Integrated care pathways in mental health

343 Pages·2006·2.74 MB·English

by  Julie Hall, David Howard, RGN

INTEGRATED CARE PATHWAYS
IN MENTAL HEALTH
Commissioning Editor:Steven Black
Development Editor:Catherine Jackson
Project Manager:Elouise Ball
Designer:George Ajayi
Illustration Manager:Bruce Hogarth
INTEGRATED CARE
PATHWAYS IN
MENTAL HEALTH
Editors
Julie Hall
RMN BSc(Hons) MSc PGCAP MA
Head of Performance and Administration Forensic Services Directorate,
Nottinghamshire Healthcare NHS Trust, Rampton Hospital, Retford,
Nottinghamshire
David Howard
MEd PhD RMN RGN CertEd DipN
Senior Mental Health Lecturer and Director MSc Organisational
Leadership in Health and Social Care, The University of Nottingham,
Nottingham
Foreword by
Antony Sheehan DSci MPhil BEd(Hons) RN DipHSM
CertEd(FE) HMFPHM
Director of Care Services, Department of Health; Professor of Health
and Social Care Strategy, University of Central Lancashire
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2006
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First published 2006
ISBN 0 443 10172 8
ISBN 13:978 0443 101724
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
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A catalog record for this book is available from the Library ofCongress
Notice
Knowledge and best practice in this field are constantly changing.As new research and
experience broaden our knowledge,changes in practice,treatment and drug therapy may
become necessary or appropriate.Readers are advised to check the most current
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Contents
Contributors vii
Foreword by Antony Sheehan ix
Chapter 1 An Introduction to Mental Health Integrated Care Pathways 1
Julie Hall and David Howard
Chapter 2 Variance Reporting and Quality Improvement 23
Julie Hall
Chapter 3 Integrated Care Pathways and the Mental Health
Modernisation Agenda 39
David Howard
Chapter 4 Integrated Care Pathways and Integrated Working 53
Simon Wood and Barrie Green
Chapter 5 Legal Aspects of Integrated Care Pathways 67
Ashley Irons
Chapter 6 Integrating Care Pathways into the Care Programme
Approach 89
Ruth Page a nd Rafael Sorribas
Chapter 7 Using Integrated Care Pathways in Forensic Services 103
Karen J. Jenkins
Chapter 8 A Care Pathway for Patients Presenting at Accident and
Emergency who have Self-Harmed 133
Carol Jackson
Chapter 9 Implementing the Scottish Schizophrenia Guidelines
through the Use of Integrated Care Pathways 157
Mark Fleming
Chapter 10 Implementing Care Pathways for Self-Harm in Acute
Inpatient Care 175
Angus Forsyth
VI Contents
Chapter 11 Using an Eating Disorders Integrated Care Pathway for
Child and Adolescent Mental Health Services 201
Marie Rawdon, Richard Oldham and Julie Lambert
Chapter 12 Using an Integrated Care Pathway to Deliver a Nurse-Led
Clozapine Clinic 221
Susan Wakefield, Jon Painter, Malcolm Peet and Joanna Chave
Chapter 13 Care Pathways for Older People’s Mental Health Care 245
Adrian Roberts
Chapter 14 Using a Care Pathway for Electroconvulsive Therapy 271
Alan Pringle
Chapter 15 An Integrated Care Pathway for Crisis Triage
and Assessment 285
Julie Hall and Jeannette Connelly
Index 321
Contributors
Joanna ChaveBA(Hons) RMN DipThorn
Nurse Manager,Rehabilitation Day Services,Rotherham,Yorkshire.
Jeannette ConnollyBA(Hons) Adv Dip(PTSD) DipN RMN
Senior Crisis Resolution Worker,Crisis Resolution and Home Treatment Service,
Sycamore Assessment Unit Grantham,Lincolnshire.
Mark FlemingBSc Dip RMN
Clinical Development Manager,NHS Ayrshire and Arran,Ayrshire Central
Hospital,Irvine.
Angus ForsythMSc BA RMN RGN PGCE ENB650
Nurse Consultant,Acute In-Patient Services,Newcastle North Tyneside &
Northumberland NHS Trust,Newcastle-upon-Tyne.
Barrie GreenMA(Crim) BA(Hons)(Forensic) DipMDO RMN
Forensic Nurse Consultant,Humber Centre for Forensic Psychiatry,Humber Mental
Health Teaching NHS Trust,Hull.
Julie HallRMNBSc(Hons) MSc PGCAP MA
Head ofPerformance and Administration Forensic Services Directorate,
Nottinghamshire Healthcare NHS Trust,Rampton Hospital,Retford,
Nottinghamshire

David HowardMEd PhD RMN RGN CertEd DipN
Director MSc Organisational Leadership in Health and Social Care,The University
ofNottingham,Nottingham
Ashley IronsBA(Hons)
Mental Health Partner,Capsticks Solicitors,77–83 Upper Richmond Street London
SW15 2TT
Carol JacksonRN DipHE BSc(Hons) MSc
Integrated Care Pathway Co-ordinator,Cherry Valley Mental Health Services,
Downshire Hospital,Downpatrick.
Karen J.JenkinsBSc(Hons) PhD CertMgmt(Open)
Clinical Effectiveness Integrated Care Pathway Coordinator,Greater Glasgow
Primary Care Division,Gartnavel Royal Hospital,Glasgow,formerly Clinical
Effectiveness Facilitator for Integrated Care Pathways,The State Hospital,Carstairs,
Lanark.
VIII Contributors
Julie LambertRMN Dip(Child and Adolescent Mental Health Nursing) Tier 1 Worker in
Community
Primary Mental Health Nurse,Lincolnshire Partnership NHS Trust,Lincolnshire
Richard OldhamRN
Acting Clinical Team Leader,Lincolnshire Partnership NHS Trust,Lincolnshire
Ruth E.PageRMN BSc MSc
Product Manager,IDX Systems UK Ltd,London
Jon PainterBSc(Hons) RMN Thorn BMedSc(Hons)
Integrated Care Pathways Manager,Doncaster and South Humber Healthcare NHS
Trust,Yorkshire
Malcolm Peet MBCHb FRCPsych
Consultant Psychiatrist,Doncaster and South Humber NHS Trust; Professor
Associate,School ofHealth and Related Research,University ofSheffield,Sheffield.
Alan PringleRGN RMN BSc(Hons)
Health Lecturer (Mental Health),University ofNottingham,Mansfield Education
Centre,Nottinghamshire.
Marie RawdonDipNursing(Mental Health)
Community Nurse Specialist/ Foster Carer Support Worker,Sleaford,Lincolnshire.
Adrian RobertsBA(Hons) PgDINF
National Pathways Coordinator,BUPA Hospitals Researcher,Clifford Price
Associates
Rafael SorribasDipHighEd
Health Informatics Development Manager,Buckinghamshire and Oxfordshire
Mental Health NHS Trusts,Oxford.

Susan WakefieldMA ARQE PG Cert AdvDip(Counselling) RMN
Senior Lecturer in Mental Health Nursing,Faculty ofHealth and Well-Being,
Sheffield Hallam University,Sheffield.
Simon WoodMB ChB MMedSc FRCPsych
Clinical Director,Humber Centre for Forensic Psychiatry,Humber Mental Health
Teaching NHS Trust,Hull
Foreword
As health and social care organisations respond to the current mental health
modernisation agenda, the use of integrated care pathways is growing rapidly.
Care pathways,which detail the expected multidisciplinary interventions within a
care experience and use variances to monitor care and quality,have been emerging
throughout UK mental health services over the last few years.Although they are
advocated within health policy, their introduction has been generally unco-
ordinated.The idea of this book arose from the dearth of accessible information
about integrated care pathways in mental health within the UK.This book is thus
a timely gathering together of the recent developments in this field in which the
authors combine discussion of relevant and developing theory with accounts of
real-time developments in practice.
Integrated care pathways have strong relationships with many of the con-
temporary drivers that underpin the delivery of mental health services.They are
advocated as a means ofensuring consistent,evidence-based,high-quality care and
are integral to the modernisation process to ensure that care experiences are built
around the needs ofservice users,their families and carers.
Providing the background of integrated care pathways in mental health, and
oftheir implementation,the opening chapters ofthis book introduce the theories
of integrated care pathways in order to give insight to readers who are new to the
concept,and to develop more experienced users’understanding ofthe professional,
legal and pol itical issues that surround their development.
From this base, the second part of the book details the development of
integrated care pathways in the major areas ofmental health practice.It is intended
for this book to be used as a resource by health and social care teams and to
facilitate this, case studies of current mental health care pathways are included
within each chapter.These focus on describing the process ofdeveloping the inte-
grated care pathway,illustrating the main challenges and identifying the benefits
of its implementation.These accounts ‘bring alive’the process of developing and
implementing an integrated care pathway and offer insights to others who are
planning to undertake such an endeavour.
This combination of knowledgeable discussion and the credible experience of
each author ensures this is an innovative text which will be ofgreat value to those
who are challenged with developing mental health care services within an inclusive
environment.There is a wealth ofevidence in this book to suggest that integrated
care pathways are able to support philosophies that place service users and carers
at the centre of the care process,yet define clearly the roles and responsibilities of
the supporting services.