Lancashire Care Library

This is a great library for receiving updates by email on latest research in health care .Some of the publications are free  but all have links and can help keep you up to date - without even trying!

The economic argument for more mental health promotion

This report although only about Wales provides some interesting information on the cost of mental illness in Wales. For example the cost of mental health care amounts to 20% of the healthcare budget which is higher than cardiovascular disease (16%) and cancer (15%). It also provides advice on how we can reduce the "burden of disease" and improve the mental health promotion of children and adults in Wales. The report gives practical examples and reasons to improve mental health care in Wales, which can only be of benefit to the people who live there. 

T-E-A-C-H Resource

I am currently looking at recovery indicators so expect to see a few coming this way over the next few weeks. This one includes some measurement tools of hope and recovery so might be useful  now or in the future.  Will add to the list of resources too just for good measure;-)

The King's Fund

This is a useful website for free downloadable publications on the health service and how it is delivered. There is a section that specifically looks as  involvement practices and how they can be improved. I keep revisiting some of the documents which tells me that it is a useful resource. I am going to add it to my links section for this reason. In particular The Point of Care section  has useful information on improving dignity and compassion.  

No Health Without Mental Health Strategy 2011

The new government strategy for mental health care in the UK is  now available with all supporting evidence on their website.  There is a lot to read but also  an easy read document. Having skimmed through a lot of it (because we already know it)  it appears to be promoting the following ideas

• mental illness is costing the country a lot of money
• people need to be more resilient
• people need to be more in control of their health and recovery
• early intervention and health promotion may reduce the burden
• stigma should be addressed locally
• primary care should be more active 
• people need to be back in work to reduce isolation and improve resiliency/ social support

Much of the above service users and carers have been asking for for some time. there is little attention to involving service users and carers ( it is mentioned once or twice)  and there is little talk of emancipation. Although there is some reference to the Equality Act  2010. All in all this document does not say anything that we do not already know in mental health care but it does use some of the above as outcome indicators. This is a start in the right direction, let's hope that the principles and outcomes within this strategy have got some power to  improve mental health care provision.

Health is Social Blog

Just found this great blog about making health care - social care, mainly using micro blogging tools like Twitter. The very generous author (also a nurse)  provides us  us with 140 uses for micro blogging in health as well as lots more information and presentations. I am going to add this to my links because I think it will be useful to follow how micro blogging  can involve service users and carers in health and social care decision making in the future.

Quality or Safety or both?

I attended a really useful conference yesterday on inter professional  learning. There were some useful discussions on safety and quality not being the same thing. Perhaps we are now at the point in our health care system that we need to be talking about safety a lot more and with dwindling budgets, quality a lot less? Some of the main issues are identified below.

Human Factors - that can lead to mistakes are hardly recognised within  the quality literature - people make mistakes when they are tired, lack knowledge and support or are simply expected to do too much.

Team working - people  do not always learn how to work as a team  which involves collaboration and  communication at all times. Developing team working skills can therefore prevent mistakes from happening if people feel valued, supported and listened to within a team. This includes peer support workers and carers who are all trying to achieve the same goal- recovery and wellness.

Communication - even if people do not work as part of a team but are more specialised they still need to be able to communicate vital information that can reduce risk and improve safety. Saying it is not my job is not a good reason. Nor is confidentiality but it is important to gain consent before passing on  personal information. Signs and symptoms are not personal information but simply your observations of what is/could be happening. Tools can be used here to give exact measurements or an overview e.g. SBAR 

Knowledge & Skills - it is difficult to have skills without knowledge but by grouping them together does not mean that they are both the same thing. You need knowledge  to  decide which skills you should be using so they cannot be used in isolation of each other.  For example in order to give medication you must not only know how to give it ( route/dose etc) but also why you are giving it and how it might interact with other substances.  Some skills require more complex knowledge than others but all skills require some knowledge and  understanding that you must be able to demonstrate that you are competent in. Simply attending conferences or one-off study days will not achieve this and could be unsafe in practice if you do not fully understand the consequences of what you are doing. Most professional bodies require this as a minimum to
be considered safe practice.  Educational courses also give 'credit' that you are competent by assessing you at the right level for your knowledge needs. However all professionals are responsible for their own safe practice ( not their managers) and must make it known if they feel practice is becoming unsafe. It can also be useful to identify what you need to know to make it safe. This can be done through clinical supervision or peer evaluation.

Consistency - is perhaps a quality issue that can be related to safety. If practice is different from area to area people will not get consistent care which can lead to mistakes being made.  Consistency means following the most up to date guidelines and evidence-based practice and being able to consistently demonstrate that you have done this.  This could be used to audit  and improve current practice in teams and in our own continual professional / personal development (CPD).

Some useful links for  measuring safety in  practice where 'how-to'guides may have been created

Patient Safety First
National Patient Safety Agency
Scottish Patient Safety Alliance
1000 Lives Plus -Wales
HSC Safety Forum -Northern Ireland

Service User Voice

This is a blog by service users on the Community Care journal website.  There has been so much going on lately within health and social care it feels hard to keep up with it all. I was looking to see who was blogging about the government reforms and found this site, it looks pretty active so will add it to the links bar.
However following the march against the cuts yesterday I fear that it will be harder to make service user's voices heard. When the politicians are not listening the public cannot be heard. 

Whose Story is it Anyway?

A recent report published about making narratives effective  for changes in practice. This is an easy to read report and gives some ideas about how involvement can be improved - this is one to download and show to as many people as you can.
I have always felt uneasy about leadership and management courses that are supposed to effect change? This report  confirms  that in saying that it is front-line works who should be empowered to make the difference as they are the ones who have the most contact with patients/ clients - at last!