Busy Team Research Articles

Quality standards for community mental health teams

SummaryThere is an increasing requirement for mental health services to demonstrate the quality of care provided. We have developed a quality report of our local community mental health team in Cornwall and suggest quality measures that we believe are useful to patients and clinicians, and possible to implement without overwhelming busy team members. They include measures of satisfaction, accessibility, safe process and review, outcomes, evidence-based practice and staff performance. Different teams may need different standards but we hope this paper will stimulate discussion and debate.

Changing perspectives of general medicine on general practice

The contribution of general practice to NHS patients cannot be commended more.1 The aspirations and visions for the future of general practice are splendid.2 However, as general medical registrars, we have started to experience the changes to the variety of referrals as well as number of admissions to the medical admissions unit (MAU). Hospital admissions may have fallen sharply and no doubt general practitioners are under pressure.3 On the other hand, in real life, working in the MAU has changed dramatically, with an increasing number of acute referrals. The expectations from patients, pressures of family members, and perhaps the fear of litigation may be compounding factors. Nevertheless, this adds to the queues of trolleys waiting outside MAU, adding to the work-load of the already busy medical team with patients to look after not only in general medical wards, but also in outlier surgical wards. We are only trying to call attention to the changing culture over the years. This trend has obviously had an impact on the dynamic young medics deciding on careers involving specialties sans general medicine. Indeed, general medicine has also slipped down the priority list in favour of specialist interests, despite remaining in the front line.4 The need for a concerted approach and greater interaction between primary and secondary care is warranted with active investment in both sectors.

The NICE guidance on supportive and palliative care — implications for oncology teams

Hold on to your stethoscopes, button down your white coats d the National Institute for Clinical Excellence (NICE) guidance on supportive and palliative care [1] has landed and will probably have significant ramifications for the daily working practices of oncologists. If we think we can sit back, relax and read this over a cup of hot cocoa, then place it on the top shelf to collect dust, we have got another thing coming d the recommendations are both radical and comprehensive and compliance will be monitored with vigour. At first glance, the 204 pages seem an onerous addition to the torrent of reading material confronting the busy oncology team. Its recommendations are, however, generally sensible, based entirely on published evidence and clearly laid out in the well-written genre of NICE documents. Its fundamental aims are to improve the well-being of both patients and staff alike, but in the short-term this might have some uncomfortable workload implications for our practice. So before implementation activity gets into full swing it is well worth a read d after all forewarned is forearmed.

A General Practitioner's Guide to Managing Severe Mental Illness. By Alan Cohen and Swaran Singh. London: Sainsbury Centre for Mental Health. 2001. 22 pp. £5 (pb). ISBN 1 870480 51 1 - Setting the Standard: The New Agenda for Primary Care Organisations Commissioning Mental Health Services. London: Sainsbury Centre for Mental Health. 2001. 32 pp. £10 (pb). ISBN 1 870480

A General Practitioner's Guide to Managing Severe Mental Illness is described as a booklet for busy general practitioners (GPs) and primary health care teams. Short, snappy and pragmatic at 22 pages with a couple of Martin Davies cartoons to brighten up the text, it is based both on common sense and

Hospital secondments of community nurses to improve stoma care.

As clinical nurse specialists working in a busy and proactive colorectal team we are continually looking for different ways of working to enhance patient care. The opportunity to review the range of skills in the team highlighted the need for a staff nurse. It was decided that this role should be an educational secondment (on a rolling programme) to give staff nurses the opportunity to develop skills in colorectal nursing. The post was piloted with a community staff nurse for it was felt that this would improve the primary/secondary interface, communication and collaborative working between the teams. The aim was to empower generalist and community nurses in the care of patients with colorectal diseases. This was delivered through a work-based programme to help develop the knowledge and skills of the nurses, in addition to enhancing multidisciplinary teamworking, in an environment of mutual regard and shared understanding.

Mental health consumer survey on a shoestring budget-it is possible!

Consumers of service in a decentralized unit of a county mental health services organization were surveyed. Two samples, one of 100 and one of 386 former clients, were selected for a questionnaire survey of satisfaction and perception of ensuing changes. This report is offered as an example of what a busy clinical team can accomplish in the midst of its basic task of providing therapeutic and diagnostic help.