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This study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for Health and Care Excellence (NICE) standard (QS140). In addition, this study also identifies any differences in transition quality between those young people with intellectual disability with and without autism.

Using routinely collected clinical data, this study identifies demographic and clinical characteristics of, and contextual complexities experienced by, young people in transition between 2017 and 2020. Compliance with the quality standard was assessed by applying dedicated search terms to the records.

The study highlighted poor recording of data with only 22% of 306 eligible cases having sufficient data recorded to determine compliance with the NICE quality standard. Available data indicated poor compliance with the standard. Child and adolescent mental health services, generally, did not record mental health co-morbidities. Compliance with three out of the five quality statements was higher for autistic young people, but this only reached statistical significance for one of those statements (i.e. having a named worker, p = 0.02).

Missing data included basic clinical characteristics such as the level of intellectual disability and the presence of autism. This required adult services to duplicate assessment procedures that potentially delayed clinical outcomes. This study highlights that poor compliance may reflect inaccurate recording that needs addressing through training and introduction of shared protocols.

To the best of the authors’ knowledge, this is the first study to examine the transition process between children’s and adults’ intellectual disability health services using NICE quality standard 140.

The purpose of this paper is to explore factors affecting implementing the National Institute for Health and Care Excellence (NICE) quality standard on alcohol misuse (QS11) and barriers and facilitators to its implementation.

Qualitative interview study analysed using directed and conventional content analyses. Participants were 38 individuals with experience of commissioning, delivering or using alcohol healthcare services in Southwark, Lambeth and Lewisham.

QS11 implementation ranged from no implementation to full implementation across the 13 statements. Implementation quality was also reported to vary widely across different settings. The analyses also uncovered numerous barriers and facilitators to implementing each statement. Overarching barriers to implementation included: inherent differences between specialist vs generalist settings; poor communication between healthcare settings; generic barriers to implementation; and poor governance structures and leadership.

QS11 was created to summarise alcohol-related NICE guidance. The aim was to simplify guidance and enhance local implementation. However, in practice the standard requires complex actions by professionals. There was considerable variation in local alcohol commissioning models, which was associated with variation in implementation. These models warrant further evaluation to identify best practice.

Little evidence exists on the implementing quality standards, as distinct from clinical practice guidelines. The authors present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.

The purpose of this paper is to provide a commentary, from a parent carer perspective, on Murphy’s overview of the NICE guidelines and quality standards on learning disabilities and behaviour that challenges.

The paper discusses the NICE approach, the content of these specific guidelines and quality standards and considers their practical relevance, with a particular focus on families of children and young people with learning disabilities and behaviour that challenges.

Gaps in research affect recommendations in some key areas including around transition and early intervention. Risk factors are not linked to clear recommendations for early identification and prevention. For families, additional work is needed to highlight where these guidelines fit with related national law and policies. Families also need to see how the guidelines can positively influence commissioners to improve life outcomes and avoid crises and deterioration in behaviour. Although NICE guidelines are often condition specific, many of our children and young people have co-existing conditions and so do not fit neatly into just one set of guidelines. That is why data collection is very important to understanding needs and to effective commissioning. There is a need to urgently identify and address the research gaps so that essential interventions are included in future NICE guidelines and standards.

A family carer perspective suggests ways in which implementation of the NICE guidelines can be supported and argues for the importance of the further research that will strengthen future versions of the guidelines.

This study investigated the application in the field of healthcare of a recently developed model of information seeking and communication. The purpose of this paper is to test the model’s validity and to identify insights that it may provide.

To investigate the model’s application to information users, the findings from published literature on physicians’ information behaviour were studied. To investigate its application to information providers, interviews were carried out with staff working for the National Institute for Health and Care Excellence and with employees of pharmaceutical companies. The findings were examined using deductive content analysis.

The findings endorse the validity of the model, with minor modifications. The model provides practical insights into the behaviour of both users and providers of information and the factors that influence them. It can be used to identify ways in which information behaviour may be positively modified in both finding and communicating healthcare information.

This research demonstrates the practical value of a new model of information behaviour which was developed using insights from earlier models. In doing so it answers criticisms that research in library and information science often fails to build on previous research and that it has little practical usefulness.

With care clusters an established framework for mental health services it is timely to consider how to use them to deliver high quality, evidence based care that is socially inclusive and recovery oriented. This paper aims to describe conceptual thinking about these issues, specifically in relation to the challenges and balances inherent in the care packages approach. It seeks to describe work to develop an internet based, high‐level description of such packages for each care cluster.

The background to the project is described, along with a discussion of the conceptual and practice issues behind the work.

With mental health care now trying to make sense of local services in terms of care clusters the authors offer a high‐level framework to help people in this sensemaking. Coherent, socially inclusive and recovery oriented packages are set out on the website.

The work discussed in the article is highly innovative, being the first systematic attempt to provide evidence‐based, high‐level care packages for the care clusters model. Hence, a limitation is the challenge remaining to operationalise the work to real world care contexts.

The website sets out a framework to help local services and commissioners plan and organise their services, drawing on the best guidance and evidence and developing care packages on the basis of the right ethos of care.

In moving to services fully commissioned and organised around the care clusters model, there remain major conceptual and practice challenges to address including operationalising evidence‐based care packages and means of flexibly delivering individual care.

This is the first view of socially inclusive packages for each of the care clusters that also draw together the best of guidance and standards of care.

The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular disease (CVD), diabetes and obesity, major contributors to poor physical health and risk of premature mortality.

The first phase of the AQuA “Don’t just screen-intervene” initiative supported five specialised community-based Early Intervention for Psychosis services in North West England to assess the effectiveness of monitoring of cardiometabolic risk in their patients using standards derived from the Lester Positive Cardiometabolic Health Resource, a nationally acknowledged framework for people with psychosis receiving antipsychotic medication. The initial findings formed the basis for a quality improvement programme which ran from November 2012 until May 2013.

By the end of a six month quality improvement programme the likelihood of a patient receiving a comprehensive cardiometabolic risk screening (evidenced by recorded measurement of body mass index or waist circumference, blood pressure, blood glucose and lipid profile, assessment of smoking status and enquiry of relevant family history) had increased from 10 to between 63 and 80 per cent.

Cardiometabolic risk monitoring from the onset of psychosis and its treatment can be improved utilising quality improvement methodology in real-world specialist mental health services. Earlier identification and treatment of risk factors that predict higher rates of obesity, diabetes and SMI may help people with SMI avoid life-restricting and life-shortening physical disorders.

Given the National Audit of Schizophrenia findings of inadequate screening in those with established SMI alongside evidence that CVD risk can emerge early in the course of psychosis, a group of early intervention in psychosis services in North West England decided to examine this aspect of their routine clinical practice. This service evaluation describes the effectiveness of a quality improvement programme based on the Lester Positive Cardiometabolic Health Resource (referred to as Lester resource henceforth) to improve the effectiveness of monitoring of risk factors that predict the likelihood of people experiencing psychosis and schizophrenia developing CVD diabetes and obesity.

A combination of social disadvantage and unhealthy lifestyles, adverse cardiometabolic impacts of antipsychotic medication and inequitable access to physical healthcare combine to put people with SMI at particular risk from CVD, the single biggest cause of premature death, and much more common than suicide (Brown et al., 2010). Despite higher rates of potentially modifiable CVD risk factors (De Hert et al., 2009) people with SMI appear to be missing out on opportunities to actively prevent conditions like CVD and diabetes compared to the general population.

People with SMI such as schizophrenia die 15-20 years earlier on average than the general population. Around 20 per cent of premature deaths can be explained by suicide and injury, but the remainder arise from a variety of natural causes such as CVD, chronic obstructive pulmonary disorder and certain cancers and infections (Nordentoft et al., 2013). The authors worked with five mental health trusts in the North West of England covering a sample of over 500 cases within early intervention services.

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.

Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.

Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.

Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.

A number of recommendations concerning data collection and future service evaluations are made.

Returning to paid or unpaid activities has a high public health impact.

This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).

This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations.

The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records.

The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation.

To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.

The purpose of this paper is to detail developments in UK alcohol policy for older people over the past 20 years, based on evidence for a growing public health problem with alcohol misuse in older people.

A literature search was carried out using health and social care databases, including grey literature.

There has been considerable progress in areas such as screening and brief intervention, low-risk drinking and service provision for integrated care in older people with dual diagnosis.

There remains a dearth of research and policy for older people with alcohol misuse and dual diagnosis prior to 2011. Although there remains limited empirical evidence for public health interventions to improve health outcomes from alcohol-related harm, improvements in population health from implementation of recent policy changes and intervention programmes remains to be seen.

This review has implications for best practice in the provision of integrated care to reduce harm and improve health and social outcomes in older people with alcohol misuse and dual diagnosis.

This review draws together a large area of research and policy on alcohol misuse in older people that has the potential to improve public mental health for older people who are at risk of alcohol-related harm.

The purpose of this paper is to estimate the accuracy and effectiveness of screening tools and subsequent interventions in the detection and treatment of intimate partner violence (IPV) in non-high-risk settings (defined here as those in which routine IPV screening does not take place in the UK, such as in general practice).

Rapid review as defined by Grant and Booth – it is used under time or financial constraint to assess what is known using systematic review methods. Medline, PsycINFO, Embase and Cochrane Library databases to May 2019 were searched for “intimate partner violence” and synonyms plus terms related to screening and interventions. A Medline update was performed in August 2020. Data were extracted with the help of a predesigned tool and were synthesised to answer the two study aims. Data were mixed quantitative and qualitative.

The search yielded 10 relevant papers on screening (6 on accuracy and 4 on effectiveness) and 13 on intervention. These showed evidence of the effectiveness of simple screening tools and of subsequent interventions. However, the evidence was insufficient to support a change in UK guidelines which currently do not recommend their use outside of current high-risk environments.

Clinicians outside of high-risk areas should consider the use of some IPV screening tools and interventions but only within research protocols to gather further evidence.