Levers and opportunities for change in the current environment
We believe the current climate around change and the need to measure performance provides an opportunity for changing and improving acute inpatient services. The following apply:
a. The Mental Health (Care and Treatment) (Scotland) Act 2003
The principles of the Act will underpin delivery of change and improvement in all mental health services.
b. The National Review of Mental Health Nursing in Scotland
This review is particularly supportive of recovery based approaches. The action plan chimes with the aims of this report including programmes for the education, training and continual professional development for acute inpatient care, staff developing inpatient models of care based on the principles of the Act and on the recovery approach (points 5 and 6 respectively).
c. New ways of working for psychiatrists
The NIMHE (National Institute for Mental Health)/Royal College of Psychiatrists pilots arising from this document highlight the benefits of cultural change and a whole systems approach.
d. Accountability
Accountability needs to be both local within health and social work services and also at NHS Board level.
e. Delivering for Health
The new policy for NHS Scotland, Delivering for Health (2005) sets out a new vision for delivering services based on a fundamental shift in the way the NHS works. This includes:
- a move from an acute, hospital-driven service to one that is community based;
- a focus on meeting the twin challenges of an ageing population and the rising incidence of long term conditions;
- a concentration on preventing ill-health;
- a focus on treating people faster and closer to home; and
- a determination to develop responses that are proactive, modern, safe and embedded in communities.
f. Delivering for Mental Health
Proposes the development nationally of standards for Integrated Care Pathways for five conditions: depression; bipolar affective disorder; dementia; personality disorder and schizophrenia. Pivotal will be the processes for admission, care planning and discharge. The development and implementation of ICPs has the potential to make a positive impact on the standard of care for inpatients.
g. Service user experience
Meaningful, early and continuing service user and carer involvement needs to be reflected in delivery and change.