National Service Framework Research Papers (original) (raw)

The National Service Framework (DoH, 2001), which lays down standards of care and service for older people, stresses the need to ensure that older people's views about their treatment are heard and acted upon. This service evaluation aimed to elicit older users' views on their experiences of systemic therapy in the NHS in North London. The psychologists used systemic therapy as one of a range of therapies offered to service users in outpatient settings at the hospital, GP surgeries and service users' homes. A lack of research in this area has meant that older adults' views about systemic therapy have yet to be heard, except perhaps during clinical work. This service evaluation therefore attempted to give voice to these views.

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- Clinical Psychology, Systemic Therapy, National Service Framework

SUMMARY Background There is much variation in the services provided for older people with mental health problems. In England, the National Service Framework for Older People (NSFOP) sought to address these inconsistencies and improve... more

- by David Challis
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- Psychology, Cognitive Science, Health Policy, England
- by Huiyu Zhou
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- Human Computer Interaction, Assistive Technology, Stroke rehabilitation, Older people

BackgroundThere is much variation in the services provided for older people with mental health problems. In England, the National Service Framework for Older People (NSFOP) sought to address these inconsistencies and improve care. This study describes the situation three years after its publication.There is much variation in the services provided for older people with mental health problems. In England, the National Service Framework for Older People (NSFOP) sought to address these inconsistencies and improve care. This study describes the situation three years after its publication.MethodsA postal survey of old age psychiatrists collected data on the NSFOP mental health model: the range of specialist mental health provision, the nature of the specialist:generic service interface and the degree of interdisciplinary/interagency working.A postal survey of old age psychiatrists collected data on the NSFOP mental health model: the range of specialist mental health provision, the nature of the specialist:generic service interface and the degree of interdisciplinary/interagency working.ResultsThree hundred and eighteen (72%) consultants responded. Considerable differences existed in the deployment of key professionals within community teams, with more than a third lacking ring-fenced social work time. Few services had dedicated rehabilitation beds and nearly a third lacked separate facilities for people with organic and functional illnesses. Increasing numbers of consultants had access to a memory clinic and there was some suggestion that liaison services were developing, but little indication of increased support for care homes. Several services had yet to agree protocols with primary care, or to implement measures promoting effective information-sharing and integrated care, and there was little evidence that the introduction of the Single Assessment Process (SAP) had significantly changed practice. Although just over half of consultants reported that mental health services were improving, less than a quarter considered community provision adequate.Three hundred and eighteen (72%) consultants responded. Considerable differences existed in the deployment of key professionals within community teams, with more than a third lacking ring-fenced social work time. Few services had dedicated rehabilitation beds and nearly a third lacked separate facilities for people with organic and functional illnesses. Increasing numbers of consultants had access to a memory clinic and there was some suggestion that liaison services were developing, but little indication of increased support for care homes. Several services had yet to agree protocols with primary care, or to implement measures promoting effective information-sharing and integrated care, and there was little evidence that the introduction of the Single Assessment Process (SAP) had significantly changed practice. Although just over half of consultants reported that mental health services were improving, less than a quarter considered community provision adequate.ConclusionsThree years after the publication of the NSFOP there remained significant gaps in services for older people with mental health problems and substantial variation in provision between districts. Copyright © 2006 John Wiley & Sons, Ltd.Three years after the publication of the NSFOP there remained significant gaps in services for older people with mental health problems and substantial variation in provision between districts. Copyright © 2006 John Wiley & Sons, Ltd.

- by Susan Benbow
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- Psychology, Cognitive Science, Mental Health, Health Policy

This study tested the effectiveness of The Life Map designed by the authors for holistic needs assessment for the promotion of mental health based on the World Health Organisation’s six Quality of Life domains (1985). Tests were conducted of test–retest reliability and validity (criterion, discriminant, construct and concurrent) compared with an existing validated needs assessment, the Camberwell Assessment of Needs Inventory CAN-R. For main analyses, 43 mental health service users (SUs) were age–sex matched with 43 of non-service users (non-SUs). The Life Map significantly discriminated between these two study groups. Non-parametric correlations in each group showed significant relationship between a general quality of life question and the ‘well-being’ and the ‘influence over’ scores in each of the six domains. Consistent significant agreement was found in test–retests conducted 2 weeks apart. Qualitative data in the Life Map was able to conceptualise the quantitative Life Map scores. This makes the Life Map a tool to improve communication between user and care-provider using a reliable felt and expressed needs assessment that empowers the service user with a ‘voice’ and empowers the care-provider with the capacity to compare aggregated needs between localities and for change over time. The limitations of this study, the Life Map’s utility to facilitate meeting Standards 1 and 2 of the UK’s National Service Framework for adult mental health and future directions are discussed.

- by Selina Horsham
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- Psychometrics, Mental Health, Primary Health Care, Spirituality
- by Jill Manthorpe
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- Psychology, Primary Care, General Practice, Service Quality

Abstract: Integrated care pathways (ICP) are increasingly used in clinical settings to provide more effective care to patients. ICPs form part of local working agreements to assist co-ordination of multi-disciplinary teams to deliver evidence-based care plans to individual patients. They also document the expected progress of specific patient groups as part of clinical records. To anticipate increased use of ICPs, we have developed Healthcare@ Home, a research-phase demonstrator for improving integration of information along the ...

- by Ali Hamza Ali
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- Service Oriented Architecture, Health Informatics, Design Support, Health Care
- by Rod Sheaff
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- Psychology, Primary Care, Mental Health, Governance
- by Les Bright
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- Service Quality, Quality of Care, Humans, Older people
- by Les Bright
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- Psychology, Primary Care, General Practice, Service Quality

Integrated care pathways (ICP) are increasingly used in clinical settings to provide more effective care to patients. ICPs form part of local working agreements to assist co-ordination of multi-disciplinary teams to deliver evidence-based care plans to individual patients. They also document the expected progress of specific patient groups as part of clinical records. To anticipate increased use of ICPs, we have developed Healthcare@Home, a research-phase demonstrator for improving integration of information along the patient path. Healthcare@Home includes support for at-home, in-clinic and mobile wireless sensor devices feeding patient-proximal data hubs, timeline-based physiological trend analysis, data aggregation/dashboarding and individualised risk stratification. These and other decision support tools are embedded in portal designs supporting â€˜end-to-endâ€™ workflows as focused by the composite needs of a National Service Framework (NSF) for patients with diabetes. Healthcar...

- by Mahesh Subramanian
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- Service Oriented Architecture, Health Informatics, Design Support, Health Care
- by John Broom
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- Nutrition and Dietetics, Primary Care, Obesity, Adolescent
- by Charlotte Gosden
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- Job Satisfaction, Medicine, Humans, Diabetes mellitus

This paper re vi ews evidence about the relationships between NHS services and nur sing and residential homes in England and W ales . Since the transfer in 1993 of responsibility for funding nur sing and residential home care for less... more

- by Sally Jacobs
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- Primary Care, Home Care, Residential care, Older people
- by Jo Porter
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- Cardiology, United Kingdom, Humans, Record Linkage
- by Ian Maconochie
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- Humans, Child, National Service Framework, Lancet
- by Jennifer Beecham
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- Sociology, Social Work, Health Education, Social Support
- by Joav Merrick and +1
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- Psychology, Primary Care, Social Work, Young People

To compare the management of heart failure with the standards set out in the National Service Framework for Coronary Heart Disease. A cross-sectional study in 26 general practices, with a combined list size of 256,188, that are members of the Kent, Surrey and Sussex Primary Care Research Network. Information was extracted on the management of 2129 patients with heart failure, of whom 2097 were aged 45 years and over. The prevalence of heart failure was 8.3 per 1000. Prevalence rates increased with age, from 0.2 per 1000 in people aged under 35 years of age to 125 per 1000 in those aged 85 years and over. Coronary heart disease (present in 47%) was the most common comorbid condition in men with heart failure, whereas hypertension (present in 46%) was the most common condition in women. Recording of cardiovascular risk factors was generally higher in younger patients than in older patients, and in men than in women. Blood pressure (92% of men and 90% of women) and smoking status (84% of men and 77% of women) were generally the best-recorded cardiovascular risk factors. Blood electrolytes were recorded in about 83% of men and 75% of women. Only 17% of men and 11% of women with heart failure had a record of undergoing an echocardiogram. Use of angiotensin-converting enzyme (ACE) inhibitors or antagonists was 76% in men with heart failure and 68% in women; lowest rates were seen in older patients. Uptake of influenza immunization was generally high, at 85% in men and 84% in women. The use of ACE inhibitors in patients with heart failure was higher than in some previous studies. However, many patients have no documentation in their computerized medical records of having undergone key investigations, such as echocardiography.

- by Simon Lusignan
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- Primary Care, General Practice, Primary Health Care, Public Health