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Steve Turner

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Everything posted by Steve Turner

  1. Content Article Comment
    Here's the reason I posted this. As a former #mentalhealth #nurse in an Assertive Outreach team I share these concerns from users of services. Related post:
  2. Content Article
    The Serenity Integrated Mentoring (SIM) model is described as "an innovative mental health workforce transformation model that brings together the police and community mental health services, in order to better support 'high intensity users' of Section 136 of the Mental Health Act (MHA) and public services." The SIM model is part of a 'High Intensity Network' (HIN) approach, which is now live in all south London boroughs. In this hub post, Steve Turner highlights the benefits and risks of this approach and seek your views on it.
  3. Content Article
    For some time now I've been looking to find out more about mental health services in Trieste, Italy. Then I met Vincenzo Passante Spaccapietra, co-host of the Place of Safety? podcast series. This has enabled me to learn more about the closure of the mental institutions in Trieste, Italy, and the work of Franco Basaglia.  I was keen to find out what really took place, what this really means in practice and how we can adopt this model in the UK. We were delighted to have become involved and to have recorded a couple of podcasts. I recommend this resource to everyone interested in safe, compassionate, patient led mental health care.
  4. Content Article Comment
    I am a supporter of NICE Guidance and former NICE Medicines & Prescribing Associate, having said that I have reservations. The NICE methodology is to engage with organisations, rather than individuals. I believe for this type of guideline, where there are multiple perspectives & gaps in evidence, this approach is flawed & old fashioned. You end up with a guideline written by a committee & open to misinterpretation. People can forget that this is guidance only, something that is supported by the NICE Guideline on Medicine Adherence: https://www.nice.org.uk/guidance/cg76 Also NICE Guidelines are lengthy documents, so I'm hoping a one page summary (or 'detail aid' ) will be produced.
  5. Content Article Comment
    Related consultation on the RPS Prescribing Competency framework for ALL prescribers now open: https://www.rpharms.com/resources/frameworks/prescribing-competency-framework/consultation
  6. Content Article Comment
    I agree Dom, patients are their own best experts. So we (us prescribers) have to build this into our practice. Then everyone benefits. I'm building a vlog series on this and other #medicines related matters: #Medicines #Prescrining #MedLearn #TeamPatient #share4safety #medication #medicinessafety
  7. Content Article Comment
    This is important for patient safety. It's one of a number of major challenges for the Patient Safety Commissioner, who I hope will be able to act independently and focus on identifying and resolving root causes of patient safety failings.
  8. Content Article
    In my tweets and posts I have suggested that patients themselves need to take more responsibility for the medicines they are prescribed. But what about vulnerable groups who may depend on decisions being made for them, and in their best interests? Whilst there are circumstances where antipsychotic (psychotropic) medicines are an appropriate option for people with autism and learning disabilities, these occasions are limited. In all cases the patient matters most, and any decision to prescribe must be part of a team based, patient-led decision, which is regularly reviewed.
  9. Content Article Comment
    An insightful and important article, that highlights the worst aspects of what is happening (in plain sight) in the UK public sector, across local government, health and social care. Speak out on this and your career ends.
  10. Content Article Comment
    I am pleased to see this landmark case on #dutyofcandour has finally been acknowledged by the Care Quality Commission. It now appears on their web page 'Background to the Duty of Candour' : Source: https://www.cqc.org.uk/guidance-providers/all-services/duty-candour-background Will Powell & his wife sacraficed £300K compensation to expose the absence of a Legal Duty of Candour in the High Court in 1996, Court of Appeal in 1997, House of Lords in 1998 & the European Court on Human Rights in 2000. In 1999 the Health Select Committee recommended a Statutory Duty of Candour as a consequence of Robbie Powell's 1997 Court of Appeal ruling, which the Government ignored. #share4safety #patientsafety #robbieslaw
  11. Content Article Comment
    This long standing #patientsafety issue needs more than 'measures ...to limit the prescribing of this drug' that are being implemented. In my view, one of the first jobs for the Patient Safety Commissioner should be to look at what is needed nationally to improve standards and competency in #prescribing, and also to increase #patient involvement in prescribing decisions. To make the mantra 'no decision about me without me', a reality, in a way that can be measured through a reduction in drug related harm. Since the demise of the National Prescribing Centre there is no national body that covers the prescribing practice, competence and learning across disciplines. I believe #patients are suffering as a result.
  12. Content Article Comment
    This important blog, in my view, highlights the need for national action on prescribing & for greater support for Care Home staff. They have been working under extreme pressure and don't always have access to the resources or learning needed to ensure prescribing is appropriate and safe. There is also, in my view, a wide variation in the processes for prescribing, reviewing, de-prescribing & monitoring the effect of medicines in Care Homes and many opportunities to share best practice. 'We would like to hear your views We are keen to explore this issue further and would like to learn more from people’s experiences concerning the prescription of antipsychotic medications for people living with dementia. Are you a carer or a family member of a person living in a care setting with experience of this issue? Do you work in a care home, nursing home or in domiciliary care and have a view on this issue?'
  13. Content Article Comment
    There are now several different guidance documents for prescribers in the UK. Not necessarily a problem if they link back to the National Competency Framework for all Prescribers. Worryingly, in my view, this new GMC Guidance doesn't.
  14. Content Article
    The General Medical Council (GMC) has updated their ethical guidance on Good practice in prescribing and managing medicines and devices.
  15. Community Post
    In the UK there is a Prescribing Competency Framework which applies to ALL prescribers. This has been in place since 2012. In my blog I use examples of, what I believe to be, fundamental prescribing failings to discuss its impact and the extent to which it has been adopted. 1. Do the prescribers in your team use the competency framework? 2. Is the competency framework part of the prescribing CPD in your organisation? 3. Is the competency framework used as part of prescribers’ annual appraisals? 4. How is prescribing competency monitored in your organisation, and is the competency framework included in clinical supervision? 5. Does your organisation use the prescribing competency framework in clinical governance sessions? 6. Is the prescribing competency framework referred to in incident investigation reports? Link to blog:
  16. Content Article
    Medicines and prescribing are highly risky areas of health care. It is estimated that more than 200 million medication errors occur in NHS every year, and that avoidable adverse drug reactions (ADRs) cause 712 deaths per year, at a financial cost of at least £98.5 million every year.[1] Many medicines and prescribing issues have been highlighted in reports and investigations into patient deaths over the years, yet the issues around prescribing competency are yet to be fully addressed. It is time this omission was rectified. This blog explains why I believe patients, the public and healthcare practitioners, need to be aware of the Prescribing Competency Framework.[2] It outlines why the framework must be applied in practice, used in clinical supervision and CPD, and why we must all speak out of it is not being followed. The benefits of this will include prevention of unnecessary medicines being prescribed, avoidance of drug related harm, and lives saved.
  17. Content Article Comment
    Good to see the issue of referrals getting lost mentioned. This is usually a 'systems problem', and it needs attention. Nobody wants this to happen. I recommend that #patients are encouraged and helped to be part of the referral process. Doing this prevented a friend's urgent referral for cardio-version / cardiac ablation being missed. Had he not chased up the referral himself, and been persistent, he would not have been treated. The referral had not got through to the relevant team. We never did find out what had happened to it. I recommend all patients (who can) keep copies of all letters / summaries / consultations /test results and referrals, and follow this up themselves if there is a delay.
  18. Article Comment
    This is a deeply disturbing story. I await the CQC report, and more importantly what happens as a result. The endless round of investigations, inquiries, recommendations, action plans, reorganisations, appointment of commissioners or 'Tsars' and the associated spin followed by little or no real change needs to end. Implementation is key.
  19. Content Article Comment
    Worrying figures. Especially as this is based on the NHS staff survey which some staff are very wary of taking part in. I believe that the survey responses (although anonymous) can be viewed by managers at Team level. This puts some staff off, as they fear they may be identified, especially when they work in small Teams. In the past I've asked the Picker Institute about this to check my facts. If anyone can expand on this, or correct me if I'm wrong, that would be helpful for us all.
  20. Article Comment
    As a clinician (nurse prescriber) I fully agree that more wide ranging inquests are needed.
  21. Content Article Comment
    A promising development. The person specification & job description of the Patient Safety Commissioner will be key. E.g, someone who is credible and comfortable at all levels, with patients, carers, the public and with professionals, has a background in inter-disciplinary working, and is able to consider things from all angles. A tall order indeed. I believe this will need an open recruitment process, and the role will need involvement of ALL stakeholders spanning professional boundaries / hierarchies, and fully including those who raise difficult questions and issues. #OneTeam #patientsafety
  22. Community Post
    The recent press release from the UK Government outlines a White Paper which contains the reforms: "Major reform of Mental Health Act will empower individuals to have more control over their treatment and deliver on a key manifesto commitment. Reforms will deliver parity between mental and physical health services and put patients’ views at the centre of their care. Plan will tackle mental health inequalities including disproportionate detention of people from black, Asian and minority ethnic (BAME) communities, the use of the act to detain people with learning disabilities and autism, and improve care for patients within the criminal justice system..." The report covers: "A package of reforms has been set out in a wide-ranging new Reforming the Mental Health Act white paper, which builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018. At the heart of the proposed reforms to the Mental Health Act is greater choice and autonomy for patients in a mental health crisis, ensuring the act’s powers are used in the least restrictive way, that patients receive the care they need to help them recover and all patients are viewed and treated as individuals. These reforms aim to tackle the racial disparities in mental health services, better meet the needs of people with learning disabilities and autism and ensure appropriate care for people with serious mental illness within the criminal justice system." Do you work for Mental Health services? Are you someone who uses Mental Health services? What are your views?
  23. Community Post
    Some years ago I stopped writing for journals, in favour of blogging & volgging. My reasons were: I specialise in patient involvement and inclusion, so I want the work of me and my colleagues to be easily found by everyone We didn't want our work to end up behind a paywall We work across disciplines and try to bypass hierarchies, especially in promoting action learning and patient led care I can see there are some really good Open Access Journals around. So my question for us all is: Which are the best Open Access Journals? Here a link to my digital profile: https://linktr.ee/stevemedgov This is our developing model of working, a away of working in healthcare that all use and participate in:
  24. Content Article Comment
    Something happened this week which reminded me how important a public inquiry into the circumstances and aftermath following the death of Robbie Powell is for us all, and for patient safety in general. I watched the ITV docudrama 'The Pembrokeshire Murders' In this programme it was twice mentioned that Dyfed Powys Police had previously been found to be institutionally incompetent. In my opinion, the script implied (unintentionally) that it was the media who found the Dyfed Powys Police institutionally incompetent. In fact it was an inquiry into the handling of the Robbie Powell case by Avon and Somerset Police that made the finding of institutional incompetence. I was saddened to see this apparent misrepresentation. The Robbie Powell case is the landmark case on patent safety that too few people know about. Important patient safety learning was lost in the cover up after Robbie's Death. I agree with the English & Welsh Health Ombudsmen and support the call for a public inquiry. #robbieslaw
  25. Content Article Comment
    It's great to see people like Raymond recognised. There are many like Raymond helping keep patients & residents safe in all health systems across the world. 👍🙏 #OneTeam 🌏
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