scholarly journals Waiting list eradication in serious mental illness (SMI) “secondary care” psychology: addressing an NHS blind spot

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S306-S306
Author(s):  
Nicola Airey ◽  
Zaffer Iqbal ◽  
Sophie Brown
Keyword(s):  
Mental Health ◽  
Secondary Care ◽  
Waiting Times ◽  
Blind Spot ◽  
Waiting Lists ◽  
Psychological Services ◽  
Waiting List ◽  
North East ◽  
Psychology Service

AimsThe poster focuses on the reduction, and eventual eradication, of waiting times within a community-based NHS psychology service in the North East of England. The poster aims to demonstrate the effectiveness of strategies implemented within a secondary care psychology service whilst examining patterns of help-seeking behaviour and treatment compliance in those waiting for therapy, and also the care needs of this cohort following a wait for services.BackgroundSecondary care waiting lists for psychological therapy, as highlighted by a recent British Medical Association audit, remain a so-called ‘blind-spot’ in mental health care provision and a national problem. Tackling waiting lists within this sector has been stated as a priority within the Five Year Forward View, however “core ingredients” of waiting list eradication methodologies and the components leading to such, have yet to be disseminated.MethodA historical audit and follow-up of clinical data were utilised to gather and analyse data of 208 individuals who were seen by the psychology service between October 2014 and March 2016.ResultNo significant differences were found between individuals who successfully completed therapy compared to those who disengaged in regard to demographic or epidemiological variables, or mental health service input. Despite lengthy waiting times of up to 3.69 years, waiting time did not significantly impact whether someone engaged with psychological services. Any form of input from psychological services led to a significant reduction in distress, as measured by the CORE-OM. No individuals who completed therapy were re-referred for psychological input at 12-month follow-up.ConclusionIf imposed appropriately over a suitable time-frame evidence-based, effective and efficient needs-led psychological input can be provided whilst eradicating a waiting list and still remaining flexible, formulation-based and person-centred.

scholarly journals The orthopaedic waiting list crisis

2021 ◽  
Vol 2 (7) ◽  
pp. 530-534
Author(s):  
Matthew Hampton ◽  
Ella Riley ◽  
Naren Garneti ◽  
Alexander Anderson ◽  
Kevin Wembridge
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Waiting Lists ◽  
Waiting List ◽  
Retrospective Data ◽  
Day Case ◽  
Number Of Patients ◽  
Robust Planning ◽  
Therapy Services ◽  
Patient Referrals

Aims Due to widespread cancellations in elective orthopaedic procedures, the number of patients on waiting list for surgery is rising. We aim to determine and quantify if disparities exist between inpatient and day-case orthopaedic waiting list numbers; we also aim to determine if there is a ‘hidden burden’ that already exists due to reductions in elective secondary care referrals. Methods Retrospective data were collected between 1 April 2020 and 31 December 2020 and compared with the same nine-month period the previous year. Data collected included surgeries performed (day-case vs inpatient), number of patients currently on the orthopaedic waiting list (day-case vs inpatient), and number of new patient referrals from primary care and therapy services. Results There was a 52.8% reduction in our elective surgical workload in 2020. The majority of surgeries performed in 2020 were day case surgeries (739; 86.6%) with 47.2% of these performed in the independent sector on a ‘lift and shift’ service. The total number of patients on our waiting lists has risen by 30.1% in just 12 months. As we have been restricted in performing inpatient surgery, the inpatient waiting lists have risen by 73.2%, compared to a 1.6% rise in our day-case waiting list. New patient referral from primary care and therapy services have reduced from 3,357 in 2019 to 1,722 in 2020 (49.7% reduction). Conclusion This study further exposes the increasing number of patients on orthopaedic waiting lists. We observed disparities between inpatient and day-case waiting lists, with dramatic increases in the number of inpatients on the waiting lists. The number of new patient referrals has decreased, and we predict an influx of referrals as the pandemic eases, further adding to the pressure on inpatient waiting lists. Robust planning and allocation of adequate resources is essential to deal with this backlog. Cite this article: Bone Jt Open 2021;2(7):530–534.

scholarly journals The views of public and clinician stakeholders on risk assessment tools for post-stroke dementia: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025586 ◽  
Author(s):  
Eugene Tang ◽  
Catherine Exley ◽  
Christopher Price ◽  
Blossom Stephan ◽  
Louise Robinson
Keyword(s):  
Risk Assessment ◽  
Qualitative Study ◽  
Secondary Care ◽  
Assessment Tools ◽  
Stroke Patients ◽  
Post Stroke ◽  
North East ◽  
Increased Risk ◽  
Diagnosis Of Dementia

ObjectiveStroke-survivors are at increased risk of future dementia. Assessment to identify those at high risk of developing a disease using predictive scores has been utilised in different areas of medicine. A number of risk assessment scores for dementia have been developed but none has been recommended for use clinically. The aim of this qualitative study was to assess the acceptability and feasibility of using a risk assessment tool to predict post-stroke dementia.DesignQualitative semi-structured interviews were conducted and analysed thematically. The patients and carers were offered interviews at around 6 (baseline) and 12 (follow-up) months post-stroke; clinicians were interviewed once.SettingThe study was conducted in the North-East of England with stroke patients, family carers and healthcare professionals in primary and secondary care.ParticipantsThirty-nine interviews were conducted (17 clinicians and 15 stroke patients and their carers at baseline. Twelve stroke patients and their carers were interviewed at follow-up, some interviews were conducted in pairs).ResultsBarriers and facilitators to risk assessment were discussed. For the patients and carers the focus for facilitators were based on the outcomes of risk assessment for example assistance with preparation, diagnosis and for reassurance. For clinicians, facilitators were focused on the process that is, familiarity in primary care, resource availability in secondary care and collaborative care. For barriers, both groups focused on the outcome including for example, the anxiety generated from a potential diagnosis of dementia. For the patients/carers a further barrier included concerns about how it may affect their recovery. For clinicians there were concerns about limited interventions and how it would be different from standard care.ConclusionsRisk assessment for dementia post-stroke presents challenges given the ramifications of a potential diagnosis of dementia. Attention needs to be given to how information is communicated and strategies developed to support the patients and carers if risk assessment is used.

SP5.1.1 The harsh reality of a long waiting list for bariatric surgery, a prospective study regarding health-related quality of life (HRQoL) among morbid obese patients following bariatric surgery versus those on a waiting list, a two-year follow-up study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jose Rodicio ◽  
María Moreno ◽  
Tamara Vico ◽  
Emilio Negrete ◽  
Covadonga Valdés ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Bariatric Surgery ◽  
Bodily Pain ◽  
Waiting List ◽  
Emotional Role ◽  
A Prospective Study ◽  
The Impact

Abstract Aims The aims of this study were to assess the changes in HRQoL during the 2 years follow-up between patients who underwent surgery and those on a long waiting list . Methods Between January to December 2017, 70 surgical patients and 69 patients on the waiting list were interviewed at baseline, 12-month and 24-month follow-up. Quality of life was measured by the SF-12v2 and the Impact of Weight on Quality of Life-Lite (IWQoL) questionnaires. Socio-demographics, clinical, and surgical-related variables were collected. Results 139 patients were analyzed, with similar baseline characteristics. Analyzing the entire sample: the higher the BMI, the worse the scores in the IWQoL. Performing more qualified work improves several aspects of the SF-12v2. In contrast, patients with depression tended to score worse on all dimensions of both questionnaires, women scored worse on the Self-Esteem domain and men improved on the Mental Health one. At 12 and 24-month follow-up, statistically significant differences were found among all aspects of the questionnaires between both groups (P<.001). Furthermore, scores were lower in all domains in the evolution of wait-listed patients, with statistically differences among Bodily Pain, Emotional Role, Mental Health, and Mental Component Summary domains (P<.05) at 12 months, but differences were not found at 24 months. Conclusions The quality of life of patients undergoing bariatric surgery is normalized one year after surgery, while patients on the waiting list get worse. Knowing the benefits of bariatric surgery, working on programs with long waiting lists should move us to fight against an unfair and unacceptable situation.

scholarly journals Improving Services for Patients with Groin Hernias: Reducing Waiting Times for Surgery

2013 ◽  
Vol 95 (7) ◽  
pp. 232-234
Author(s):  
TD Reid ◽  
H Al-Momani ◽  
J Lloyd-Evans ◽  
ZM Saeed ◽  
P Plumb ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Secondary Care ◽  
Waiting Times ◽  
Family Doctor ◽  
Waiting List ◽  
Outpatient Department ◽  
The Uk ◽  
Groin Hernias

Inguinal hernia repair is one of the most common operations performed in the UK, with over 70,000 procedures carried out per year. Consequently, patients with groin hernias place a major demand on the surgical resources of our NHS hospitals. Patients referred to secondary care for a repair are typically first assessed in the outpatient department, where an appropriate pre-assessment is arranged, and then either a date for surgery is allocated or the patient is placed on a waiting list. Moreover, as the priority for many of these steps on this pathway is typically 'routine' rather than 'urgent', the vast majority of patients with groin hernias will experience a considerable wait after seeing their family doctor.

The Cardiac Waiting Game: Are Patients Prioritized on the Basis of Clinical Need?

1997 ◽  
Vol 10 (4) ◽  
pp. 216-224 ◽  
Author(s):  
S. Langham ◽  
M. Soljak ◽  
B. Keogh ◽  
M. Gill ◽  
M. Thorogood ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Waiting Time ◽  
Smoking Status ◽  
Current System ◽  
Artery Bypass ◽  
Waiting Times ◽  
Waiting Lists ◽  
Waiting List ◽  
Use Of Resources

Waiting lists for coronary artery bypass grafting (CABG) have been a recurring problem for many hospitals, putting pressure on hospitals to manage waiting lists more effectively. In this study, we audited the records of 1594 patients who had coronary artery bypass surgery in 1992 and 1993 in three London hospitals, to assess their waiting time experience. Patients' actual waiting times were compared with an appropriate waiting time defined using an adapted version of a Canadian urgency scoring system. Influence of other factors (sex, age, smoking, hypertension, diabetes and obesity) on actual waiting time was assessed. A comparison of patients' actual waiting times with an appropriate waiting time, defined by the urgency score, showed that only 38% were treated within the appropriate period. Thirty-four per cent were treated earlier than their ischaemic risk indicated, and 28% with high ischaemic risk were delayed. Actual waiting time was associated with a patient's sex and smoking status but not with the other factors studied. The current system of prioritizing patients awaiting CABG is not concordant with a measure of appropriate waiting time. This could have arisen due to a number of factors, including the contracting process, waiting list initiatives, and methods of waiting list administration and patient pressures. The use of a standard method for prioritizing patients would enable a more appropriate use of resources.

scholarly journals Improving access to services through a collaborative learning system at East London NHS Foundation Trust

2018 ◽  
Vol 7 (3) ◽  
pp. e000337 ◽  
Author(s):  
Amar Shah ◽  
Auzewell Chitewe ◽  
Emma Binley ◽  
Forid Alom ◽  
James Innes
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Collaborative Learning ◽  
Health Services ◽  
Secondary Care ◽  
Waiting Times ◽  
Learning System ◽  
Improvement Project ◽  
Face To Face ◽  
Wide Range

Early intervention following initial referral into healthcare services can have a significant impact on the prognosis and outcomes of patients. Long waiting times and non-attendance can have an immediate and enduring negative impact on patients and healthcare service providers. The traditional management options in reducing waiting times have largely revolved around setting performance targets, providing financial incentives or additional resourcing. This large-scale quality improvement project aimed to reduce waiting times from referral to first appointment and non-attendance for a wide range of services providing primary and secondary care mental health and community health services at East London NHS Foundation Trust (ELFT). Fifteen community-based teams across ELFT came together with the shared goal of improving access. These teams were diverse in both nature and geography and included adult community mental health teams, child and adolescent mental health services, secondary care psychological therapy services, memory services, a musculoskeletal physiotherapy service and a sickle cell service. A collaborative learning system was developed to support the teams to come together at regular intervals, share data, test and scale-up ideas through quality improvement and have access to coaching from skilled improvement advisors in the ELFT central quality improvement team. Over the course of the 2-year project, waiting time from referral to first face-to-face appointment reduced from an average of 60.6 days to 46.7 days (a 23% reduction), non-attendance at first face-to-face appointment reduced from an average of 31.7% to an average of 20.5% (a 36% reduction), while referral volume increased from an average of 1021 per month to an average of 1280 per month (a 25% increase).

Low-intensity sleep intervention in a youth mental health service: a case series analysis

2020 ◽  
pp. 1-14
Author(s):  
Rebecca Rollinson ◽  
Isabel Price ◽  
Brioney Gee ◽  
Jonathan Lyons ◽  
Ben Carroll ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Young People ◽  
Secondary Care ◽  
Case Series ◽  
Youth Mental Health ◽  
Effect Sizes ◽  
Low Intensity ◽  
Series Analysis

Abstract Background: There is increasing evidence of a strong association between sleep and mental health in both adolescents and adults. CBT for insomnia is being applied to good effect with adults with mental health difficulties but there are few studies examining its applicability to adolescents within mental health services. Method: We carried out a case series analysis (n = 15) looking at the feasibility, accessibility and impact of a low-intensity sleep intervention for young people (14–25 years) being seen by a secondary care Youth Mental Health team in the UK. The intervention was based on cognitive behavioural therapy for insomnia (CBTi) and acceptance and commitment therapy (ACT) approaches and involved six individual sessions delivered on a weekly basis by a graduate psychologist. Routine outcome measures were used to monitor insomnia, psychological distress and functioning with assessments at baseline, session 3, session 6 and at 4 weeks after end of intervention. All participants scored in the clinical range for insomnia at the start of the study. Results: High uptake, attendance and measure completion rates were observed. Large effect sizes were observed for insomnia, psychological distress and functioning. Twelve of the fifteen participants (80%) no longer scored above threshold for insomnia at follow-up. All seven under-18s no longer met threshold for clinical ‘caseness’ on the Revised Child Anxiety and Depression Scale (RCADS) at follow-up. Discussion: The findings suggest that the intervention was well accepted by young people and feasible to apply within a secondary care setting. Strong effect sizes are encouraging but are probably inflated by the small sample size, uncontrolled design and unblinded assessments.

Analysis of public dental service waiting lists in Queensland

2015 ◽  
Vol 21 (1) ◽  
pp. 27 ◽  
Author(s):  
Ratilal Lalloo ◽  
Jeroen Kroon
Keyword(s):  
Low Income ◽  
Waiting Times ◽  
Open Data ◽  
Waiting Lists ◽  
Dental Service ◽  
Waiting List ◽  
Dental Services ◽  
Public Dental Service ◽  
Data Policy ◽  
The Impact

Information on public dental service waiting lists is available as part of the Queensland Government open data policy. Data were summarised across the care categories and health districts to present the total number and percentage of people waiting for care and who have waited beyond the desirable period. As of 31 December 2012 there were 130 546 people on the dental waiting list; of these 85.8%, 8.5% and 2.2% were waiting for general care desirable within 24, 12 and 3 months, respectively. Across all care categories, almost 56% of those on the waiting list were beyond the desirable waiting period. The average number of people on the waiting list and the average number waiting beyond the desirable time differ substantially per clinic by district. Ongoing analysis of the Queensland public dental service waiting list database will determine the impact on patient waiting times of Federal Government initiatives announced in 2012 to treat an estimated 400 000 patients on waiting lists nationwide over the next 3 years and to expand services to assist low-income adults to receive dental services.

Waiting time information services: what are the implications of waiting list behaviour for their design?

2002 ◽  
Vol 25 (4) ◽  
pp. 40 ◽  
Author(s):  
David Cromwell ◽  
David Griffiths
Keyword(s):  
Waiting Time ◽  
Elective Surgery ◽  
Waiting Times ◽  
Waiting Lists ◽  
Information Services ◽  
Waiting List ◽  
Surgical Units ◽  
Time Information ◽  
Over Time ◽  
Sydney Australia

In some countries, patients requiring elective surgery can access comparative waiting time information for various surgical units. What someone can deduce from this information will depend upon how the statistics are derived, and how waiting lists behave. However, empirical analyses of waiting list behaviour are scarce. This study analysed three years of waiting list data collected at one hospital in Sydney, Australia. The results highlight various issues that raise questions about using particular waiting time statistics to make inferences about patient waiting times. In particular, the results highlight the considerable variation in behaviour that can exist between surgeons in the same specialty, and that can occur over time.

The effect of independent treatment centres on patient case mix within orthopaedic waiting lists

2006 ◽  
Vol 88 (8) ◽  
pp. 276-278
Author(s):  
BJ Bolland ◽  
C Corbin ◽  
IJ Bissell ◽  
JM Latham
Keyword(s):  
Patient Outcome ◽  
General Hospital ◽  
Waiting Times ◽  
Waiting Lists ◽  
Current Drive ◽  
Waiting List ◽  
Case Mix ◽  
Patient Case ◽  
Hospital Resources ◽  
Routine Procedures

There is concern that the current drive to reduce waiting lists and promote alternative providers, such as independent sector treatment centres (ISTCs), will lead to a change in the case mix of patients remaining on the waiting lists of local hospitals. The reallocation of routine procedures on medically fit patients to alternative providers will result in an increase in the proportion of complex or medically unwell patients remaining on a Trust's waiting list. Overall waiting times for routine surgery will be reduced but there are concerns about the uncertain effects on patient outcome, general hospital resources and the experience of orthopaedic trainees.

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