vol 23 (4) ◽  
pp. 203-206 ◽  
Author(s):  
Lesley Allen ◽  
Sushila Bala ◽  
Richard Carthew ◽  
Stephanie Daley ◽  
Eugene Doyle ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Old Age ◽  
National Health ◽  
Preliminary Data ◽  
Clinical Implications ◽  
Lessons Learnt ◽  
National Health Service Trust ◽  
Old Age Psychiatry

Aims and methodThe implementation of the Health of the Nation Outcomes Scales for Old Age Psychiatry services (HoNOS66+) in a National Health Service trust is described. Some preliminary data are reported for illustrative purposes.ResultsLessons learnt from this process are identified, and further work needed both on the glossary for the scales and on systems for trapping data is suggested.Clinical implicationsThese remain uncertain. It may be that HoNOS65+ will remain a purely administrative tool.

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