Primary mental health care

Filling the chasm: reimagining primary mental health care | Centre for Mental Health

This report explores local initiatives which bridge the gap between primary care and secondary care mental health services, supporting people have more complex needs, don’t meet secondary care thresholds, or present with multiple or medically unexplained symptoms.

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Image source: http://www.centreformentalhealth.org.uk

It finds that primary care services in many areas of England have developed a number of different approaches to addressing mental health needs that other services do not meet. The report describes promising approaches in eight local areas.

The report calls on NHS England to make primary mental health care a central strand of the long-term NHS plan, due to be published later this month. The NHS needs to identify effective models of primary mental health care and invest in local services to help them meet the needs of their communities. The report also calls on Health Education England to invest in the workforce for primary mental health care.

The report identified some key elements for future primary care developments:

  • Identifying the opportunities for prevention and promotion of mental health – including in the perinatal period; with children and young people; and through providing information and resources
  • Maximising social interventions for mental health – moving away from anti-depressants and therapy as the only solutions, improving awareness of community resources
  • Culture change – embracing the holistic approach – valuing social support and linking to physical health initiatives
  • Empowering the person – moving ‘from patient to person’ – enabling people to make their own decisions about what they need to focus on, addressing social factors and causes of mental health problems
  • Bridging the gap between primary and secondary care – co-locating services, employing senior staff to provide consultancy and supervision

Full report: Filling the chasm. Reimagining primary mental health care | Centre for Mental Health

 

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Understanding new models of integrated care

Integrated care is not quick, or cheap, but new systematic review finds sufficient evidence that it is a goal worth pursuing 

The National Institute for Health Research (NIHR) has published Ways of integrating care that better coordinate services may benefit patients. This systematic review, part of the NIHR Signal series, looks at international literature to understand how new care models may affect patients, providers and systems. It includes a qualitative review of attitudes, barriers and enablers of integration and finds new integrated care models can increase patient satisfaction, perceived quality of care and improve access to services. It is less clear whether there may be effects on hospital admissions, appointments or healthcare costs.

Baxter S, Johnson M, Chambers D et al. Understanding new models of integrated care in developed countries: a systematic review. Health Service Delivery Research. 2018;6(29).

Falls Prevention Nurses lead collaborative falls service improvement with West Yorkshire Fire and Rescue Service

NHS England | October 2018 | Falls Prevention Nurses lead collaborative falls service improvement with West Yorkshire Fire and Rescue Service

The Falls Prevention Nurses at Bradford District Care NHS Foundation Trust (BDCFT) have led change by working in partnership and collaboratively on falls prevention with the West Yorkshire Fire and Rescue Service (WYFRS). They  identified unwarranted variation and missed opportunities to enhance their falls prevention work. Which led them to begin offering falls awareness training for WYFRS, supporting them to start providing falls prevention advice and information to their service users as part of their day to day work and linking with their ‘Safe and Well’ strategy (Source: NHS England)

Read the full story from NHS England 

Rethinking outpatient services: Learning from an interactive workshop

Nuffield Trust | August 2018 | Rethinking outpatient services: Learning from an interactive workshop

A new briefing from the Nuffield Trust in collaboration with health leaders across the country looks at outpatients. The authors reflect on how several STPs have outlined plans  to reduce the number of outpatients. Leicester, Leicestershire and Rutland intends to reduce outpatient activity by 30% by removing unnecessary new and follow-up appointments. Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby are aiming to achieve a reduction in consultant-led first outpatient appointments by a fifth. 

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This briefing reveals opportunities to improve the design of services and challenges if some services should be delivered in their current form.

Read the full news item from the Nuffield Trust 

Download the briefing in full here 

Breast cancer survivors control their follow-up care in Maidstone

NHS England | August 2018 |Breast cancer survivors control their follow-up care in Maidstone

A new case study from NHS England highlights how patients with breast cancer in  are able to control  their own care in Maidstone, Kent.  The Open Access programme enables patients to have access to regular mammograms, support advice and appropriate clinical follow up up to five years following treatment for breast cancer. The programme recognises patients as individuals and that the way in which they want to be supported may change during their recovery, the team introduced an Open Access Programme, based upon a successful model in place at the Royal Marsden Hospital.

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Early results

  • A reduction of 3,000 breast outpatient appointments
  • Patients access suitable clinical appointments and contact their nurse appropriately.

Patient benefits

  • Timely referral to an appropriate clinician (ie surgeon, oncologist, nurse)
  • Appointments aligned to patient need or want
  • Fast access to the Cancer Nurse to answer questions and concerns.

Full story at NHS England 

Achieving the Provision of Integrated Care

This report traces the development and impact of integrated care to date, highlights some examples of successful practice and draws out the key lessons for later-adopters |  National Association of Primary Care

This report suggests that a number of of factors – ageing populations, an increased prevalence of multiple chronic disease and rising expectations of what health care and technology can offer –  combined with limited human and financial resources, have placed health  systems under intolerable and unsustainable strain.

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Image source: http://napc.co.uk

Integrated Care Systems, where health providers collaborate with other community  stakeholders to prevent ill health, provide more comprehensive care closer to home, keep people out of hospital and reduce costs, is seen as the antidote to these problems. This approach is now spreading around the world, taking many different forms from country to country.

This report of a two-day symposium attended by health experts from the UK, USA and Ireland, traces the development and impact of integrated care to date, highlights some examples of successful practice and draws out the key lessons for later-adopters.

Full report:

Achieving the Provision of Integrated Care:  Exploring the development and successful
implementation internationally of new models of integrated care

 

How fixing the NHS’s broken pay system can deliver better outcomes for patients

An NHS bonus: how fixing the NHS’s broken pay system can deliver better outcomes for patients | Centre for Policy Studies

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Image source: http://www.cps.org.uk

This report argues that by introducing greater flexibility into the system, and linking pay more closely with performance and objectives, both NHS productivity and patient outcomes could be improved. It urges the Government, and NHS managers, to make reform of the pay system an urgent priority as part of the new funding settlement.

Full report available here