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Practical Considerations when setting up a Supported Self-help service for common psychological problems
Status of the Self-help Worker with the Practice Team
For maximum effectiveness, Guided Self-help Workers should be fully integrated members of the practice teams to ensure seamless transitions of care for patients. Please note that this does not necessarily suggest that the Guided Self-help Worker needs to be permanently housed in the practice, merely that when working within the practice they are seen as part of the team and not an outside agency.
Accommodation - In order for the service to run as effectively and efficiently as possible it is advisable that the Guided Self-help Workers have the use of a room in which they may see patients in confidential surroundings, with a degree of comfort, and which is "just another room" in which practice services take place. This approach may result in less DNAs and reduces the stigma sometimes associated with attending sessions in secondary service locations.
Access to administrative assistance
Administrative assistance to book/cancel/rebook appointments, photocopy materials, order/re-order literature is essential for the smooth running of the service to ensure that the patient benefits from the workers full attention (rather than cutting the session short or having it interrupted to gather missing information) in any given session.
Access to appointment booking systems
The Guided Self-help worker is another "bookable" practice resource. A quick and accessible appointment booking system, adapted to the local system*, should be made available so that patients leaving a GP consultation at which they were referred to the Guided Self-help Worker, may visit reception on their way out and book a suitable appointment. This way there is no paperwork, no chance of double booking and the reception staff can fill empty spaces, even at short notice if people cancel. Also as patients generally visit the Guided Self-help Worker 2-3 times, it is important that the appointment booking system takes account of the fact that spaces should be left for returning patients as well as those who require a first appointment.
*Issues of stigma, perhaps in close-knit communities, may need to be taken into consideration when designing the booking system. Delivery in other ways such as posting materials and the offer of telephone support might also be considered.
Access to patient notes
In order to ensure continuity of care and to provide the Guided Self-help Worker with information directly related to the provision of this episode of care it is preferable that they are given access to patient notes.
Access to IT
It is important to record progress made following each guided self-help session. The best way to do this is electronically as it facilitates sharing information with other practice staff and ensures seamless care for the patient. (see access to patient notes above)
Access to photocopying/printing facilities, Access to storage facilities for self help materials
(See access to administrative assistance)
In order that the Guided Self-help Work, practice staff and other primary care workers have instant access to self-help materials in printed and hard-copy electronic formats, it is necessary to keep a small stock of each resource at hand. This means that the practice will be required to provide storage facilities and perhaps a stock-taking regime with "top-up" facilities for printing of materials.
Transportation of materials
Guided Self-help Workers may offer sessions at more than one practice. This will necessitate the transportation of self-help materials (unless each practice keeps a stock of materials as per above). Therefore consideration should be given to the transportation of large volumes of printed materials/ CDs etc
Liaison Person for Guided Self-help Service
It is probable that each Guided Self-help Worker will attend more than one GP practice, therefore, in order that the operational and personal aspects of this role are effectively co-ordinated for the benefit of both the employee and those for which they provide the service, a Coordinator/Senior Guided Self-help Worker should be appointed for each Community Health Partnership area to act as a liaison for all Self-help Workers in that area.
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