Tackling culture change to transform mental health services

Mandip Kaur for the King’s Fund Blog | 16th March 2017

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Traditionally, mental health services are delivered by Children and Adolescent Mental Health Services (CAMHS) up until the age of 16 or 18 – or when a young person leaves school or college – at which point they’re expected to transition to adult mental health services. It’s long been recognised that this is a poor boundary for service transition, often having a further detrimental effect on mental health.

Forward Thinking Birmingham delivers mental health services for children and young people aged up to 25, combining the expertise of Birmingham Children’s Hospital, Worcester Health and Care Trust, Beacon UK, The Children’s Society and The Priory Group. The partnership’s vision is that Birmingham should be the first city where mental health problems are not a barrier to young people achieving their dreams. The transformational changes to the service were driven by the need to address disjointed and fragmented care provision, complicated service models, long waiting lists and rising demand. The service operates a ‘no wrong door’ policy and aims to provide joined-up care, focusing on individual needs, with improved access and choice for young people.

Read the full blog post here

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How big data is being mobilised in the fight against leukaemia

In a project funded by Bloodwise and the Scottish Cancer Foundation, we have created LEUKomics. This online data portal brings together a wealth of CML gene expression data from specialised laboratories across the globe | Lorna Jackson & Lisa Hopcroft for The Conversation

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Image source: Paulo Henrique Orlandi Mourao – Wikimedia // CC BY-SA 3.0

Our intention is to eliminate the bottleneck surrounding big data analysis in CML. Each dataset is subjected to manual quality checks, and all the necessary computational processing to extract information on gene expression. This enables immediate access to and interpretation of data that previously would not have been easily accessible to academics or clinicians without training in specialised computational approaches.

Consolidating these data into a single resource also allows large-scale, computationally-intensive research efforts by bioinformaticians (specialists in the analysis of big data in biology). From a computational perspective, the fact that CML is caused by a single mutation makes it an attractive disease model for cancer stem cells. However, existing datasets tend to have small sample numbers, which can limit their potential.

Read the full blog post here

Best practice in Memory Services: Learning from across England

This report summarises the findings from a series of visits carried out by NHS England’s National Clinical Director for Dementia

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The visits were to a number of memory services which were experiencing longer waiting times from referral to assessment. The audit found that there had been significant successes in a number of clinics in improving access times over the past year, often in challenging circumstances.

Common features of the services which were reducing waiting times were:

  • Reviewing the assessment pathway and reconfiguring workforce to match demand. Some achieved this through upskilling existing staff, using vacancy funding creatively or investing in new staff.
  • Developing joint clinical protocols for referral and diagnosis, follow-up care, access to and reporting of scans and care home management
  • Supporting memory services in primary care 3,4.

Based on the findings the top ten tips to service improvement are:

  1. Involve service users and carers at every step
  2. Understand current and future demand and map against available capacity
  3. Review referral protocols
  4. Review brain scan (CT/MRI) protocols
  5. Examine DNA rates
  6. Ensure correspondence clearly states diagnosis and accompanying ‘Read Codes’
  7. Identify education and training opportunities
  8. Consider protocol for diagnosis in primary care including care homes
  9. Review with commissioners the role of specialist nurses
  10. Become MSNAP accredited and share best practice examples

Read the full report here

Total transformation of care and support

The Social Care Institute for Excellence has published Creating the five year forward view for social care: how transformed and integrated health and care could improve outcomes and cost-effectiveness.

This updated paper explores the potential for scaling up the most promising examples of care, support and community health services, initially using data from Birmingham City Council, modelling their outcomes and costs.  Originally published in November 2016, it has been updated to include additional models.

The report contains the following chapters:

Vision for transformed care: Re-shaping services around the needs and strengths of individuals, families and communities.

Key messages and summary: Outcomes can be improved, and costs reduced, if the sector scales up promising practice.

Case studies: Six models of care and their potential impact on costs and outcomes.

Models of care: Overview of promising practice that support transformative change in health and social care.

Conclusions and next steps

The paper is available to download here

Smoking cessation in secondary care: acute and maternity settings

Self-assessment framework for NHS acute trusts to develop local action to reduce smoking prevalence and the use of tobacco | Public health England

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The self-assessment tool breaks down the NICE guidance into 4 areas:

  • systems required to implement the guidance
  • communication required
  • training that will help staff to successfully implement the recommendations
  • treatments that should be available to support staff and service users

This self-assessment tool supports all of the recommendations applicable to acute services in the NICE guidelines on Smoking cessation in secondary care.

Please save the self-assessment file to your computer and click ‘enable editing’ before using it.

Public Health England has also developed a suite of resources including a self-assessment tool to support the implementation of NICE guidance in mental health settings.

View the full framework here