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Welcome to Celebrating Positive Practice in County Durham and Darlington. 19 September 2013 Mrs. Jo Turnbull, Chairman. PATIENT & CARER INVOLVEMENT. Lucy Prowse – Patient & Carer Involvement Support Officer Anthea Motson - Patient & Carer Involvement Officer Pam Elliot - Carer

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Welcome to celebrating positive practice in county durham and darlington

Welcome to Celebrating Positive Practicein County Durham and Darlington

19 September 2013

Mrs. Jo Turnbull, Chairman


Patient carer involvement

PATIENT & CARER INVOLVEMENT

Lucy Prowse – Patient & Carer Involvement Support Officer

Anthea Motson - Patient & Carer Involvement Officer

Pam Elliot - Carer

Paul Wait – Ward Manager, Farnham Ward,

Lanchester Road Hospital


What is involvement

What is involvement?

Involvement partnership

Our relationship

Work together to help shape and improve our services and help with people’s recovery


Types of involvement activity
Types of involvement activity

  • Meetings and consultations

  • Task and finish groups - reviewing services and providing feedback

  • Service improvement workshops

  • Hospital inspections (PLACE visits)

  • Ward visits (validation visits)

  • Recruitment and selection

  • Staff training and induction

  • Recovery stories – sharing your experience

  • Trust conferences and events

  • Readers’ panel – reviewing our leaflets and information


How to get involved

How to get involved

Do you have experience of our services and are interested in being involved?

Details held on our database

Involvement opportunities sent via email or post


What our service users & carers have said about involvement:

“My involvement with the Trust has enhanced my recovery since my discharge and I feel the best I’ve been in my life” from a service user.

“I have found absolute salvation being involved with various carers groups and being involved helped put my mind at rest from personal problems” from a carer.


Recruitment selection
Recruitment & Selection involvement:

ANTHEA MOTSON

Patient & Carer Involvement Officer


Recruitment selection1

Recruitment & Selection involvement:

Background:

Historically staff involved service users and carers in recruitment and selection by inviting them to sit on interview panels.

Partnership working with HR was undertaken to promote involvement in their documentation and Trust Induction.


Recruitment selection2
Recruitment & Selection involvement:

Currently:

  • The Medical Education department hold their own database & train service users and carers in recruitment & selection.

  • Work is ongoing obtaining 360 degree feedback on the current interview process.

  • The trust is hoping to arrange a Values Focus Group to involve service users and carers in recruitment of staff on the basis of the Trust Values.

  • A focus group was set up to look at job descriptions to see if they are sufficiently service user / carer focused.


Recruitment selection3
Recruitment & Selection involvement:

PAM ELLIOT

Carer


Training for carers
Training for Carers involvement:

PAUL WAIT

Ward Manager, Farnham Ward

Lanchester Road Hospital


Any questions

ANY QUESTIONS involvement:


Crisis teams the future

Crisis Teams involvement:The Future



Core provision
Core Provision involvement:

  • Rapid assessment following referral.

  • A viable alternative to hospital admission.

  • Intensive home treatment.

  • Facilitated early discharge from hospital where admission has been unavoidable.

  • Prevent relapse


Facts
Facts involvement:

  • 24 hour service/7 days a week

  • Referrals for crisis assessment average around 160/month

  • Geographical area covered is from Consett to Seaham

  • We aim to see people within 4 hours of referral

  • Able to work intensively in people’s homes

  • Home Treatment case load is often between 20-30 people .


What s next
What’s next involvement:

  • Change perception service users/professionals

  • Be more flexible

  • Creative crisis care planning

  • Bespoke home treatment-build around individual needs

  • Integration with other services

  • User friendly/stop repetition

  • Accessible

  • Listen to feedback/constantly evolve.


Benefits
Benefits involvement:

  • Care can be delivered at home.

  • Service user has greater individual input into their episode of care.

  • Increased carer involvement.

  • Integrated working.

  • Supporting community teams.

  • Build on existing coping mechanisms and social networks.


Developments

Developments involvement:



Benefits1
Benefits involvement:

  • Purpose built

  • Intensive home treatment in our home

  • Help stabilise mental health

  • Step up

  • Step down

  • Can assist in early discharge

  • Seeing it from the service users perspective.


Why involvement:

  • Give people greater choice –an alternative

  • Provide supportive care – relapse prevention

  • Step in earlier to prevent escalation of crisis

  • Facilitate resolution in crisis situations particularly for those with limited support or felt to be vulnerable

  • Focus on recovery


Conclusion
Conclusion involvement:

Crisis Teams have been established for several years within mental health services. The development of the new Crisis and Recovery House is the next step. It will enable people to have more choice with regards to their treatment and care, and allow services to intervene earlier, which ultimately improves outcomes and aids recovery.



How service users with a drug problem are supported in substance misuse services

HOW SERVICE USERS WITH A DRUG PROBLEM ARE SUPPORTED IN SUBSTANCE MISUSE SERVICES

JUDITH DURKIN - CLINICAL COORDINATOR.

ANGELA SCULLY-SERVICE USER, SMART RECOVERY FACILITATOR.


Key themes
KEY THEMES SUBSTANCE MISUSE SERVICES

  • INDEPENDENT/SUPPLEMENTARY NON MEDICAL PRESCRIBING WITHIN SUBSTANCE MISUSE SERVICES

  • THE DISTRIBUTION OF NALOXONE TO SERVICE USERS/PARENTS/ CARERS AND OTHERS.

  • WORKING AND SUPPORTING PREGNANT SERVICE USERS.

  • ROAD TO RECOVERY - ANGELA SCULLY.


Independent supplementary non medical prescribing
INDEPENDENT/SUPPLEMENTARY NON MEDICAL PRESCRIBING SUBSTANCE MISUSE SERVICES

  • LEGISLATION AND GUIDANCE WHICH HAS SUPPORTED THE DEVELOPMENT OF NON MEDICAL PRESCRIBING - NEIGHBOURHOOD NURSING A FOCUS FOR CARE 1986, FIRST CROWN REPORT 1989.

  • CHANGING PROFESSIONAL BOUNDARIES.

  • SUPPORTING THE ETHOS OF THE NHS.

  • RENEGOTIATION IN HEALTH CARE LABOUR.

  • INTRODUCTION OF NURSE - LED CLINICS.



Benefits of non medical prescribing to service delivery and client care
BENEFITS OF NON MEDICAL PRESCRIBING TO SERVICE DELIVERY AND CLIENT CARE

  • TIMELY ACCESS TO SUBSTITUTE PRESCRIBING.

  • IT IS AN APPROPRIATE, EFFECTIVE AND COST EFFECTIVE INTERVENTION .

  • IT IS STRUCTURED AROUND CLIENT NEED.

  • GIVES PATIENT CHOICE AND CONVENIENCE.

  • AND GIVES CONSIDERATION TO BEST PRACTICE BASED ON EVIDENCE .

  • LEADING TO CONSISTENCY OF CARE DELIVERY FOR CLIENTS.


Non medical prescribing provision within the substance misuse division
NON MEDICAL PRESCRIBING PROVISION WITHIN THE SUBSTANCE MISUSE DIVISION

  • COMMUNITY SUBSTANCE MISUSE SERVICES – SUBSTITUTE PRESCRIBING, DETOXIFICATION, SYMPTOMATIC RELIEF,OPIATE BLOCKERS.

  • HARM MINIMISATION SERVICES – ANTIBIOTICS, VACCINATIONS

  • RECOVERY INJECTABLE OPIOID SERVICE – SUPPORTING THE SMOOTH TRANSITION BETWEEN SERVICES.



Future developments
FUTURE DEVELOPMENTS RELIEF DURING DETOXIFICATION TO SUPPORT RECOVERY.

  • NON MEDICAL PRESCRIBING PROVISION INCREASED TO 75% ACROSS COUNTY DURHAM.

  • INCREASE ACCESS TO NURSE LED CLINCS.

  • DEVELOP THE ROLE OF THE INDEPENDENT NURSE PRESCRIBER AND THE PRESCRIBING OF CONTROLLED DRUGS.


Naloxone distribution
NALOXONE DISTRIBUTION RELIEF DURING DETOXIFICATION TO SUPPORT RECOVERY.

  • IN 2011 – THERE WAS A TOTAL OF 1,772 MALE AND 880 FEMALE DRUG POISONING DEATHS INVOLVING BOTH LEGAL AND ILLEGAL DRUGS.

  • HEROIN/MORPHINE DEATHS HAD DECREASED BY 25% TO 596 IN 2011 BUT WAS STILL 596 DEATHS TO MANY.

  • THE HIGHEST MORTALITY RATE WAS IN THE AGE GROUP 30-39.



  • NALOXONE IS AN ANTIDOTE THAT RAPIDLY BUT TEMPORARILY REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • IN 2005 THE LAW WAS AMENDED TO PERMIT EMERGENCY ADMINISTARTION OF NALOXONE BY TRAINED MEMBERS OF THE PUBLIC.


Kaizan event key themes
KAIZAN EVENT KEY THEMES REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • INCREASE AWARENESS OF OVERDOSE PREVENTION AND THE USE OF NALOXONE

  • DEVELOP AN OVERDOSE PREVENTION TRAINING PACKAGE – TO INCLUDE, BASIC LIFE SUPPORT AND ADMINISTRATION OF NALOXONE

  • TRAIN STAFF TO DELIVER THE PACKAGE


Outcomes of kaizan
OUTCOMES OF KAIZAN REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • PATIENT GROUP DIRECTION.

  • TRAINING PACKAGE.

  • PROCEDURE.

  • STANDARD WORK.

  • LEAFLETS.

  • QUESTIONNAIRES.

  • POSTER.


Evaluation
EVALUATION REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • OVER 50 TRAINING EPISODES COMPLETED.

  • A KEY PRIORITY FOR SERVICES.

  • THREE NALOXONE USED IN OVERDOSE SITUATIONS WHICH ARE 3 LIVES SAVED.


Supporting pregnant service users
SUPPORTING PREGNANT SERVICE USERS REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • MULTI AGENCY GROUP ESTABLISHED TO EXPLORE THE DELIVERY OF A ROBUST SERVICE MODEL

  • REVISITED AND UPDATED IN 2012, LEADING TO -

  • STANDARDISED WORKING ACROSS COUNTY DURHAM.

  • THE PROMOTION OF PARTNERSHIP WORKING WITH THE WIDER CARE TEAM ENSURING CONSISTENT SAFE PROACTIVE PRACTICES.


Service user involvement
SERVICE USER INVOLVEMENT REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • SUPPORTING THE DEVELOPMENT OF THE PREGNANCY PATHWAY.

  • DEVELOPMENT OF SERVICE USER LEAFLETS.

  • DEVELOPMENT OF THE PREGNANCY CARE PLAN.


2012 service user audit
2012 SERVICE USER AUDIT REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM..

IDENTIFIED -

  • GOOD PRACTICE IN SAFEGUARDING THE NEEDS OF THE CHILD

  • APPROPRIATE REFERRALS TO THE LOCAL AUTHORITY WHEN CONCERNS WERE IDENTIFIED

  • POSITIVE CLIENT ENGAGEMENT WITH SUBSTANCE MISUSE SERVICES POSTNATALY


Road to recovery
ROAD TO RECOVERY REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

ANGELA’S STORY.


Hospital liaison service update

Hospital Liaison Service Update REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

Chris Binns, Operational Service Manager


Hospital liaison service
Hospital Liaison Service REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Psychiatric liaison services provide mental health care to people being treated for physical health conditions in general hospitals.

  • Mental health disorders such as depression, anxiety, alcohol and memory problems are very common in general hospital. Research has shown that they are often not recognised or treated

  • Untreated mental health issues can lead to longer hospital admission and poorer physical health overall in hospital inpatients and increased health care costs.

  • An effective liaison psychiatry service offers the prospect of saving money as well as improving health

    .


What did will be different
What did will be different? REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Extend location of services and visibility

  • Better Support to hospital staff

  • Increased hours of working

  • Improved Multi disciplinary approach

  • Post discharge support

  • Service for High Intensity Users of Hospital Services


Patient stories
Patient stories REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.


Whats next
Whats next... REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Improving follow up for people who self harm

  • Working with Specialities within the Hospital

  • Development of MUPS service

  • Service Evaluation

    And hopefully long term funding....


Questions
Questions? REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.


Refreshment break
Refreshment Break REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Refreshments served on the mezzanine level and market place


Patient and carer feedback

Patient and Carer Feedback REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

How the Trust obtains and acts on feedback from patients and carers, what it tells us and what we do about it. Corinne Aspel

Lead Senior Nurse Patient Experience


Trust values and associated behaviours
Trust Values and Associated Behaviours REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Commitment to quality

  • Respect

  • Involvement

  • Wellbeing

  • Teamwork


Benefits in collecting and using patient feedback
Benefits in collecting and using patient feedback.... REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • helps to improve communication between patients and staff

  • helps to build trust and confidence in the NHS locally and nationally

  • informs planning and service improvement

  • helps the organisation to provide accessible and responsive services based on people’s identified needs and wants

  • helps patients to shape the services that they use.


What it says to those who access our services
What it says to those who access our services : REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • we need and value your views on how we are doing

  • we are actively looking at how we are doing, and striving to do better

  • we look at your comments regularly and give a quick response to your opinions

  • we are open and honest, showing you how we have responded to your feedback

  • we will keep you informed about how other patients experienced care here


What it says to staff
What it says to staff.... REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • we believe that your satisfaction with your work is key to giving patients and service users a positive experience of care

  • we will involve you in designing systems to gather and respond to feedback

  • we will support you to improve services, building our reputation as a high-quality service provider.


Current patient experience system
Current Patient Experience System REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Electronic touch screen devices in use to collect feedback ( anonymous )

  • A wide range of services are covered

  • Reports monthly to participating teams pie charts and written feedback

  • Acting on feedback


Results for durham and darlington july 2013
Results for Durham and Darlington –July 2013 REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • 92 patients completed discharge surveys from inpatient areas. 16 carers gave us feedback

  • 49 patients completed surveys in 3 community teams in July. 13 carers gave us feedback


Adult services
Adult services REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Maple ( WPH) scores Farnham (LRH) – scores above 78% for all questions

  • Elm (WPH) 100% felt staff were friendly and approachable but poor scores for feeling valued and understood similar picture for Tunstall (LRH)


Adult services1
Adult services REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Cedar (WPH) 58% felt safe during their stay

  • All areas excellent scores for friendly and approachable staff and being made to feel welcome by staff


Adult community
Adult Community REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Two teams surveyed Darlington Affective team and South Durham Affective team

  • Overall feedback very good but poor scores for being given a copy of care plans in the Darlington team


Older peoples services
Older peoples services REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Oak (WPH) overall scores excellent lowest scores for purpose and side effect of medication being explained 60 and 50%

  • Roseberry (BLU) again overall scores excellent 2 of 3 patients did not always feel listened to or have side effects of medication explained


Community
Community REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Sedgefield CMHT – excellent scores for majority of questions except side effects of medication explained 50%) and being given a copy of their care plan but this had increased from 35% in June to 56% in July


Carer feedback
Carer feedback REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Numbers of carers giving us feedback are small and this is an areas we would like to improve.

  • No themes are evident from feedback to date but each area are asked to action any questions which score poor.


Developments1
Developments REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

  • Friends and Family Test question introduced in July - early indications are that we will get more valuable typed feedback ( see display for examples of the feedback received from this question in July 48 positive comments received and 3 negative)

  • Activity questions added to the inpatient survey to understand the range of activities available and the times they are available, and if they were helpful in the persons recovery

  • Staff experience

  • Learning Disability and Children's surveys introduced


Lanchester road hospital
Lanchester Road Hospital REVERSES THE EFFECTS OF HEROIN AND OTHER OPIOIDS. IT IS REQUIRED TO BE ADMINISTERED VIA INJECTION TO THE OVERDOSE VICTIM.

Adult Learning Disability Service


Getting feedback from the people who use our learning disability service
Getting Feedback from the people who use our learning disability service.

A Service User from the Trusts Reference Group visit patients once they have been discharged.

They get feedback about the persons stay while in hospital.


The reference group
The Reference Group disability service.



I was involved in my care, I had choices and options, I could ask questions.

I didn’t want to be involved in the CPA but staff helped me understand and I understood it.

I liked the staff, they handled situations well when I got upset.


I was sick of stopping in, you had to smoke outside. I used to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

Nothing to do sitting bored – chose to watch the TV


Hard Mattress – making my back hurt! to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

Sometimes I didn’t really like the food

50% of people did not like the food!


What we did
What we did! to go to the shops and café with the staff. I was fed up, liked to spend more time outside.


We have ordered some new to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

Mattresses!

We have changed the

way food is cooked.


We bought a new Computer to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

Touch Screen for everyone to

use


We have developed to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

a good timetable

of activities!


Jackie - 0191 441 5800 to go to the shops and café with the staff. I was fed up, liked to spend more time outside.


Learning disability service
Learning Disability Service to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

  • What support and treatment is available for those patients who may have a Dementia?

    • Shirley Hall, Occupational Therapist


Children and young people s services
Children and Young People’s Services to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

  • Dr Lynne Howey


Cyp iapt model duncan law
CYP-IAPT Model to go to the shops and café with the staff. I was fed up, liked to spend more time outside.(Duncan Law)


Question time
Question Time?? to go to the shops and café with the staff. I was fed up, liked to spend more time outside.


Summary of morning
Summary of Morning to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

  • Mrs Jo Turnbull, Chairman


  • Lunch available on the mezzanine level to go to the shops and café with the staff. I was fed up, liked to spend more time outside.

  • Market place stands

  • Networking opportunities with your Governors, staff and other members

  • Expense payments – registration desk

  • Please take the time to complete your evaluation form and if you have a specific question you have not been able to ask – write it down and leave it with us.


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