High Quality Patient Care and Treatment
In this section:
- Care and Treatment Planning
- Attendance by Clinical Staff at Case Reviews
- Medicines Management
- Psychological Therapies Service (PTS)
- Skye Centre Activities
Treatment planning processes within the Hospital are well established. There is a co-ordinated approach to annual and intermediate reviews, the Care Programme Approach (CPA), clinical risk assessments, Integrated Care Pathways (ICPs), and to ensuring that the Hospital meets national guidance and legislation relating to treatment planning and discharge processes.
Within a safe and secure setting, expert and high quality, care and treatment is delivered by multi-disciplinary teams comprising psychiatry, nursing, occupational therapy, pharmacy, psychology, activity and recreation, social work and security.
Key Performance Indicator (KPI)
Patients have their care and treatment plans reviewed at six monthly intervals.
Performance decreased in 2019/20 with 88% of patients having their care and treatment plans reviewed at six monthly intervals compared to 96% achieved in 2018/19. The target is 100%. Anincrease in compliance is predicted for 2020/21.
Key Performance Indicator (KPI)
Patients will have their clinical risk assessment reviewed annually.
Performance remained only slightly below the 100% target throughout the year. The average figure for this indicator in 2019/20 was 97.68%.
Attendance by Clinical Staff at Case Reviews
In addition to multi-disciplinary clinical teams, all patients are assigned a Key Worker on admission to the Hospital. The Key Worker is an experienced Registered Nurse who, in collaboration with the patient, is responsible for the assessment, planning, implementation and evaluation of the day to day care of the patient. As the identified practitioner for a small group of patients, the Key Worker will develop a positive, caring, and therapeutic relationship over time with each of their patients and their family or carers. The Key Worker is supported by an Associate Worker.
Key Performance Indicator (KPI)
Attendance by clinical staff at case reviews.
The table below provides comparative data on the extent to which professions met their attendance target.
The State Hospital’s Pharmacy services continue to be provided from NHS Lothian which includes medicines supply from St John’s Hospital, Livingston plus a specialist on-site Clinical Pharmacy Service. This ensures all patients have a regular review of both their physical and mental health medicines, and supply challenges around medicine alerts and shortages are dealt with effectively.
Through a local multi-disciplinary Medicines Committee three main work-streams are overseen. These include Medicine Management, Clinical Effectiveness, and Safe Use of Medicines.
Key activities undertaken during 2019/20 focused on policy development, quality improvement initiatives from clinical audit projects, resilience planning, and a proactive approach to reducing medication incidents.
The introduction of electronic prescribing in collaboration with NHS Lothian
remains a main objective supported through the Scottish Government’s eHealth Strategy.
Psychological Therapies Service (PTS)
Psychological therapies and assessments promote psychological wellbeing and reduce the risk of harm. Interventions help patients to understand how and why their mental health problems developed, the link between mental health and offending behaviour, what they need to learn about themselves and their situation to promote recovery and wellbeing, and how they can manage and prevent themselves from harming others in the future.
The number of referrals to group therapies remains high. During the reporting period of January to December 2019:
- There were 86 new referrals (compared to 80 in 2018/19).
- 115 patients received individual highly specialist interventions i.e. offence focused work, specialist psychological assessments and individualised therapy in recognition of the highly complex problems and needs of patients.
- Psychological therapy nurses delivered 14 group supervision sessions and 18 individual sessions to the nursing staff group.
- Two new interventions were developed to support the reduction of patient obesity.
- Active engagement took place with patients to encourage them to participate in psychological therapies.
- Two audits were undertaken to support clinical practice: (1) a formulation quality audit comparing formulations to the ideal, and (2) an audit of all research activity for the previous five years including the number of studies published.
Key Performance Indicator (KPI)
Patients will be engaged in psychological therapies.
Performance over the course of 2019/20 was above target, with the exception of Quarter 2 which fell below the 85% target, however remained in the green zone.
Key Performance Indicator (KPI)
Patients will commence psychological therapies <18 weeks from referral date.
All but one patient commenced treatment within this timescale in 2019/20.
Psychological Therapies (general information) Psychological Therapies Service (February 2021)
The Skye Centre service is defined by four Activity Centres (Patient Learning, Sport & Fitness, Craft & Design, and Gardens & Animal Assisted Therapy) and also includes an Atrium where patients can access the Activity Group Room, Café, Library, Shop and Bank. A variety of groups and services are facilitated in the Skye Centre including the Patient Partnership Group, Christian Fellowship Group, Multi-faith services, Psychological Therapies groups and Allied Health Professions groups. In 2019/20, seven volunteers supported activity within the Skye Centre.
The Skye Centre Annual Report 2019/20 provides an update on patient activity from 1 June 2019 to 31 May 2020. Key pieces of work undertaken and future developments are also highlighted within the report. Key achievements during the year included delivery of the Patient Day Project, successful pilot and subsequent roll- out of the RiO patient timetable, and induction for new patient admissions.
Skye Centre Therapies and Activities (general information - Skye Cenre) (February 2021)
Key Performance Indicator (KPI)
Patients will be engaged in off-hub activities.
This indicator has seen a slight improvement from 81.7% in 2018/19 to 83% in 2019/20. The target is 90%. There was slight fluctuation during the year that was mainly due to patient discharges and new admissions not being approved by the clinical team to attend activity at the Skye Centre within the agreed timeframe.