scholarly journals Locked doors or sentinel nurses?

2000 ◽  
Vol 24 (9) ◽  
pp. 327-328 ◽  
Author(s):  
Bob Adams
Keyword(s):  
Psychiatric Care ◽  
Acute Psychiatric Wards ◽  
The Uk ◽  
Locked Doors ◽  
Park Hospital ◽  
The Doors

Towards the end of 1998 we decided to introduce a facility to lock the doors of the acute psychiatric wards at Bootham Park Hospital, York. At first sight this would appear to be a retrograde step for modern psychiatric care in the UK. But this was a reasoned and planned move which has resulted in improved care for patients overall.

Necrotising (malignant) otitis externa in the UK: a growing problem. Review of five cases and analysis of national Hospital Episode Statistics trends

2015 ◽  
Vol 129 (6) ◽  
pp. 600-603 ◽  
Author(s):  
G Chawdhary ◽  
N Liow ◽  
J Democratis ◽  
O Whiteside
Keyword(s):  
Otitis Externa ◽  
Severe Infection ◽  
Fold Increase ◽  
Antibiotic Resistant ◽  
Catchment Population ◽  
Malignant Otitis Externa ◽  
The Mean ◽  
The Uk ◽  
High Index Of Suspicion ◽  
Park Hospital

AbstractBackground:Necrotising (malignant) otitis externa is a severe infection causing temporal bone osteomyelitis. Although rare, our experience (reported herein) shows local doubling of cases in 2013. Hospital Episodes Statistics data for England over 14 years also indicate increased incidence nationally. Specific learning points in management are also discussed.Methods:A retrospective review was conducted of patients admitted in 2013 to Wexham Park Hospital, Slough, UK (catchment population, 450 000). In addition, the UK Government Hospital Episodes Statistics data were interrogated.Results:There were five cases of necrotising (malignant) otitis externa in 2013, representing a local doubling on previous years. The mean age of patients was 82 years. All cultures grew Pseudomonas aeruginosa; no isolates were antibiotic resistant. All patients responded to systemic anti-pseudomonals on clinical, biochemical and radiological parameters. Hospital Episodes Statistics data showed a six-fold increase in the number of cases from 1999 (n = 67) to 2013 (n = 421).Conclusion:Our experience suggests increasing necrotising (malignant) otitis externa incidence, and retrospective analysis of Hospital Episodes Statistics data supports this observation. Necrotising (malignant) otitis externa poses challenges in management, as exemplified in our cases, requiring a high index of suspicion and early aggressive treatment to achieve cure.

scholarly journals The interface between old age psychiatry and the law

2002 ◽  
Vol 8 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Brian Murray ◽  
Robin Jacoby
Keyword(s):  
Old Age ◽  
Psychiatric Care ◽  
Common Law ◽  
Civil Law ◽  
The Elderly ◽  
Legal Aspects ◽  
Northern Irish ◽  
Care For The Elderly ◽  
Old Age Psychiatry ◽  
The Uk

This article aims to provide a practical overview concentrating on civil legal aspects of psychiatric care for the elderly. We limit ourselves to English law (which also has jurisdiction in Wales; Scottish and Northern Irish law may be similar, but not identical). Civil law can, in turn, be divided into statute law (legislation provided by Parliament) and common law (the UK, unlike some European countries, has a strong tradition of law based on previous rulings by judges).

First episodes of psychosis in Afro-Caribbean and White people

1998 ◽  
Vol 172 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Noriyoshi Takei ◽  
Rajendra Persaud ◽  
Peter Woodruff ◽  
Ian F. Brockington ◽  
Robin M. Murray
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Care ◽  
Population Based ◽  
Consecutive Series ◽  
White People ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Uk ◽  
First Admission

BackgroundThere have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.MethodWe followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.ResultsNinety-seven per cent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.ConclusionsAfro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.

The Nottingham Acute Bed Study: Alternatives to acute psychiatric care

1997 ◽  
Vol 170 (3) ◽  
pp. 247-252 ◽  
Author(s):  
A. Beck ◽  
T. J. Croudace ◽  
S. Singh ◽  
G. Harrison
Keyword(s):  
Resource Use ◽  
Psychiatric Care ◽  
Community Support ◽  
Decision Makers ◽  
Psychiatric Services ◽  
Community Based ◽  
Residential Community ◽  
Acute Psychiatric Wards ◽  
Population Ratio ◽  
Acute Psychiatric Care

BackgroundAlthough modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing reed for acute care.MethodWe surveyed key decision makers in a community-oriented district service with a low acute psychiatric bed to population ratio, in order to examine alternatives to hospitalisation in a cohort of consecutive admissions over a six-month period.ResultsAlternatives to acute ward hospitalisation were identified for 29% of admissions, and for 42% of those with an admission duration of more than 60 days. Residential options were chosen more often than intensive community support. Simulated bed day savings were considerable.ConclusionsIn a community-oriented service, key decision-makers could identify further alternatives to acute ward hospitalisation, although relatively few non-residential, community support options were chosen. Although this methodology has limitations, data based upon keyworker judgements probably have greater local ‘ownership’, and the option appraisal process itself may challenge stereotyped patterns of resource use.

scholarly journals UK devolution and the international perspective of the College

2010 ◽  
Vol 7 (4) ◽  
pp. 99-100
Author(s):  
Nick Craddock
Keyword(s):  
Northern Ireland ◽  
Psychiatric Care ◽  
International Perspective ◽  
Psychiatric Practice ◽  
Healthcare Settings ◽  
Service Models ◽  
Healthcare Model ◽  
The Uk ◽  
Over Time

Some principles of psychiatric practice are applicable across all healthcare settings and epochs, whereas other issues are more specific to one healthcare model and/or time. The increasing divergence of service models and underlying policies in the four UK devolved jurisdictions (England, Northern Ireland, Scotland and Wales) means that this distinction between general and specific issues has increasing relevance to the College. There are many benefits in identifying, and being strong advocates for, the generic principles of excellent psychiatric care, which are transferable across settings and relatively stable over time. These are also, of course, the principles that will have the most relevance in a broad international perspective that goes far beyond the UK.

scholarly journals Community-oriented psychiatric care

1989 ◽  
Vol 13 (1) ◽  
pp. 26-27 ◽  
Author(s):  
Joseph Connolly ◽  
Isaac Marks
Keyword(s):  
Psychiatric Care ◽  
Community Care ◽  
Multidisciplinary Teams ◽  
Role Changes ◽  
Hard Evidence ◽  
The Uk

The College is debating how to train psychiatrists for community care (CC) that is spreading – ahead of hard evidence of its value for certain problems in the UK. Much future psychiatry will be practised in the community outside hospital within multidisciplinary teams not always led by a psychiatrist, and wherein the lead-rôle changes frequently within a single meeting depending on whose expertise and readiness to accept responsibility emerge.

scholarly journals Long-stay in forensic-psychiatric care in the UK

2018 ◽  
Vol 53 (3) ◽  
pp. 313-321 ◽  
Author(s):  
Laurie Hare Duke ◽  
Vivek Furtado ◽  
Boliang Guo ◽  
Birgit Angela Völlm
Keyword(s):  
Psychiatric Care ◽  
Forensic Psychiatric ◽  
The Uk

scholarly journals Patients or prisoners? Time to reconsider the voting rights of mentally disordered offenders

2016 ◽  
Vol 40 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Gareth Rees ◽  
James Reed
Keyword(s):  
Psychiatric Care ◽  
Voting Rights ◽  
International Human Rights Law ◽  
Human Rights Law ◽  
Mentally Disordered Offenders ◽  
International Human Rights ◽  
Mentally Disordered ◽  
The People ◽  
Electoral Register ◽  
The Uk

SummaryAlthough the Representation of the People Act 2000 permits most psychiatric in-patients to register on the electoral register, transferred prisoners and those admitted to hospital under hospital orders remain disenfranchised by law. This article clarifies the voting rights of individuals receiving in-patient psychiatric care and contends that the selective disenfranchisement of some mentally disordered offenders is problematic, discriminatory and may breach international human rights law. There are therefore strong arguments for the UK government to address this long-standing inequality before the next general election.

scholarly journals Acute inpatient psychiatry in England: an old problem and a new priority

2006 ◽  
Vol 15 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Community Care ◽  
Leisure Activities ◽  
International Standards ◽  
Psychiatric Admission ◽  
Admission Ward ◽  
Acute Psychiatric Wards ◽  
Underlying Causes ◽  
The Uk ◽  
Psychiatric Beds ◽  
Bed Numbers

AbstractWith the development of community care, the number of National Health Service psychiatric beds in England has been reduced to between one-fifth and one-quarter of those provided in the mid-1950s. Psychiatric bed numbers are close to the irreducible minimum if they have not already reached it. The problems facing today's acute psychiatric admission wards include: poor design, maintenance and ambience; a lack of therapeutic and leisure activities for patients leading to inactivity and boredom; frequent incidents of aggression and low-level violence and problems with staffing. It is suggested that there are a number of underlying causes: First, there has been failure to plan inpatient services, or to define their role, as attention has focused on new developments in community care. Second, the reduction in bed numbers has led to a change in the casemix of inpatients with a concentration on admission wards of a more challenging group of patients. Third, admission ward environments are permeable to the adverse effects of local street life, including drug taking. After years of neglect, acute inpatient psychiatric services in England are now high on the UK Government agenda. The paper lists a number of national initiatives designed to improve their quality and safety. A recent review of qualitative research suggests that acute psychiatric wards in other countries face similar problems to those reported in England. It is suggested that there might be a need for joint action which might take the form either of international research about acute inpatient care or the development of international standards and a common quality improvement system.

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