Stepping into the void: Developing a Forensic LD Care Pathway

1. Stepping into the void: Developing a Forensic LD Care Pathway Ian Hamilton (Northumbria University & NTW NHS Trust)

2. Strategic Health Authority made money available to put a Forensic LD nurse into an established Forensic Mental Health hostel No particular rationale or remit with funding Background

3. Service structure i.e. step down approach to rehabilitation Challenge for service to rehabilitate pts back to the local community i.e. no established care pathways, limited Forensic expertise in community Forensic LD services

5. Describe hostel service i.e. hostel managed by local housing association who provide 24/7 cover with a Forensic Mental health clinical team working into hostel Describe Forensic team structure & role of hostel staff The hostel service

6. Initial role of LD nurse in Forensic MH hostel: Shadowing MH nursing colleagues, co-working including assessment of MH referrals Acting as named nurse for MH referrals Attending weekly ward rounds in Forensic MH service Changes to team Part time involvement Professional Issues supervision Developing a role & issues

7. Discuss referral system & initial referral from psychiatrist who had experience of hostel service in previous MH role Joint assessment with hostel staff Staff training re LD In-reach work: process & plan Integration to hostel (plan & timescale) Luck, fate or the future?

8. Challenges encountered during the integration process - RMO on discharge & in the future Involvement of Community S/W & CTLD Issues re vulnerability Issues re providing structured activities during leave to hostel Some challenges

9. Transfer to hostel Current situation including challenges e.g. loss of Forensic LD nurse & support for MH colleagues Future referral into service i.e. Establishment of Care Pathway for Forensic LD Re location of the hostel out of the city The Care Pathway established?