• Hand-held computers in clinical audit: A comparison with established paper and pencil methods

      Curl, Marie; Robinson, David K. (1994)
      The performance of hand-held computer terminals was compared with that of paper and pencil data collection methods. The study was carried out on two wards, with a comparative study in the medical audit unit at Rampton Hospital, one of three special hospitals managed by the Special Hospitals Service Authority. These were analysed, focusing on time factors, error rates, ease of use and financial implications. Findings showed that the electronic system saved time, reduced staffing costs and errors and had unit-wide potential. The electronic data collection contributed to a cost-effective and flexible data-processing system for use in auditing.
    • The closure of a long-stay psychiatric hospital: A longitudinal study of patients' behavior

      Francis, Valerie M.; Vesey, Patrick; Lowe, Gail (1994)
      This paper summarises longitudinal data based on repeat assessments of the behavioural functioning of 90 long-stay psychiatric patients. Data were gathered over a period of 4-5 years that spanned a hospital closure and the resettlement of patients in various alternative settings. Time-series analyses of individual data sets showed that resettlement led to no significant behavioural change in the majority of patients. However, some significant behavioural improvements were evidenced for approximately 20% of the group, while behavioural deterioration occurred in approximately 12%. Supplementary findings showed that following resettlement the quality of care provided significantly improved in many respects. However, access to social, recreational or vocational activities was reduced. In addition, the level of physical health symptomatology was shown to increase for this group of patients.;
    • Improving delivery of care through change management

      Robinson, David K.; Bills, Keith (1996)
      This article describes an evidence-based care initiative and programme of clinical change which set out to improve the delivery of nursing care and related health outcomes for mentally disordered offender patients at Rampton Hospital. The programme has implications for all nursing specialties with studies also validated in mainstream psychiatric and general nursing contexts.
    • Destination and dependency of psychogeriatric inpatients at discharge from Nottingham hospitals following the 1990 NHS and Community Care Act

      Page, Kim; Blagden, Karen; Biswas, Asit (1996)
      This study examines the impact of the National Health Service (NHS) and Community Care Act on the discharge of patients from inpatient psychogeriatric wards in Nottingham. All inpatients discharged from five psychogeriatric acute assessment wards between April 1 and September 30, 1993 were included in the study. The dependency ofeach patient was assessed using the balance of care method and relationships between dependency and destination at discharge were examined. The dependency status of patients discharged between April 1993 and September 1993 was compared with the dependency and destination at discharge of all inpatients admitted during the corresponding period in the previous year. There was a larger proportion of high-dependency patients admitted in 1993 than in 1992. There was no difference between the two periods in the median length of stay. No association was found between length of stay and dependency, nor between dependency status and destination at discharge. The first 6 months of the implementation of the Act has had negligible impact on discharge activity in these wards as measured by length of stay and destination at discharge.
    • Surfing the Internet: Challenges for healthcare

      Robinson, David K. (1997)
      As the 21st century approaches more and more people are getting 'on-line' and discovering the wealth of information that is available to them via the Internet. At little cost, individuals can access and search for information worldwide and exchange ideas and opinions with international colleagues. With such opportunities healthcare professionals cannot afford to be left behind. This article provides an introduction to the world of Internet and the exciting possibilities it offers.
    • Delivering quality

      Money, Della (2000)
    • The origins and essence of US social policy: On taxonomies, time and transfers

      Manning, Nick (2006)
      Our understanding of US social policy has not been advanced by the classification of welfare states that has dominated social policy analysis in recent years. But in biology and cosmology we can find useful examples of the way in which we can develop more theoretically informed and dynamic classifications. A common feature has been the incorporation of time and developmental paths into classification. The way in which social and political developments unfold over time is particularly important in social policy and, in the case of the USA, this has enabled us to understand that social policies can and have changed, with a rich mix of progressive and regressive policies evolving and receding over the decades. In view of the dominance of the USA in world affairs and the global transfer of resources, ideas and polices across regions, this more subtle analysis of the nature of US social policy is essential.
    • Professionalizing action research--a meaningful strategy for modernizing services?

      Hall, Julie E. (2006)
      Background: This paper outlines how a specific action research approach can be used to secure practice development in services which have found sustained change difficult. For the purpose of this paper discussion focuses upon using professionalizing action research (a form of action research) to secure transformation in acute inpatient mental health services. This speciality has experienced long-term difficultly in meaningful practice change. Not limited to this context parallels can be made with other health and social care services requiring significant modernization.; Aim: The aim is to critically discuss the use of professionalizing action research as an approach to sustainable change.; Discussion: clarifies whether this method is a suitable vehicle for change, which is ideally suited to services which have a poor record of practice development.; Method: A review of action research and practice development literature forms the basis of this paper. The literature is sourced through bulletin boards, electronic databases and the British Library Classification Scheme. Keywords searched are action research, team learning, managing change and practice development. Following definition; the components of professionalizing action research are analysed using the themes of educative base, problem focus, improvement and involvement.; Findings: The educative base of professionalizing action research is collaborative reflective practice which is used to initiate meaningful change, rooted in everyday practice. The benefit of this is that change actions are based in real-time situations. The problem focus component of professionalizing action research is used to emphasize the views of service users and carers. This is positive in terms of the patient and public involvement agenda although this theme does emphasize limitations of the approach. The final components are involvement and improvement, these are debated as pluralistic notions and the implications of this are acknowledged.; Conclusion: Reviewing the literature and theoretical application indicates the value of professionalizing action research as a process for modernization. The strength of the approach lies in the opportunity for team learning and change which is grounded in the context of services and pursued through collaboration.;
    • Supporting transitions

      Clegg, Jennifer (2006)
      We introduce this chapter by describing the context of our work and the various ways that systemic ideas have affected it. Three systemic ideas inform our transition interventions: "side-step autonomy", "keep multiple realities alive", and "expect engagement and disengagement". These ideas organize the structure of subsequent sections. We summarize the research literature that supports and explains the ideas, some of which may be unfamiliar to professionals working in intellectual disability services. Vignettes illustrate the issues and give some ideas of how we engaged with families or systems seen within our clinic. We conclude by pulling together our thoughts about this work, including some personal reflections. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(chapter)
    • Forensic telepsychiatry

      Stankard, Paul; Younus, Saleem (2007)
      Comments on the article by Roland M. Jones et al. (see record 2006-22613-010). Although Jones et al. describe the development of services, they do not state whether they have assessed patients themselves using videoconferencing facilities. If they have, it would be useful to establish links between telepsychiatric services within the UK, forensic or otherwise. It is crucial for services across the UK to share experiences and promote practices. The promotion of telepsychiatry has the potential to change current practice positively. This is particularly important if we are to succeed in delivering timely, easily accessible and clinically sound psychiatric services, with the additional spotlight on cost-efficiency with respect to health service delivery. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Forensic telepsychiatry in the United Kingdom

      Saleem, Younus; Taylor, Mark H.; Khalifa, Najat (2008)
      Forensic telepsychiatry remains in its infancy in the United Kingdom. This article sets out to describe how it can be used within a community forensic service, and the future challenges ahead in the United Kingdom. It looks at relevant academic, governmental, and legal resources and is designed as a scholarly reflection by clinicians rather than as a formal literature review.; (c) 2008 John Wiley & Sons, Ltd.
    • A review of the literature on the historical development of community mental health services in the United Kingdom

      Bartlett, Peter; Callaghan, Patrick (2008)
      Community mental health encompasses a diverse range of statutory, voluntary and informal care services. However, little has been written about how changes in policy, legislation and philosophies throughout time impact on the service user experience of mental health care today. The purpose of this paper was to review the literature using systematic approaches and address the question: 'How have historical factors influenced the development of community mental health care in the United Kingdom?' Following a comprehensive literature search, we included 70 texts. Owing to the difficulties of classifying historical texts numerically, two themes were identified: (1) changing perspectives towards mental illness and the mentally ill; and (2) the complexities of mental health care provision. We structured the review around these themes. A narrative approach was used to illustrate the diversity within the identified texts. In response to the review question, an exploration of the historical literature demonstrates that some form of community care has always been evident. It also suggests that over time different philosophical ideas have influenced mental health policy and service structure. These have in turn shaped the care a service user receives when they come into contact with mental health professionals.
    • Treating young people with eating disorders: Transition from child mental health to specialist adult eating disorder services

      Bouman, Walter P. (2008)
      Background: The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) of young people with eating disorders may pose a number of difficulties, including an inconsistent referral process and age boundaries. Methods: We compared young adults referred to a specialist Adult Eating Disorders Service (AEDS) who had previous involvement with CAMHS for the treatment of their eating disorder with those who did not. Information regarding the socio-demographic characteristics and eating disorders symptomatology of patients assessed by an AEDS over a 4-year period was collected. Results: Patients who had previous involvement with CAMHS (particularly the ones treated as in-patients) presented with a lower self-esteem and more maturity fears (MF) than those without previous involvement. Conclusions: This study discusses the implication of these results in transitional arrangements between CAMHS and Adult services. It also highlights the need for heightened awareness of particular issues of self-esteem and maturation in these patients moving between services. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association.
    • Value-based practice: A critique

      Houghton, Philip; Diamond, Bob (2010)
      Values-based practice (VBP) is currently being put forward as an important framework for decision making and practice within mental health services. This article argues that it is seriously weakened by paying too little attention to concepts such as power and interest.
    • Predictors of progression from high to medium secure services for personality-disordered patients

      Tetley, Amanda C.; Evershed, Sue (2010)
      A significant number of inpatients in English high secure hospitals are detained under the Mental Health Act of 2007 with a diagnosis of personality disorder. The main route of discharge for these patients is via medium-security units. This study sought to determine if male personality-disordered patients' ability to progress from high to medium secure services is associated with a level of violent risk (Historical, Clinical, Risk Management 20), clinical psychopathy (Psychopathy Checklist-Revised (PCL-R)) and evidence of specific personality disorder diagnoses (assessed using the Personality Diagnostic Questionnaire-4th edition plus (PDQ-4+) and Personality Assessment Inventory (PAI)). Sixty-five male inpatients within an English high secure personality disorder service who had been assessed using the relevant instruments in 2001 were followed up six years post-assessment to determine if they had progressed to a medium secure service. The results revealed that the antisocial scales of the PAI and PDQ-4+, the PCL-R (particularly factor 1) and the PAI-Paranoid scale were reliable inverse predictors of institutional progression. The findings from this study suggested that the needs of more severely antisocial and psychopathic, individuals might require greater consideration within forensic psychiatric services. Copyright (C) 2009 John Wiley & Sons, Ltd.
    • Difficulties in the pathway from high to medium secure services for personality-disordered patients

      Tetley, Amanda C.; Evershed, Sue; Krishnan, Gopi (2010)
      Personality-disordered patients detained in high secure psychiatric hospitals appear to experience difficulties progressing to medium secure services. Accordingly, this study sought to explore the problems encountered in this pathway. To do this, data relating to referrals to medium secure services were collated for previous and current patients from a Personality Disorder service (n = 68) and a Dangerous and Severe Personality Disorder service (n = 12) in one English high secure hospital. The results highlighted the poor success rate of referrals to medium secure units and revealed the extensive delays encountered in the transfer process. Further to this, they also identified the poor success rate of patients periods of trial leave at medium secure units. Taken together, these findings are consistent with reports that consultants in medium secure units are reluctant to accept personality-disordered patients and that these units lack the infrastructure to treat this patient group. © 2010 Taylor & Francis.
    • Forensic telepsychiatry in UK

      Saleem, Younus (2010)
      Having developed the first Forensic Tele-psychiatry Service in UK in 2005 the presenter would like to share this experience with the attendees of the symposia. Recommendations under Part III of the Mental Health Act 1983 have also been made. They have been accepted by both the Magistrates' as well as Crown Courts. Assessments were primarily undertaken using the already existent video-link facilities within local Magistrates'/Crown courts and HM Prisons. The above experience supports the view that this saves time, cost and improves access to psychiatric services. The presenter has also developed a Forensic Telepsychiatry Steering Group, with a research subcommittee, based in Nottingham. They are coordinating several research projects, exploring the use of teleconferencing facilities within forensic psychiatry. The session will discuss how the above is relevant to Forensic Psychiatrists and also address its importance to the training of forensic psychiatrists. Tele-psychiatry has been used by other services in UK in Forensic settings albeit in a narrow remit not involving actual gate keeping assessments, preparation of Court Reports etc. The session will discuss how it is crucial for services across the UK and beyond to share experiences and promote innovative practices. It will aim to explore ways to succeed with regard to delivering timely, easily accessible and clinically sound psychiatric services, with the additional spotlight on cost-efficiency, saving valuable professional time and 'going green' with respect to health service delivery.