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Authority Areas (authority + area)
Kinds of Authority Areas Selected AbstractsIncreasing practice nurse access to alcohol trainingDRUG AND ALCOHOL REVIEW, Issue 3 2002ANN DEEHAN Abstract Policy makers have repeatedly placed emphasis on the role of primary care in screening for at-risk alcohol consumption and delivering public health messages to the general population. Research has pointed to primary care staff holding negative attitudes towards alcohol misusing patients. Training has traditionally been seen as the key to increasing the capacity of the medical field to engage with alcohol misusing patients but little work has been undertaken to examine the potential barriers to training take up. Consequently, the aim of this study was to explore the willingness of practice nurses to be trained in alcohol screening and brief intervention, and whether identifiable barriers to training exist and how they may be overcome. All practice nurses (n = 82) in an outer London (UK) Health Authority Area were twice mailed an invitation to an alcohol training seminar and a telephone invitation was made to all of those who did not reply to the mailings. Those who did not attend (n = 66) were contacted to take part in a short structured telephone interview ,89% (59/66) were contacted successfully and interviewed. Respondents were experienced in primary care and viewed health promotional activity as a valid part of their role. Few had undertaken previous alcohol training and as a group they were highly active in attending training events with training undertaken tending to be related directly to perceived practice needs and priorities: thus this group could not be characterized as unwilling to be trained. Barriers to training at alcohol events were found to be either personal or work-related, with most nurses interested in receiving further training or information. These data imply that the ways in which training is organized and delivered require sensitivity to identifiable barriers if it is to reach and effect changing practice among practice nurses successfully. A range of possibilities are identified as alternative approaches to the provision of elective training events which may be more acceptable to the target population of health-care staff. [source] A collaborative approach to embedding graduate primary care mental health workers in the UK National Health ServiceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2008Janine Fletcher MSc Abstract The UK National Health Service (NHS) workforce has recently seen the arrival of the Graduate Mental Health Worker (GMHW) in primary care. We established a Quality Improvement Collaborative to assist in embedding this new workforce in one Strategic Health Authority Area of England. The intervention utilised ,collaborative' technology which involves bringing together groups of practitioners from different organizations to work in a structured way to improve the quality of their service. The process was evaluated by an action research project in which all stakeholders participated. Data collection was primarily qualitative. During the project, there was an increase in throughput of new patients seen by the GMHWs and increased workforce satisfaction with a sense that the collaborative aided the change process within the organizations. Involvement of managers and commissioners from the Primary Care Trusts where the GMHWs were employed appeared to be important in achieving change. This was not, however, sufficient to combat significant attrition of the first cohort of workers. The project identified several barriers to the successful implementation of a new workforce for mental health problems in primary care, including widespread variation in the level and quality of supervision and in payment and terms of service of workers. A collaborative approach can be used to support the development of new roles in health care; however, full engagement from management is particularly necessary for success in implementation. The problems faced by GMHWs reflect those faced by other new workers in healthcare settings, yet in some ways are even more disturbing given the lack of governance arrangements put in place to oversee these developments and the apparent use of relatively unsupported and inexperienced novices as agents of change in the NHS. [source] Independent sector mental health care: a 1-day census of private and voluntary sector placements in seven Strategic Health Authority areas in EnglandHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2007Barbara Hatfield PhD Abstract The aims of this study were (i) to map the extent of all mental health placements in the independent sector, for adults of working age, and elderly people (excluding those with a diagnosis of dementia placed in Local Authority care homes), on a census date, across the areas in which the study was commissioned; (ii) to identify the characteristics of the population in placements; (iii) to explore some of the characteristics of the placements and the patterns of use within the private and voluntary sectors; and (iv) to identify the funding source of placements, and cost differences between the private and voluntary sector. The study took place in seven Strategic Health Authority areas, and information was sought from all Primary Care Trust and Social Services commissioners of mental health services, including regional secure commissioning teams, within those areas. A cross-sectional sample was used. Information was requested in relation to every individual meeting the inclusion criteria, placed in independent (private or voluntary) psychiatric hospitals, registered mental nursing homes and care homes on a specified study ,census date' of 28 June 2004 in six of the Strategic Health Authority areas, and 7 October 2004 in the seventh. Information was recorded on a standard questionnaire specifically designed for the study. Information was obtained on 3535 adults and 1623 elderly people in private or voluntary facilities. The largest groups of adults and elderly people had diagnoses of severe mental illnesses (42.1% and 30.5%, respectively), and placements were described as ,continuing care' or rehabilitation, with a ,niche' in specialist forensic care. Around four-fifths of units were in the private sector, which for adults was significantly more expensive than the voluntary sector. A large proportion of units (47.2% of adult placements and 59.3% of placements for elderly people) had only single placements from particular commissioning authorities, whilst others had large numbers, raising issues for effective commissioning. The distance of placements from patients' area of origin, is also an issue highlighted by the study. The study findings are discussed in relation to commissioning practice, and the development of the independent sector in mental health care. [source] Toolkit for assessing the readiness of local safeguarding children boards: origins, ingredients and applicationsCHILD ABUSE REVIEW, Issue 5 2005Tony Morrison Abstract A central plank in the transformation of children's services in England and Wales is the creation on a statutory footing of Local Safeguarding Children Boards in every local authority area. The focus of the boards will be on the promotion, multiagency coordination and scrutiny of services to safeguard and promote children's welfare. They replace Area Child Protection Committees, which were judged to be ineffective. This paper presents the origins, ingredients and applications of an audit and preparation Toolkit designed to support the establishment of the new boards. The Toolkit was developed from the findings of a survey of 204 members of 16 ACPCs by the first author, and has been tested and refined through work with a large number of ACPCs. This survey identified problematic aspects of interagency collaboration that will need remedying if the new boards are to succeed where the previous committees failed. These include: the board's strategic relationship to wider children's planning fora; operational definition of the term ,safeguarding'; collective accountability; level of membership; performance management capacity; service user consultation. The ingredients of the Toolkit are described in relation to the findings of the survey. The paper concludes with a discussion of the applications and approaches to be considered in using the Toolkit. Copyright © 2005 John Wiley & Sons, Ltd. [source] Movement and change: independent sector domiciliary care providers between 1995 and 1999HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2001Patricia Ware Abstract Promoting the development of a flourishing independent sector alongside good quality public services was a key objective of the community care reforms of the last decade. This paper charts some of the ways the independent domiciliary care sector is changing, as local authorities shift the balance of their provision toward independent sector providers and away from a reliance on in-house services. Two surveys of independent domiciliary care providers were carried out in 1995 and 1999. The aims of the studies were to describe the main features of provider organisations, such as size of business, client group and funding sources; to examine the nature of provider motivations and their past and future plans; to consider how local authorities manage the supply side of social care markets; and to examine the effects on providers of the development of the mixed economy. The first survey in 1995 was conducted in eight local authority areas, which by 1999 had increased to 11 because of the creation of three new unitary authorities. The findings are based on 261 postal surveys together with 111 interviews between the two studies. The research illustrates a domiciliary care market that is still relatively young with many small but growing businesses. There are considerable differences in the split between in-house and independent sector services in individual authorities and a common perception among independent providers that in-house services receive favourable treatment and conditions. Spot or call-off contracts continue to be the most common form of contract although there are moves toward greater levels of guaranteed service and more sophisticated patterns of contracting arrangements. There remains an ongoing need to share information between local authorities and independent providers so that good working relationships can develop with proven and competent providers. [source] The Galicia study of mental health of the Elderly I: general description of methodologyINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2000Professor R. Mateos Abstract Reports of epidemiological surveys do not always adequately provide a careful description of the methodology used and the sociocultural context involved. The objective of this paper is to describe the methodology used in a survey whose aim was to study the prevalence of the wide range of psychiatric disorders that were present in a population aged 60 and above who were living at home. The Galicia Community Study of Mental Health of the Elderly was designed in two phases. In the first, a random sample of 3,580 people over 60 years of age, representative of each of the nine public health authority areas, was interviewed at home. The 60-item version of Goldberg's General Health Questionnaire (GHQ) was the screening instrument. In the second phase, all the traced subjects with high GHQ scores (N = 532) and a representative sample (N = 149) of people below the cut-off point, were interviewed at home using the Diagnostic Interview Schedule (DIS-III). This paper analyses the sociodemographic context of Galicia (a natural region in south-western Europe with a population of 2.7 million inhabitants), the sampling method, the sociodemographic makeup of the sample, the fieldwork, and the method for obtaining the estimate of prevalence. Copyright © 2000 Whurr Publishers Ltd. [source] Community pharmacy services to drug misusers in the south west of England: results of the 2003,2004 postal surveyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2006Rachel M Britton research pharmacist Objectives To quantify current levels of methadone dispensing and supervised consumption for the treatment of drug misuse in community pharmacies in the south west of England. To compare 2003,2004 data to estimates made in 1995. Setting All community pharmacies in the strategic health authority areas of Avon, Gloucestershire and Wiltshire; Dorset and Somerset; and South West Peninsula (n = 903). Method A self-completion postal questionnaire was addressed to the ,pharmacist in charge', with up to three reminders. Descriptive data were collected on demography and drug misuse services provided by the pharmacist. Key findings An overall response rate of 78.3% (707/903) was achieved. Of all respondents, 69.2% (n = 489) dispensed methadone for the treatment of drug misuse, and 70.1% of these pharmacies (n = 343) reported providing a supervised methadone consumption service. The total number of clients receiving methadone through pharmacies in the south west was 3427, with a mean number of 7.0 clients per pharmacy; 49.5% of all clients receiving methadone had their daily doses supervised by the pharmacist. The majority of prescriptions issued for methadone (72.9%, n = 2503) were from general practice. Conclusions The majority of pharmacies (69.2%) in south west England dispense methadone and other drugs to drug misusers with just under half of the clients (49.5%) receiving their methadone by supervised consumption. [source] Changing structures: Necessary but not sufficientCHILD ABUSE REVIEW, Issue 4 2007Kate Skinner Abstract Moves are afoot across the UK to change the mechanisms for managing local inter-agency child protection policy and practice. This is being achieved through the development of Safeguarding Boards in England and Wales and guidance on Child Protection Committees that took effect from August 2005 in Scotland. Following our review of one Scottish Child Protection Committee (the SCPC), we are concerned that these changes focus almost exclusively on structure and pay scant attention to process and relationships. The study we undertook was an in-depth evaluation of the functioning of the SCPC and used a range of qualitative methods. The main findings were that the size of the committee, its coverage of three local authority areas, and its patterns of working meant that some aspects of its work were highly developed and effective, such as the guidelines and multi-agency training, while others, such as links with practice and the management of information systems, were poor. Considering these findings in the light of systems theory suggests that improving the effectiveness of child protection committees, and similar bodies, may need to be based on greater attention being paid to issues of authority, trust and negotiation among their members. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||