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The BMJ’s freedom of information requests show how budget constraints are affecting public health services. Gareth Iacobucci reports
Millions of pounds have been stripped from frontline public health services in England as a result of the government’s cuts, The BMJ can reveal. According to the findings of our investigation, councils are disinvesting in areas such as prevention, addiction services, sexual health, and weight management after a 6% government cut in the public health grant for this financial year. More cuts are planned for 2016-17.
Animal assisted therapy service, Home Safari has introduced two week old pygmy goats, Billy and Elliot to their growing array of animals that regularly visit our Trust.
The two new arrivals visited the Sheridan Ward at Hollins Park today to the delight of many service users and staff.
Each Friday the team visit units across the Trust to deliver animal assisted therapy for service users and patients which improves social interaction, health and wellbeing.
Home Safari Animal Therapist, Cheron Mannion explained how they have been a great help to service users and said: "the response from service users has been unbelievable. Everyone loves them and there are smiles and grins everywhere."
The LGA has launched a series of case studies that illustrate the positive work councils are undertaking with their local partners to support people living with autistic spectrum conditions (ASC) in their communities.
Following the government’s Spending Review, the NHS has just over two years at best to stabilise rapidly deteriorating finances and declining standards of patient care. At that point the harsh reality of planned real growth in funding of only 0.2 per cent in 2018/19 (and even less the following year) will have to be confronted.
Open access. Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery.
NEP is looking to recruit Band 5 Nurses and Senior Healthcare Assistants to work in its Tendring area operations, in order to supplement the current workforce.
Anyone interested can expect to find out more about the role, the Trust and the benefits that working for the NHS brings. Support with paperwork will be offered on the day for prospective applicants, as well as the opportunity to participate in a formal interview.
The Bromley Home Treatment Team, which includes doctors, nurses and psychological therapists, provides care 24 hours a day 7 days a week for up to 20 patients at any one time and up to 1200 patients a year.
The team takes referrals from other services, self-referrals and third parties and provide an intensive community alternative to hospital. They provide choice in where care is delivered and reduce the length of inpatient stay with a step down care approach. It is thought they reduce the number of admissions and lengths of stay by around 30 per cent.
A psychiatric nurse or other member of the team visits most service users daily for up to an average of 40 minutes. The team deal with people when they feel at their worst or most vulnerable, and work with them during these life crises in a non-judgemental and compassionate way.
The team use an outcomes measurement system to assess the real time severity of patients’ mental health, monitor these changes with time, and use them to both aid clinical decision making and get a better understand of what is working well and what is not.
NHS England has today (12 February 2016) launched a 30 day public consultation on a number of proposed new products for specialised services, (including service specifications and clinical commissioning policies).
There has already been extensive engagement on these national specifications and policies. They have been developed with the support and input of lead clinicians and tested with stakeholders. This approach has helped ensure that the views of key stakeholders have informed and influenced the development of the specifications and policies to date.
Managing demand for planned health care is described in this report as a “wicked problem” – demand for healthcare is outpacing capacity to meet it.
Health economies have tried various approaches to managing demand; referral management centres, expanded roles, direct access amongst others. But the evidence base has been mixed, of variable quality and sometimes conflicting findings.
This synthesis of evidence sets out to understand what works but with a particular focus on context, to understand what works, in what settings and why.
Best Example of Collaborative Working – NWC Research and Innovation Awards 2015 Cheshire Constabulary and mental health services are working together to provide an immediate response to police incidents that would benefit from mental health services, through Street Triage. It is supported by Cheshire and Wirral Foundation Trust and 5 Boroughs Partnership NHS Foundation Trust.
A police officer and a community psychiatric nurse work together, sharing information and expertise.
Both parties assess situations with the nurse using mental health expertise, access to diagnosis and risk history, and the officer looking at the law/crime, offending history and current situation. Together they decide the most appropriate course of action, taking into consideration customer care, illness, safeguarding and the law.
Some aspects of crisis care appear effective according to a broad NIHR overview of mental health crisis services. Crisis resolution teams that offer home treatment and support early discharge from hospital, is one successful example – although UK implementation is very variable. Early intervention service models are helpful for people with psychosis, as is collaborative care for those with depression. Crisis houses and acute day hospitals, known as “safe havens”, are popular with service users, and supported employment may help prevent future crises. Finally, liaison psychiatry teams might improve waiting times and reduce re-admission. Many of these interventions are recommended in NICE guidance. Overall, there was sparse evidence on cost-effectiveness.
A new national plan launched by NHS England today vows to support people with learning disabilities to lead more independent lives and have greater say about the support they receive.
Under the plan, people with learning disabilities and/or autism will be given a greater say in the support they receive and the number of hospital beds for them will be halved.
There is now a steadily-growing evidence base for the effectiveness of early intervention in psychosis (McGorry, 2015; Secher et al., 2014), alongside evidence of its cost effectiveness (Hastrup et al., 2013; McCrone et al., 2013). Despite this evidence, it has been argued that proper funding and implementation of EI services across difference countries is lacking (Addington et al., 2013).
A new technical report has just been published which examines the availability of EI services for psychosis across Europe (McDaid et al., 2016).
Is prison the right environment for those with severe mental health issues? Evidence indicates that increasingly people with mental health problems are finding themselves incarcerated (Bradley, 2009). There is a growing consensus that this may not be the best environment for those with mental illness, with custody exacerbating issues, and increasing risk of self-harm and suicide (Bradley, 2009).
A new report showcasing how GPs are designing and leading innovative schemes to improve the integration of care in the best interests of patients, has been published by the Royal College of GPs today. Case studies include Derbyshire GP practice employing MH worker; GP-led Child Health Clinic on Shetland; Brighton Memory Assessment Service