Practical Participation–practical hints and tips to help you to involve child...CYP MH
CYP IAPT 2014 National Conference
Run by young people, this will be a practical workshop with tools that delegates can take away and use in their own area, with a focus on the participation priorities.
Cross-Sector Working: The challenges of ‘difference’ between health organisat...CYP MH
CYP IAPT 2014 National Conference
Navigating through service developments and improvement can at times be difficult. This difficulty can be even more challenging when working across organisations/ sectors. What is a challenge for one sector is a way of life for another. The language we use and our ideas of social philosophy can provide a rich platform to develop or a rocky shore of pitfalls. Throw into the mix the requirements of CYP IAPT and service transform and you could have a perfect storm! In this workshop we hope to show that these choppy waters can lead to calm seas and the value we can gain from each other far outweighs any difficulties. The value of understanding each other positions, learning from each other and ultimately delivering a better service is at the end of the day what we all want.
Involving Young People in Commissioning – Young People’s Involvement in the C...CYP MH
CYP IAPT 2014 National Conference
This workshop focuses on the Sheffield model of involving young people in commissioning Mental Health Services, incorporating examples of existing good practice in young people’s participation in decision making in the commissioning process. Discussions will explore key implementation factors, such as what this means for commissioners, the challenges and opportunities involved, how individual services can make this work for them and what kind of support may be necessary.
Delivering a digitally enhanced service - WorkshopCYP MH
CYPMH conference 2016 Future in Mind Vision to Implementation
Delivering a digitally enhanced service to support a transformation in integrated Children’s Health Services in Berkshire - Berkshire CAMHS with young service users
Practical Participation–practical hints and tips to help you to involve child...CYP MH
CYP IAPT 2014 National Conference
Run by young people, this will be a practical workshop with tools that delegates can take away and use in their own area, with a focus on the participation priorities.
Cross-Sector Working: The challenges of ‘difference’ between health organisat...CYP MH
CYP IAPT 2014 National Conference
Navigating through service developments and improvement can at times be difficult. This difficulty can be even more challenging when working across organisations/ sectors. What is a challenge for one sector is a way of life for another. The language we use and our ideas of social philosophy can provide a rich platform to develop or a rocky shore of pitfalls. Throw into the mix the requirements of CYP IAPT and service transform and you could have a perfect storm! In this workshop we hope to show that these choppy waters can lead to calm seas and the value we can gain from each other far outweighs any difficulties. The value of understanding each other positions, learning from each other and ultimately delivering a better service is at the end of the day what we all want.
Involving Young People in Commissioning – Young People’s Involvement in the C...CYP MH
CYP IAPT 2014 National Conference
This workshop focuses on the Sheffield model of involving young people in commissioning Mental Health Services, incorporating examples of existing good practice in young people’s participation in decision making in the commissioning process. Discussions will explore key implementation factors, such as what this means for commissioners, the challenges and opportunities involved, how individual services can make this work for them and what kind of support may be necessary.
Delivering a digitally enhanced service - WorkshopCYP MH
CYPMH conference 2016 Future in Mind Vision to Implementation
Delivering a digitally enhanced service to support a transformation in integrated Children’s Health Services in Berkshire - Berkshire CAMHS with young service users
This is a 2-hour presentation and discussion given to the residents at Boston University as part of the Dental Public Health program.
The topic discusses leadership in public health and the new competencies in this field. Also, some practical tools in project management and leadership were presented.
Open, Transparent & Visible Leadership - Dr Mark Newbold - MLS2013Steven Kinnear
Dr Mark Newbold's Presentation on Open, Transparent and Visible Leadership and Healthcare Social Media at the NI Medical Leadership Symposium 2013. www.marknewbold.com www.medleadsymposium.co.uk
Modern Healthcare's Best Places to Work in Healthcare Conference and Awards C...Modern Healthcare
Modern Healthcare hosted the Best Places to Work in Healthcare Conference and Awards Celebration Thursday, October 23, 2014 at the Fairmont Chicago Millennium Park.
About the Conference:
During this event attendees gained valuable insights from top healthcare leaders and innovators on best practices and strategies that make their organization a Best Place to Work. Click here to view the full conference program:
http://www.modernhealthcare.com/assets/PDF/Final-Program-Best-Places-Conference-10.23.14.pdf
In 2015, LWB began the implementation of the Leading Practice strategy, aiming to build a learning culture among a 4,200-strong workforce that improves leadership and practice quality at the frontline.
This is a 2-hour presentation and discussion given to the residents at Boston University as part of the Dental Public Health program.
The topic discusses leadership in public health and the new competencies in this field. Also, some practical tools in project management and leadership were presented.
Open, Transparent & Visible Leadership - Dr Mark Newbold - MLS2013Steven Kinnear
Dr Mark Newbold's Presentation on Open, Transparent and Visible Leadership and Healthcare Social Media at the NI Medical Leadership Symposium 2013. www.marknewbold.com www.medleadsymposium.co.uk
Modern Healthcare's Best Places to Work in Healthcare Conference and Awards C...Modern Healthcare
Modern Healthcare hosted the Best Places to Work in Healthcare Conference and Awards Celebration Thursday, October 23, 2014 at the Fairmont Chicago Millennium Park.
About the Conference:
During this event attendees gained valuable insights from top healthcare leaders and innovators on best practices and strategies that make their organization a Best Place to Work. Click here to view the full conference program:
http://www.modernhealthcare.com/assets/PDF/Final-Program-Best-Places-Conference-10.23.14.pdf
In 2015, LWB began the implementation of the Leading Practice strategy, aiming to build a learning culture among a 4,200-strong workforce that improves leadership and practice quality at the frontline.
MS nurses skills development workshop - Emma Matthews and Liz WilkinsonMS Trust
Aims:
To provide some practical tips to managing communication & consultations effectively
How to keep on top of the admin!
How and what to audit
How to develop and maintain being a specialist
Where to find support
Australia has one of the most affordable, accessible and comprehensive healthcare systems in the world. The Commonwealth Department of Health and Ageing promotes good health and ensure all Australians have access to key health and family services
iHV regional conference: Josephine Johnson - Health Visitors as leaders in th...Julie Cooper
Presentation by Josephine Johnson at the Institute of Health Visiting Regional Professional Conferences 2015.
Josephine Johnson is Project Lead at NHS England.
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
Guidance is an assistance made available by a competent counselor to an individual of any age to help him direct his own life, develop his own point of view, make his own decision & carry his own burden.
Counseling is essentially a process in which the counselor assists the counselee to make interpretations of facts relating to a choice, plan or adjustment which he needs to make.
This presentation developed by Michelle Constable and Jim McManus, explores how health psychology can help the work of Environmental Health Officers and was part of an introductory workshop for the Environmental Health Profession organised by the Beds and Herts Branch of the Chartered Institute of Environmental Health
Enhanced Maternal Care – The Yorkshire & Humber experience - Sarah WinfieldIntensive Care Society
I work as a Consultant Obstetrician and am based at Leeds General Infirmary. I have a special interest in maternal medicine and high risk obstetrics and I run the Obstetric Cardiac and Renal Service in this tertiary referral centre. I also work with the Diabetes team and am part of the twice weekly Diabetic Antenatal Clinic at St. James’s University Hospital. I see women with pre-existing medical conditions for pre-pregnancy counselling and I participate in the consultant on-call rota at LTHT.
I am the Yorkshire and Humber Clinical Network Clinical lead for maternity services and try to link this with my clinical role to optimise what can be achieved to improve maternity services for women and their families in Yorkshire and Humber.
Join us for an interactive, reflective, and hands-on learning session for school and mental health leaders. Together, we will build out your leadership toolkit to develop the mental health systems and practices on your school campus. In this workshop, we will cover the best practices for school mental health, funding streams (such as Medi-Cal and the Mental Health Services Act) that sustain those practices, and policy approaches that support them. Participants will leave with strategies and knowledge that will support enhanced leadership to drive school mental health equitably in their school community.
Similar to CAMHS Specialist trainees management april 2013 (20)
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
3. Personal introduction
• Current placement
• Management courses/experience
• Strengths & weaknesses
• Why attending this course?
4. Whatever happens?
• Massive turmoil
• Adaptation and innovation
• Need the right number of staff with the right skills
in the right place at the right time for the right
price!
• Winners and Losers
5. Major Competency
• Managing a budget
• Managing Risk
• Handling complaints
• Involving service users
• Evidenced based practice
• Applying good practice standards
• Monitoring and analysing outcomes
• Audit
• Influencing organisations
6. Managing Yourself
• How is your desk & office organised?
• What clinical and administrative tasks do you
delegate? e.g. booking appointments, messages,
notes & filing.
• How do you organise your diary & tasks – paper or
computer?
• How easy am I to work with (this is not only about
being nice)
7. Managing Yourself
Exercises
• Review weekly job plan & log of activity for one
week
• How much do I cost to employ?
• 360 appraisal – exercise or utility
• Preparation for next session – will you? Action
orientation or words?
8. Core Clinical Skills for C&A Psychiatrists
• Identification and treatment of psychosis, severe depressive
illness, organic mental states, severe somatoform disorders
• Psychopharmacology
• Advice in respect of high risk of self-harm, suicide and harm
to others
• Advice on treatment of severe, complex ADHD, OCD and
TICS
• Advice on and management of Eating disorders
• Identification of, formulation of, and advice in, complex cases
e.g child protection, LAC, Youth offending
• Certain types of paediatric liaison work
• Assessment of complex or atypical ASD
10. Is there clarity?
• What we do
• What we could do
• What we should do
• What we are asked to do
• How we do it together
11. Clinical Competencies of a Team
• Initial formulation and diagnosis of most cases
• Risk assessment of self-harm and harm to others
• Formulation and management of most cases of self-
harm
• Initial ADHD assessment and treatment of cases not
needing medication
• Family therapy clinics
• Parent management skills
• Cognitive-behavioural therapy
12. Potential Risks at Team Level
• The model is not owned by everyone in teams
and services
• No appropriate skill mix in teams
• Too many interfaces
• Isolation, confusion of roles
• Lose good practice, especially working
together in patch teams
• If one is the only specialist in that area what
happen when they are off?
13. MDT
• “One obstacle to the smooth running of
multidisciplinary teams is the desire of doctors to be
in charge.” Cottrell 1993
14. Departmental Organisation
• What are the structures & processes?
• Who is in the department?
• Who decides what, and where?
• What are the lines of management –
personnel/clinical?
• What are the management/departmental
meetings – who attends and what is decided?
• What arrangements are there for appraisal?
15. Departmental Organisation
Exercises
• Review departmental structure and personnel [3
mins ]
• Review structure & purpose of departmental
meetings [3 mins]
• Describe 3 potential improvements
16. Leadership & Teamworking
• Who sets goals & how are these evaluated?
• How is activity information used?
• Is there a service description & priorities?
• Is there a regular development day? How is
this organised & evaluated?
• How are new developments planned &
agreed?
• How is expertise recognised?
17. Communication & Meetings
• What is the remit?
• Who attends – and how is this decided?
• What is the agenda?
• Are minutes kept and distributed?
• Focussing on what has to be decided, and what actions are
agreed
• How are decisions and actions implemented and reviewed?
• How to deal with non-attenders, or people who talk too
much or too little?
18. Clinical Governance
• What are the structures & processes for
clinical governance?
• How does CAMHS relate to these?
• How is audit organised?
• What protocols are in place and how are
these reviewed?
• What audits have been completed?
• How are clinical incidents reported and
reviewed?
19. Conflict & Negotiation
• How to manage people who moan (problems)?
• How is efficiency & effectiveness monitored?
• What about punctuality and absence?
• What are the disciplinary processes?
• Difficult people e.g. non-participation,
critical/hostile
20. Service Development
• What are the departmental processes for
generating & developing the service?
• How are these negotiated within the trust/CCG
and with other agencies?
• What funds are available for development?
• What are the national trends & drivers for
development priorities?
21. Managing Change
• How is change planned & implemented?
• Is change negotiated or imposed?
• How are team members involved or
informed?
• How do people react?
23. External context
• Which trust & directorate? CCG?
• CD, MD, CEO, Ch, board: who & how?
• When & where? Who represents you?
• Multiagency CAMHS planning? Who, when &
where?
• Health England impact on CAMHS
24. Fragmented funding, multiple
assessments and gatekeepers
Conduct
disorder
Statement
of SEN
Children
in need
At risk
register
ASSET APIR
£3
billion
Social
Worker
Youth
offending
team
Child
psycho-
logist
Ed
welfare
officer
Connex
-ions
PA
SENCO &
Ed Psycho-
logist
LEA special
educational
needs
Connex
-ions
EWSCAHMSYOTSocial
Services
Youth
workers
Youth
Service
£300
million
£300
million
£100
million
£350
million
£500
million
£1
billion
= assessment
= worker
= agency
Health
visitor
ccg
Risks to
parents
£?
million
Children’s
Fund
£150
million
25. The overall goal of comprehensive child and
adolescent mental health services should be
that of delivering seamless multi-sectoral
mental health services for children,
adolescents, young people and their families.
The services must be effective, sensitive and
appropriate to the needs of the local
population, and based on achieving the best
from partnerships in care.
TOGETHER WE STAND, HAS, 1995
26. GPs, Paediatricians, Teachers, School Nurses,
Youth Justice Workers, Health Visitors,
Social Workers, Voluntary Agencies etc
Tier 1
Individual Professionals Trained
in Children and Young People’s Mental Health
e.g. Psychiatrists, Psychologists, Therapists etc
Specialist Multi-disciplinary
Teams
Tier 2
Tier 3
Very
specialist
services, incl.
children away from home Tier 4
The 4-tier model for CAMHS
PrimaryM
entalHealthW
orkersetc
Health Advisory Service, 1995. Together We Stand
27. National Service Framework forNational Service Framework for
Children, Young People and MaternityChildren, Young People and Maternity
ServicesServices
NSF Standard 9:
The Mental Health and Psychological Well-being
of Children and Young People
28. “All children and young people, from
birth to their eighteenth birthday, who
have mental health problems and
disorders have access to timely,
integrated, high quality multidisciplinary
mental health services to ensure
effective assessment, treatment and
support, for them, and their families.”
NSF Standard 9:
The Mental Health and Psychological Well-being
of Children and Young People
30. • Services are shaped by their histories and
organised for the convenience of the provider not
the client (Cabinet Office, 2001).
• Audit Commission report (2002): a general
consensus that agencies need to work more closely
together to meet the needs of young people, but
different spending priorities, boundaries and
cultures make this difficult to achieve in practice
• Interagency working of such services tend to
'underlap' rather than overlap and agencies can
ignore the complexity their clients present
Multi-agency work
31. Barriers
Professional barriers – different professional cultures
leading to different perceptions of role and priority and
disagreement about assessment and intervention with
young person
Communication barriers - often different professions and
different organisations approach the same issue from a
different perspective and use different terms;
Organisational barriers - different organisations may
have different goals, priorities and structures;
Resource barriers - there may not always be sufficient
money or time to support joint working.
33. So what are users saying theySo what are users saying they
want?want?
• What children, young people and their families and
carers want is often quite simple.
• They want consistent relationships with people who
can help and to be treated with dignity and respect.
CAMHS Review 2008
34. Features of effective services – as defined byFeatures of effective services – as defined by
children, youngchildren, young
people and their parents and carerspeople and their parents and carers
• Awareness
• Of mental health and how to deal with it
• Trust
• Build a trusting relationship
• Regular contact with the same staff
• Clarity over confidentiality arrangements
35. Features of effective servicesFeatures of effective services
• Accessibility
• Convenience
• Accessible information and advice available
• Single point of entry to specialist mental health services
• Age-appropriate services
• Communication
• Being listened to, given individual attention
• Straightforward, no technical jargon
36. • Involvement
• Being valued
• Opportunity to discuss what services and interventions
are available
• Support when it’s needed
• Available when the need first arises, not when things
reach crisis point
• Support and follow up
Features of effective servicesFeatures of effective services
37. • Holistic approach
• services that think about you as an individual; for example,
providing help with practical issues and addressing your
physical health as well as your mental health
Summary of key findings from Focus groups and interviews with
children, young people, parents and carers, conducted specifically for
the Independent CAMHS Review Expert Group.
Features of effective servicesFeatures of effective services
38. Some Levers for Change
• Users and carers [Families]
• NSF Change for Children - Every Child Matters
• Comprehensive CAMHS
• Workforce challenge
• NHS Modernisation
• Commissioner-driven through contracting,
contestability and service redesign
• Performance indicators
• Activity data
• Waiting times
40. How to develop a service?
• Developing new roles, to bring new people into
the mental health workforce
• Developing the roles of existing staff, to enable
them to take on more or different tasks
• Ensuring that the skills of all staff are being
used in the most efficient and effective way
41. Key lessons and actions
• No single blueprint for CAMHS
• Small changes can be easy wins
• Change one role and change all
• Leadership to support change is essential both
from clinicians and managers
• There is more shared in common that distinct
between professions [ Ten Essential Shared
Capabilities]
• Will involve cultural change
42. Solutions [AIMS]
• Child & Family input into service design
• Clarity about realistic roles
• Recognise finite capacity and capabilities and
avoid wishing unrealistic demands upon them
• Vertical and horizontal integration of services
• Clarify corporate responses
43. Solutions [ACTIONS]
• Use explicit plans and protocols for demand
management
• Re-organise services to respond to need not
diagnostic labels
• Consider information needs of all stakeholders
• Recognise concept of burden and impact
• Complexity means multiple respondents may be
needed
• Matching between wants, needs, evidence of
effectiveness and availability of expertise
• Supportive information systems
44. There are no well worn paths….
…. People and services will need
to move out of their comfort
zones.
45. Preparing For A
Consultant Post
• What kind of post are you looking for?
• What posts are currently available in the North
West?
• Ways to appraise a vacant post
Editor's Notes
Snowball In a team What do you think are the core clinical competencies for a child & adolescent team [choose a particular colour paper]
Potential Risks at Project Level lack of dissemination lack of sustainability Potential benifits Consultants are not responsible for less complex, lower tier work but freed to focus on complex cases Providing a better service in existing resources Clearer roles, clear mechanisms for checking case loads and ensuring staff are operating appropriately Able to concentrate on one area, becoming more experts, the job will be more satisfying (helping with recruitment and retention) Team members will be able to develop and feel more valued and responsible
David Cottrell Psychiatric Bulletin 1993, 17:733-735 In defence of multidisciplinary teams in child and adolescent psychiatry
Introduce Me Introduce each other 3 CAMHS skills/competencies that you have Aims of session : Introduce NWW Introduce NWW CAMHS Leave with thoughts with regard to the future
Look at what we have done – created vast array of programmes, a torrent of funding streams, multiple targets, separate inspections, fragmented accountability And look at the impact on the child - each funding stream its own xxx and gatekeeper nobody has the full picture of the child ’s needs but each xxx the child and the child is passed from agency to agency
Still has great resonance – how close are we to achieving this?
Multi-agency work remains very difficult Audit Commission report (2002 p.52): Snowball Between teams How can we change working practice for Multi-agency work
Snowball On your own What do you think are the core clinical skills for a child & adolescent psychiatrists [choose a particular colour paper]
Levels of levers Patient-driven through choice, voice and competition Commissioner-driven through contracting, contestability and service redesign Nationally-driven through standards, targets, agencies and regulatory approaches
Eg support time and recovery workers, graduate mental health workers, associate practitioners Eg nurse prescribers, clinical pharmacists Eg changing the pattern of working of consultant psychiatrists to make the best use of their expertise
Not a Recipe Needs work More of a approach Cultural change is very difficult tribal nature of professional training a potential barrier Enhance effective person –centred services through new ways of working in multidisciplinary multi agency context 10 Essential Shared Capabilities Distinct Contributions Project plan Project management Time Team based Service users and carers from the outset Clear communication strategy Data demonstration Share experiences [e.g Active Shadowing] DOAS Interest is essential Supportive management structure Board level ‘permission’ HR, finance, governance etc – make use of them Expect problems-revise assumptions Service users and carers from the outset
There are no well worn paths People and services will need to move out of their comfort zones.