The Ten Essential Shared Capabilities: a framework for mental health practice

The 10 Essential Shared Capabilities (ESC) are a description of the core aspects of practice that support effective implementation and delivery of mental health care. The ESC have been derived directly from work with users, carers and mental health personnel. To support their introduction a learning pack was developed giving examples of the 10 ESC as they relate to current practice. A pilot programme across England was developed to test the acceptability and potential utility of these materials and this paper reports on the evaluation of that pilot programme. Facilitators (n=75) and learners (n=579) were asked to rate each of the seven modules contained in the learning pack. A number of recommendations have been made to improve the materials that are being acted upon

Values and behaviours: using the Ten Essential Shared Capabilities to support policy reform in mental health practice

This paper will review aspects of current policy in mental health with specific reference to policy that has a values focus. In this context, values refers to the standards and expectations we hold and which we use to guide aspects of practice performance. Service users state that core values that support, respect choice, collaboration, and customer service are critical foundation stones of a trusting therapeutic relationship. Attending to these foundations for practice has merit in ensuring the quality of care delivery in mental health. This paper will analyse what this means for the mental health workforce in their engagement with service users and delivery of policy priorities. Finally, the paper will explore resources, such as the Ten Essential Shared Capabilities (see Appendix 1), which support engagement and ongoing promotion of person-centred mental health care

Older people and research partnerships

Increasing consumer consultation is a priority for those involved in health and social care research and practice, with promoting greater public participation being widely accepted as 'a good thing' (Reason, 1994: 3). However, whilst such consultation may improve the quality of research and practice, there is a need to recognise the considerable investment of time and energy that is required for success (Baxter et al., 2001). Given the extra resources needed, it is important to understand how consultation and user involvement can work to benefit all parties. This paper describes our experiences of working together on a research project exploring people's involvement in decision-making processes when using care services in later life. When we started the project in March 2001 each of us could draw on a range of experiences that we hoped would make a valuable contribution. We have now worked together for over two years and this paper describes how our combined efforts have not only enhanced the overall quality of the research but also had personal benefits that we did not anticipate when we started ou

Reducing avoidable deaths from failure to rescue: a discussion paper.

AIM: This article proposes a radical new approach to the monitoring and governance of services, and the education and training of nurses to meet 'failure to rescue' requirements. BACKGROUND: Healthcare policy in the UK that seeks to ensure safe and effective services for the acutely ill has largely failed, resulting in adult patients dying unnecessarily. Despite grand rhetoric, UK governments have distanced themselves from implementation, resulting in patchy localised developments and creating inconsistent service responses. DESIGN AND DATA SOURCES: This article draws on a review of research and UK policy literature and best international practice to propose a new national framework approach that combines competency development, governance and performance monitoring to address 'failure to rescue' shortcomings. IMPLICATIONS FOR NURSING: Paramount is a nationally agreed and fit-for-purpose competency tool using simulation to assess staff in order to improve recognition of the deteriorating patient. Service improvements should include increased investment in telemedicine; service performance should be communicated through publicly available ratings and overseen by patient panels; and governance will require strengthening through enhanced Care Quality Commission/Monitor input, which should be linked to the maintenance of foundation trust status. CONCLUSION: Health professional bodies, regulators, providers and the Government must work together to strengthen the safety and effectiveness of acute services. This will require investment in staff competency and enhancement of the governance to ensure services consistently meet public expectations and reduce unnecessary deaths

Learning from contract change in primary care dentistry: a qualitative study of stakeholders in the north of England

The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: ‘commissioners’ views of managing local NHS dental services’; ‘the risks of commissioning for patient access’; ‘costs, contract currency and commissioning constraints’; and ‘local decision-making and future priorities’. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating ‘units of dental activity’. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided

Conversation-analysis (CA) as a tool for exploring interaction in an online video-conferencing based support service

Purpose: Around 60% of people with dementia in the UK live at home. The experience of caring for a family member with dementia can be rewarding and positive, but it can also be significantly stressful. Current healthcare policy is encouraging greater provision to support family carers. Along with respite-care, day-care and support group-based initiatives, there has also been a focus on developing dementia-specific communication training. Approach: We outline a new initiative ‘Empowered Carers’ which is being piloted in the North of England. Empowered Carers is an online support and communication training service for family carers who are caring for someone with dementia at home. It utilises online video conference-calling technology to connect carers with support workers, and also allows for simultaneous interactions involving other family members. A central tenet of the approach is a theoretically grounded support model, based on the concept of mentalisation. Findings: We describe the background to Empowered Carers, and how a conventional evaluation strategy for the initiative is being used alongside a socio-linguistic approach (Conversation Analysis – CA). This aims to provide empirical evidence about how the assimilation of mentalisation is reflected in the structuring of speech patterns in carers during support sessions. Value: We explain the CA method, how it has been applied to similar talk-based therapeutic settings, and why its ability to explore sequential linguistic patterns across extremely large data-sets is particularly suited to studying interaction in emerging online arenas. Keywords: Conversation Analysis (CA); carer support; Video-conferencing; real-time online support services; mentalisation; family carers; dementia

Learning from safeguarding adult reviews on self-neglect: addressing the challenge of change

Abstract   Purpose – One purpose is to update the core data set of self-neglect safeguarding adult reviews and accompanying thematic analysis. A second purpose is to address the challenge of change, exploring the necessary components beyond an action plan to ensure that findings and recommendations are embedded in policy and practice.   Design/methodology/approach – Further published reviews are added to the core data set from the web sites of Safeguarding Adults Boards. Thematic analysis is updated using the four domains employed previously. The repetitive nature of the findings prompts questions about how to embed policy and practice change, to ensure impactful use of learning from SARs. A framework for taking forward an action plan derived from SAR findings and recommendations is presented.   Findings – Familiar, even repetitive findings emerge once again from the thematic analysis. This level of analysis enables an understanding of both local geography and the national legal, policy and financial climate within which it sits. Such learning is valuable in itself, contributing to the evidence-base of what good practice with adults who self-neglect looks like. However, to avoid the accusation that lessons are not learned, something more than a straightforward action plan to implement the recommendations is necessary. A framework is conceptualised for a strategic and longer-term approach to embedding policy and practice change.   Research limitations/implications – There is still no national database of reviews commissioned by SABs so the data set reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. This makes learning for service improvement challenging. Reading the reviews reported here enables conclusions to be reached about issues to address locally and nationally to transform adult safeguarding policy and practice.   Practical implications – Answering the question “how to create sustainable change” is a significant challenge for safeguarding adult reviews. A framework is presented here, drawn from research on change management and learning from the review process itself. The critique of serious case reviews challenges those now engaged in safeguarding adult reviews to reflect on how transformational change can be achieved to improve the quality of adult safeguarding policy and practice.   Originality/value – The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice. The paper also contributes new perspectives to the process of following up safeguarding adult reviews by using the findings and recommendations systematically within a framework designed to embed change in policy and practice.     Keywords: Safeguarding adult reviews, change, self-neglect, action plans   Paper type: Research pape

Preparing young people with complex needs and their families for transition to adult services

© RCN Publishing Company Limited 2018Improving survival rates for children and young people with complex health needs requires a robust system for transition to adult services. Effective planning is essential to ensure a smooth transition process that is in the best interests of the young person and their family. This article discusses the needs and requirements for planned and purposeful transition processes to support young people with complex healthcare needs and their families. It considers the preparation of adult services, the team, the young person and their parents in line with an integrated approach and the nurse’s role. Recommendations for practice include the necessity for an integrated approach to ensure optimum outcomes and ascertaining the potential value of a nurse-led service in delivering the transition process. A carefully tailored planning strategy should be developed to prepare and support young people with complex health needs through transition

Mental Health, Vulnerability & Risk in Police Custody

Purpose: The issue of mental health and policing is a subject that has been debated from a number of different perspectives. The purpose of this paper is to report on the findings of a case study that explored mental health difficulties and vulnerability within police custody. Design/Methodology/approach: The design of the study was qualitative, and it utilised telephone semi-structured interviews with all levels of the custody staff. This approach was taken because the aim of the study was to explore how people in different roles within the organisation, worked to safeguard vulnerable people in custody. Findings: The findings from this study identified a number of interesting themes that could be explored further in later studies. Overall the respondents expressed frustration that vulnerable people find themselves in police custody for low-level crime when it could have been avoided with improved mental health services in the community. Additionally, the findings demonstrated that despite the processes that are designed to safeguard the detainee, tensions still exist including, timely access to mental health assessments, appropriate training and support for staff, and the use of appropriate adults. Research limitations/implications: Although the study was small in scale, the custody facility delivered detainee facilities for about 5000 individuals per year. The research and information obtained supported the Force lead to identify opportunities for improving the customer journey as well as further research to identify how officers and staff relate to vulnerable individuals in contact with the police service Practical implications: Social implications: Originality/value: Despite the limitations of the study, the findings have captured interesting data from a range of professionals working in one police custody suite and therefore it presents a holistic overview of some key issues around mental health, vulnerability and safeguarding within the context of police custody