Leadership, membership and reporting systems
Forums need to effect positive, sometimes immediate and crucially, sustainable change within the acute care setting. NHS Boards need to delegate the appropriate level of authority and responsibility to the Forums to achieve this objective.
Forums will be expected to demonstrate delivery. Leadership/Chairmanship of the Forum must be of sufficient seniority to make resource decisions.
Senior medical, nursing and social work staff together with mental health lead from Community Health Partnership, service users and carers, voluntary sector representation, health improvement, training, planning and information officer all need to be engaged in the Forum.
What outcome measures need to be in place?
Service users need access to the right care and treatment, at the right time, in the right environment and delivered in a way that puts them at the centre of their care and not at the centre of a system.
To aid recovery, quickly and with the right supports service users should feel involved and in control of their own lives, and have high expectations of themselves and of the services they access.
Staff should feel and be valued, involved, respected and supported. Positive work environments and structures engender creativity and innovation. The best mental health systems are those backed with excellent resources, information, leadership and training. To create acute wards as centres of excellence will require full partnership with service users, carers, NHS staff, social work, housing voluntary sector and primary care colleagues.
It is essential that robust outcome measures are in place for the right changes at a pace that reflects the very real need for change. The recommendations contained in the SOSS report (April 2006), offer insights for the adoption and mainstream practice of using mental health outcome measures in routine clinical practice. Outcome measures need to be about both process and people. Process outcomes might include:
- Discharge planning against an agreed standard;
- Length of stay;
- Re-admission data;
- Use of the Mental Health Act;
- Data on frequency of inappropriate behaviours in wards e.g. instances of use of illicit drugs; and
- Assessment of interagency and whole system working.
Other outcome measures could include:
- The Recovery Orientated Practice Index ;
- Avon Mental Health Measure;
- Measures of service user and carer satisfaction;
- Camberwell Assessment of Need;
- Measures of staff satisfaction;
- Data on staff sickness and retention rates;
- Results of inspections of inpatient facilities against an agreed standard (see above);
- Delivery of actions arising from the National Mental Health Nursing Review;
- Ensuring that all staff have values based training;
- All registered practitioners to have skills based training in delivering psychological interventions and be able to demonstrate the delivery of these skills;
- Availability of information to service users and carers (again against an agreed standard);
- Training and Development of staff;
- Availability of support for carers; and
- Outcomes from Critical Incident Reviews.
Links will need to be made the work being taken forward under the Benchmarking initiative.