scholarly journals Specialist personality disorder services in England: a case for managed clinical networks?

2005 ◽  
Vol 29 (10) ◽  
pp. 365-368 ◽  
Author(s):  
Kingsley Norton ◽  
Julian Lousada ◽  
Kevin Healy

Following the publication by the National Institute for Mental Health in England (NIMHE) of Personality Disorder: No Longer A Diagnosis of Exclusion (National Institute for Mental Health in England, 2003), it is perhaps surprising that so soon after there have been threats to the survival of some of the small number of existing specialist personality disorder services to which it refers. Indeed, one of the few in-patient units specialising in such disorders (Webb House in Crewe) closed in July 2004. Such closures or threats argue for closer collaboration in planning between the relevant secondary and tertiary services and also between the Department of Health, the NIMHE and local National Health Service commissioners. Not safeguarding existing tertiary specialist services, at a time of increasing awareness of the needs of patients with personality disorders, may be short-sighted.

1972 ◽  
Vol 120 (557) ◽  
pp. 433-436 ◽  
Author(s):  
D. G. Morgan ◽  
R. M. Compton

Department of Health and Social Security statistics show a steady rise in the use of outpatient services from the inception of the National Health Service; since the Mental Health Act of 1959, the numbers of new outpatient and clinic attendances have increased by one-third and one-fifth respectively (D.H.S.S., 1971). However, as our knowledge of the actual functions of out-patient services and their relationship to in-patient care is at best only rudimentary, the recent article by Mezey and Evans (Journal, June 1971, 118, p. 609) is a much needed contribution towards evaluating these different facilities of the psychiatric services.


2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill

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.


2020 ◽  
Vol 20 (3) ◽  
pp. 183-200
Author(s):  
Elizabeth Chloe Romanis ◽  
Anna Nelson

COVID-19 has significantly impacted all aspects of maternity services in the United Kingdom, exacerbating the fact that choice is insufficiently centred within the maternity regime. In this article, we focus on the restrictions placed on homebirthing services by some National Health Service Trusts in response to the virus. In March 2020, around a third of Trusts implemented blanket policies suspending their entire homebirth service. We argue that the failure to protect choice about place of birth during the pandemic may not only be harmful to birthing people’s physical and mental health, but also that it is legally problematic as it may, in some instances, breach human rights obligations. We also voice concerns about the possibility that in the absence of available homebirthing services people might choose to freebirth. While freebirthing (birthing absent any medical or midwifery support) is not innately problematic, it is concerning that people may feel forced to opt for this.


2009 ◽  
Vol 25 (03) ◽  
pp. 262-271 ◽  
Author(s):  
Eva Susanne Dietrich

Objectives:The aim of this study was to examine the impact of the National Institute for Health and Clinical Excellence's (NICE's) negative and restricting technology appraisals on the number of prescription items dispensed and the corresponding total net ingredient costs for drugs from 2000 to 2004 in the ambulatory care of the National Health Service (NHS) in England and Wales. In addition, it is discussed whether the NICE approach could be a role model for Germany.Methods:The number of prescription items dispensed and the net ingredient costs of thirty-one drugs reimbursed by the NHS were analyzed, thereof thirteen drugs descriptively and twenty-one drugs with regression analyses. Data were extracted from the “Prescription-Costs-Analysis-Statistics” for the ambulatory care of the British Department of Health (England 1993–2005). In the case of the twenty-one drugs analyzed by regression analyses, predictions were established how the prescribing and the costs would have developed without NICE's drug appraisal. Finally, conclusions were drawn whether NICE's negative and restricting drug appraisals had a decreasing effect or not.Results:For 97 percent of the drugs analyzed in this study, the publication of NICE's fourteen negative and restricting technology appraisals of drugs between 2000 and 2004 did not reduce the number of prescription items dispensed and net ingredient costs in the ambulatory care of the NHS in England and Wales.Conclusions:Cost-effectiveness appraisals as performed by NICE or the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) are a useful and important tool to enhance the discussion about methods and acceptance of evidence-based medicine in general.


2006 ◽  
Vol 30 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Niamh Power ◽  
Dawn Harwood ◽  
Akintunde Akinkunmi

Rollo May Ward, a long-term medium secure facility integrated within the West London Mental Health National Health Service (NHS) Trust, is the first dedicated long-term NHS medium secure unit to have opened in England. It caters for a group of men with complex clinical needs and risk assessment issues who had previously been inappropriately detained within high secure services owing to a lack of suitable, less secure placement facilities. We describe the background to the development of the long-term medium secure service, the referral and assessment processes, the structure of the ward and the therapeutic programmes available to patients. We also outline the characteristics of the first 21 patients to be admitted to the ward and offer advice for similar future developments.


2012 ◽  
Vol 36 (11) ◽  
pp. 401-403 ◽  
Author(s):  
Frank Holloway

SummaryThe Health and Social Care Act 2012 brings in profound changes to the organisation of healthcare in England. These changes are briefly described and their implications for mental health services are explored. They occur as the National Health Service (NHS) and social care are experiencing significant financial cuts, the payment by results regime is being introduced for mental health and the NHS is pursuing the personalisation agenda. Psychiatrists have an opportunity to influence the commissioning of mental health services if they understand the organisational changes and work within the new commissioning structures.


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