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Content ArticleDespite the prevalence of diabetes amongst individuals with Serious Mental Illness (SMI), diabetes care is not currently audited within mental health inpatient settings as it audited in physical health settings. This project piloted an audit to assess the diabetes care within London NHS Mental Health Trusts. The Health Innovation Network in partnership with South London and Maudsley NHS Foundation Trust (SLaM) developed and piloted a diabetes audit. Following the SLaM pilot, the audit was completed by all nine London Mental Health Trusts. A diverse approach was taken to spread and adoption. This included piloting the audit within one MH Trust, refining, and then rolling out the audit to eight London Mental Health Trusts.
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Content ArticleThis briefing was commissioned by the Maternal Mental Health Alliance who are dedicated to ensuring all women, babies and their families across the UK have access to compassionate care and high-quality support for their mental health during pregnancy and after birth. One woman in five experiences a mental health problem during pregnancy or after they have given birth. Maternal mental health problems can have a devastating impact on the women affected and their families. NICE guidance states that perinatal mental health problems always require a speedy and effective response, including rapid access to psychological therapies when they are needed. Integrated care systems (ICSs) have a unique opportunity to ensure that all women who need support for their mental health during the perinatal period get the right level of help at the right time, close to home.
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- Maternity
- Mental health
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Content ArticleAt the beginning of 2023, The Jordan Legacy launched a new strategy designed to raise the bar in terms of collective ambition in suicide prevention and to plot a course of collective practical action that can realise that ambition. This report is the first in a series summarising what is emerging from this action research project, as well as the organisation's wider, ongoing action learning initiatives, focusing on reducing the number of suicides in the UK. The researchers asked people affected by suicide to provide responses to two key questions: How can we significantly reduce the annual number of suicides in the UK, from the 6000+ level it’s been at for 15 years? How far can we go?
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- Self harm/ suicide
- Mental health
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News Article
Government reports on 'overdue' major conditions strategy
Patient-Safety-Learning posted a news article in News
The Government must provide the health service with more support to fulfil its ambition of extending healthy life expectancy and reducing premature death, an expert has warned. It comes after the Department for Health and Social Care (DHSC) published an interim report on its Major Conditions Strategy, a 5-year blueprint to help manage six disease groups more effectively and tackle health inequality. The groups are cancer, cardiovascular disease – including stroke and diabetes – musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia. The Government said the illnesses "account for over 60% of ill health and early death in England", while patients with two or more conditions account for about 50% of hospital admissions, outpatient visits, and primary care consultations. By 2035, two-thirds of adults over 65 are expected to be living with two or more conditions, while 17% could have four or more. Sally Gainsbury, Nuffield Trust senior policy analyst, said the Government is right to focus on the six conditions, but "will need to shift more of its focus towards primary prevention, early diagnosis, and symptom management". She added: "What's less clear is how Government will support health and care systems to do this in the context of severe pressures on staff and other resources, as well as a political culture that tends to place far more focus on what happens inside hospitals than what happens in community healthcare services, GP practices and pharmacies. This initiative is both long overdue and its emphasis has shifted over time. The Major Conditions Strategy is being developed in place of a White Paper on health inequalities originally promised over 18 months ago." Read full story Source: Medscape, 16 August 2023- Posted
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- Long-term conditions
- Cancer
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Content ArticleIn this blog for the Royal College of Physicians, patient Hayley Hall argues that engaging members of the public in digital transformation will help ensure that changes made bring real benefits not just to the health service also but to patients, carers, family members and communities.
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- Digital health
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News Article
Women with poor mental health ‘have 50% higher risk of preterm birth’
Patient-Safety-Learning posted a news article in News
Women who struggle with their mental health have an almost 50% higher risk of preterm births, according to the biggest study of its kind. The research, published on Tuesday in the Lancet Psychiatry, examined data from more than 2m pregnancies in England and found about one in 10 women who had used mental health services had a preterm birth, compared with one in 15 who did not. The study also found a clear link between the severity of previous mental health difficulties and adverse outcomes at birth. Women who had been admitted to psychiatric hospital were almost twice as likely to have a preterm birth compared with women who had no previous contact with mental health services. And women with history of mental health difficulties faced a higher risk of giving birth to a baby that was small for its gestational age (75 per 1,000 births compared with 56 per 1,000 births). The study recommends that when pregnant women are first assessed by doctors and midwives they should be sensitively questioned in detail about their mental health. One of the reports authors, Louise Howard, professor emerita in women’s mental health at King’s College London, said such screening would help identify “clear red flags for a possible adverse outcome”. Read full story Source: Guardian, 14 August 2023 -
News Article
Concerns over patient monitoring as anti-depressant use surges
Patient_Safety_Learning posted a news article in News
Coroners have raised multiple warnings about the way a commonly-used medication is being prescribed to at-risk patients, HSJ has found. HSJ has identified at least nine ‘prevention of future deaths’ reports issued by coroners since 2017 which highlighted the way the deceased’s prescription for sertraline was handled, with two of these issued since the start of 2023. It comes as Open Prescribing data suggests sertraline prescriptions have increased by almost 40 per cent since 2019, which has led to concerns that GPs are struggling to meet the growing demand for follow-up checks. Read full story Source: HSJ, 9 August 2023 -
News Article
Antidepressants: I wasn't told about the side-effects
Patient_Safety_Learning posted a news article in News
About one in seven people in the UK now take medication to treat depression but some say they are not being given appropriate advice about the potential side-effects of the drugs they have been prescribed. Seonaid Stallan's son Dylan was a teenager when he began receiving treatment for body dysmorphia and depression. "He was struggling with the way he felt about himself, the way he looked," Seonaid said. "He was extremely anxious. He would be physically sick. He would be unable to leave the house." Dylan, from Glasgow, was treated with the antidepressant Fluoxetine from the age of 16. But when he turned 18, his medication was changed to Sertraline. Within two months of his prescription change he had taken his own life. Read full story Source: BBC, 9 August 2023- Posted
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- Mental health
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News Article
‘Disappointing’ failure to boost community care revealed by internal data
Patient_Safety_Learning posted a news article in News
A ‘disappointingly slow’ transformation of community services means thousands of mental health patients are still presenting at emergency departments within weeks of being discharged from an inpatient facility. Experts said an NHS England-led community transformation programme, launched in 2019 as part of a £2.3bn investment in mental health services, should have helped reduce readmission rates, but internal data seen by HSJ suggests the rates have actually increased since then. The data reveals for the first time the proportion of patients discharged from inpatient care who then present to accident and emergency within two months. The proportion of adult patients was 11 per cent in 2018-19, when the investment programme was launched, and had increased to 12 per cent by 2022-23, representing around 6,000 adult cases. The situation appears worse for children, with an 18 per cent readmission rate within two months, up from 17 per cent in 2018-19. Read full story Source: HSJ, 8 August 2023- Posted
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- Mental health
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News Article
Trust given warning notice over rapid tranquillisation
Patient Safety Learning posted a news article in News
A mental health trust has been served with a warning notice ordering improvements in its processes around rapid tranquillisation of patients. The Care Quality Commission said the trust needed to ensure all staff at Kent and Medway NHS and Social Care Partnership Trust followed local and national recommendations to monitor and record a patient’s physical health when rapid tranquillisation was administered. Inspectors were concerned staff were not always aware of the potential impact of these medications. Serena Coleman, CQC deputy director of operations in the south, said: “We found some staff weren’t always using the least restrictive options to make sure that people’s behaviour wasn’t controlled by an excessive use of medicines. “As required medication, such as lorazepam and promethazine, was being used quite frequently but we couldn’t always find records to explain why these medications were necessary. There were examples where reviews hadn’t happened for long periods, meaning staff couldn’t be sure it was still appropriate to administer to people." Read full story (paywalled) Source: HSJ, 3 August 2023- Posted
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- Medication
- Adminstering medication
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Content ArticleThis book, edited by Chartered Health Psychologist Holly Blake, demonstrates the breadth of research on work, health and wellbeing, during and beyond the COVID-19 pandemic, covering workforce impacts and workforce interventions in various countries and settings. Learning from this research will help to build global preparedness for future pandemics and foster resilience for responding in times of crisis and uncertainty.
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- Staff safety
- Mental health
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News Article
Patients ‘not thin enough’ for help as NHS battles eating disorder crisis
Patient_Safety_Learning posted a news article in News
Desperately ill people with eating disorders are being refused NHS treatment for “not being thin enough”, as new figures reveal the health service is in the grips of a growing eating disorder crisis. Shocking figures obtained by The Independent show at least 5,385 patients – the overwhelming majority, 3,896, of whom are children – were admitted to general wards for conditions such as anorexia and bulimia in 2021-22, more than double the number in 2017-18. It comes as separate analysis of NHS figures suggests the number of children being treated for eating disorders more than doubled from 5,240 in 2016-17 to 11,800 in 2022-23. Read full story Source: Independent 1 August 2023 -
News ArticleMinisters are backing a potentially “dangerous” new model allowing police to reduce their response to mental health incidents after failing to formally assess the risk of harm or death. Officials are monitoring any “adverse incomes” from the National Partnership Agreement, which will see police forces stop attending health calls unless there is a safety risk or a crime being committed. Policing minister Chris Philp said a pilot by Humberside Police gave him confidence in national roll-out, which aims to “make sure that people suffering mental health crisis get a health response and not a police response”. Mental health charities and experts have warned the plans could be “dangerous”, and a coroner raised the alarm following a woman’s suicide after police failed to respond to her disappearance. A report published last month said action was needed to prevent future deaths, warning that the new model could “allow each agency to regard such a situation as the other’s responsibility, whilst nobody is on the ground attempting to retrieve a seriously ill patient”. Read full story Source: The Independent, 26 July 2023
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- Mental health
- Patient safety incident
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Content ArticleAt the time of her death, Heather Findlay, aged 28 years, was in the care of the East London Foundation Trust (ELFT), detained under section 2 of the Mental Health Act at Mile End Hospital. At approximately 3pm on 11 June 2020, she was on s17 escorted leave, standing with a healthcare assistant (HCA) at the front gates of the hospital having a cigarette, when she turned to the HCA, said “I’m sorry I have to do this to you” and ran away. ELFT contacted the Metropolitan Police Service (MPS) at 3.17pm, but by 3.58pm, Ms Findlay had been found by a member of the public in a nearby park. At inquest, the jury came to a conclusion of death by suicide and giving a medical cause of death of: 1a hypoxic ischaemic encephalopathy 1b sodium nitrate toxicity.
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EventuntilThe NHS long term plan (LTP) builds on the commitments for mental health services set out in the five-year forward view for mental health (FYFVMH), emphasising collaboration and the use of digital innovations to deliver more personalised and streamlined care. The mental health implementation plan 2019/20-2023/24 provides a framework to support the delivery of these commitments locally, and sets out a combination of fixed, flexible and targeted approaches, with core national targets supported by flexibility for local systems to agree how best to deliver services. To support the ambitions within the Plan, the NHS has made a renewed commitment that funding for mental health services will grow faster than the overall NHS budget, creating a new ringfenced local investment fund worth at least £2.3 billion a year by 2023/24. In 2022 the Government issued a call for evidence to inform a new, 10-year cross-government Mental health and wellbeing plan. In January 2023 the Government announced it will publish a Major Conditions Strategy that will include mental health. The Government has said a joined up strategy will ensure that mental health conditions are considered alongside physical health conditions. The GovConnect Mental Health annual conference is committed to providing learning and solutions which improve mental health and wellbeing outcomes, particularly for people who experience worse outcomes than the general population. This is a key part of our Governments commitment to ‘level up’, and address unequal outcomes and life chances across the country. The government has committed to develop a new cross-government, 10-year plan for mental health and wellbeing for England to support this objective. Mental Health 2023 – Delivering Collaborative Whole Pathways of Care. Will give attendees the opportunity to engage with key personnel from delivery partners and national stakeholder organisations, providing an assessment of FYFVMH transition to LTP planning and delivery progress, addressing the 13 core areas of mental health services provision set out in the implementation plan, including child and adolescent mental health, maternal mental health services, the mental health of older people, and care for people with serious mental illness. Along with learning and interactive debate on: How can we improve the quality and effectiveness of treatment for mental health conditions? How can we all support people living with mental health conditions to live well? How can we improve the quality and effectiveness of treatment for mental health conditions? How can we all improve support for people in crisis? How can we all intervene earlier when people need support with their mental health? We invite all organisations and individuals from all NHS settings, Local authorities, independent and VCSE sectors and private providers to join us at the Royal Society of Medicine, London. Register for the conference
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Content ArticleThis is part of our series of Patient Safety Spotlight interviews, where we talk to different people about their role and what motivates them to make health and social care safer. Martin talks to us about the role of Professional Nurse Advocates (PNAs) in improving patient safety through restorative clinical supervision for nurses. He also talks about the need to recognise the close relationship between staff safety and patient safety, and the impact that long waiting lists and limited NHS capacity are currently having.
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- Nurse
- Staff safety
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Content ArticleThe major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). It will focus on six major groups of conditions: cancers cardiovascular diseases, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders This briefing by NHS Confederation examines how the upcoming major conditions strategy can set the conditions to prevent, treat and manage multimorbidity in England.
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- Implementation
- Long-term conditions
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EventThis joint conference hosted by The Mental Health – Time for Action Foundation and Safely Held Spaces is aimed at stimulating discussion and promoting change in the way mental health services view the role of the family in the therapeutic process. Going beyond the “carer-patient” model, the conference brings into focus the broader perspective that mental health is not just an individual concern but involves the whole family system. Recognising the importance of the family system’s wellbeing promotes a more holistic approach to mental health. Our objective is to foster an environment for learning and discussion about the latest evidence-based practices across the NHS and third sector organisations. The conference will encompass a series of talks, workshops, and interactive panel discussions. You will have the opportunity to engage with a network of families experiencing mental distress, paving the way for collaborative efforts.
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- Mental health
- Innovation
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News Article
Managers wrongly dismissed doctor with PTSD, tribunal rules
Patient Safety Learning posted a news article in News
A trust breached its own internal illness policy when managers sacked a doctor who had PTSD and had been drunk at work, an employment tribunal has ruled. Judges criticised the move as a “complete failure” by East and North Hertfordshire Trust when Vladimir Filipovich was dismissed in July 2019. Dr Filipovich was summoned to a hearing following allegations he had been drunk at work, did not disclose a diagnosis of post-traumatic stress disorder to his employer, and failed to take a recommended prescription of Citalopram. In a decision published this month, the tribunal sharply criticised how the trust’s investigator handled the Citalopram claim, concluding he “did nothing to investigate the matter whatsoever”, and found ENHT had “appeared to simply take legal advice” on how to dismiss Dr Filipovich. The tribunal also concluded ENHT “stopped following” its own illness policy, which aimed to get practitioners to return to work, and “abandoned” its requirement to obtain the latest occupational advice. Read full story (paywalled) Source: HSJ, 21 July 2023- Posted
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- Mental health
- Doctor
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News ArticleNHS mental health services are stuck in a “vicious cycle” of short staffing and overwhelming pressures, a government committee has warned. Rising demand for mental health services has “outstripped” the number of staff working within NHS organisations, according to the public accounts committee. A report from the committee warned that ministers must act to get services out of a “doom loop” in which staff shortages is hitting morale and leading people to quit the already-stretched services. It found staffing across mental health services has increased by 22% between 2016 and 17 and 2021 and 22 while referrals for care have increased by 44% over the same period. Healthcare leaders warned there are 1.8 million people on the waiting list for NHS mental health care with hospital bosses “deeply concerned”. Read full story Source: The Independent, 21 July 2023
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- Leadership
- Mental health
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News Article
Only one in five staff at care scandal trust confident in execs
Patient Safety Learning posted a news article in News
Just one-fifth of staff at a trust engulfed in an abuse scandal expressed confidence in the executive team, according to the Care Quality Commission (CQC), which has downgraded the trust and its leadership team to ‘inadequate’. The CQC inspected Greater Manchester Mental Health Trust following NHS England launching a review into the trust in November 2022 after BBC Panorama exposed abuse and care failings at the medium-secure Edenfield Centre. The two inspections, made between January and March 2023, which assessed inpatient services and whether the organisation was well-led, also saw the trust served with a warning notice due to continued concerns over safety and quality of care, including failure to manage ligature risks on inpatient wards. Inspectors identified more than 1,000 ligature incidents on adult acute and psychiatric intensive care wards in a six-month period. In the year to January, four deaths had occurred by use of ligature on wards which the CQC said “demonstrated that actions to mitigate ligature risks and incidents by clinical and operational management had not been effective”. Read full story (paywalled) Source: HSJ, 21 July 2023- Posted
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- Staff factors
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News Article
Just one-fifth of staff speak up in trust’s internal inquiry
Patient Safety Learning posted a news article in News
Just one in five staff who were approached in a trust’s internal inquiry – prompted by an undercover broadcast raising serious care concerns – engaged with the process, a report has revealed. Essex Partnership University Foundation Trust said it took “immediate action” to investigate issues highlighted in a Channel 4 Dispatches programme into two acute mental health wards last year. This included speaking to staff identified as a high priority in the investigation. However, a new Care Quality Commission report has revealed, of the 61 staff members the trust approached, only 12 engaged with the process. Read full story (paywalled) Source: HSJ, 19 July 2023- Posted
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Content Article
Video: Living with schizophrenia (6 July 2023)
Patient-Safety-Learning posted an article in Mental health
In this video, Chris tells his story of how he dealt with a traumatic childhood and subsequent diagnosis of schizophrenia. He talks about the medication and therapy that have helped him. Warning: The film does contain references to distressing themes.- Posted
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- Mental health
- Schizophrenia
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News Article
‘Hips, knees and eyes’ funding focus ‘not fair’, says medical leader
Patient Safety Learning posted a news article in News
Physical health and “hips, knees and eyes” still command the lion’s share of government money, despite persistent calls for fairer mental health funding, the Royal College of Psychiatrists’ departing president has told HSJ. Adrian James also said future leaders must tackle bed and workforce shortages, while upcoming inquiries into poor care must allow people to speak openly without fear. NHS England CEO Amanda Pritchard has called the minimum investment standard for mental health “non-negotiable”. However, in an interview with HSJ, Dr James said mental health services are often missing out while “big chunks” of government money are allocated to reduce waiting lists. He said: “The [covid] recovery plan that was negotiated with the government really was about your hips, knees and eyes, in spite of big voices – one of them mine – saying, ‘what about the mental health backlog’. At that point, we didn’t get any extra money.” Read full story (paywalled) Source: HSJ, 18 July 2023- Posted
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- Organisation / service factors
- Mental health
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Content ArticleIn this blog post, Diana Jones, an addiction treatment expert from Archstone Behavioral Health, addresses the topic of stigma and discrimination in addiction treatment. The post explores the importance of creating safe and inclusive environments for individuals seeking recovery. It offers practical strategies such as education, empathy, cultural sensitivity, bias recognition, and shared decision-making to promote positive change in addiction treatment practices. By challenging societal misconceptions and fostering compassionate care, healthcare professionals can help individuals overcome barriers and receive the support they need for successful recovery.
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- Discrimination
- Treatment
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