Challenging behaviour services review finds specialist congregate services use more restrictive approaches with limited effect.

by John Northfield

This literature review looked at evaluations of service provision in the UK for people with challenging behaviours, reviewing the literature from 1990 to 2010 looking at studies that evaluated a range of UK service provision in terms of impact on … Continue reading →

NHS Evidence QIPP, case study: Care Funding Calculator

The London boroughs of Barnet and Islington, Southwark, Havering and Harrow have delivered substantial savings in residential care for people with learning disabilities by using a fair pricing tool. By implementing the Care Funding Calculator (CFC) – a tool developed to prevent councils paying different amounts for similar care packages – local purchasers can better understand the costs for accommodation‐based care. This has allowed them to assess the level of staff support required to meet an individual's needs and agree a price based on relevant market knowledge. By moving towards different types of accommodation - such as supportive living under a tenancy or enabling users to invest in shared ownership schemes - more individuals have been able to live in their home area rather than being restricted to 'out of borough' residential options. The average saving per PCT area in each London borough was £500,000 mainly achieved through a reduction in the number of high cost residential placements. This equates to almost £200,000 per 100,000 population. Sarah Hollingworth, Department of Health lead on the initiative, said: "In some councils it is the social worker's responsibility to negotiate costs and terms with care providers – understandably their primary concern is sourcing and arranging the care needed as quickly as possible. By making a strategic shift towards to commissioning other types of living options we have delivered real cash savings, whilst still meeting the needs of individuals." For more details see the NHS Evidence QIPP collection.

People with Intellectual Disabilities: Towards a Good Life? Kelly Johnson and Jan Walmsley with Marie Wolfe Policy Press, University of Bristol, Bristol. 2010. 204 pp., £24.99. ISBN 978-1-84742-068-8.

Born of justifiable frustration with current policy and a desire to initiate a wave of new thinking, Kelly Johnson and JanWalmsley consider the ‘good life’ and what it might be for men and women with an intellectual disability (ID). This book, divided into three parts, each comprising three chapters, begins with MarieWolfe, a woman with a learning disability, reflecting on her life (Chapter 1). Her reflections that encompass her involvement in the advocacy movement, living both independently and in group homes, and her hopes and aspirations for the future are followed (Chapter 2) by a discussion of the ‘good life’. Here the authors, through a wide ranging collection ofWestern minds, search for new ideas and report upon their attempts to ascertain what the ‘good life’ might comprise. Their findings, although far from definitive, point to the enduring significance of reason, along with the importance of both freedoms and duties.While clearly uncomfortable with defining the ‘good life’, the authors reel off the usual obstacles to achieving it: oppression, absence of physical safety, a failure of recognition and, tellingly for our society, narrowly defined and imposed definitions of happiness that rely upon the accumulation of positional goods. Armed with this and Marie’s description of her life, Johnson and Walmsley reflect directly on the ‘good life’ for men and women with IDs (Chapter 3)…..

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What Makes a Good NurseWhy the Virtues are Important
for Nurses
Derek Sellman
Foreword by Alan Cribb
'Derek Sellman's text is both a timely and highly absorbing journey deep into the heart of nursing. It reveals a timeless and essential set of key virtues that should be a major part of the moral compass of every nurse. Subsequently, it should be read by all nurses - and most certainly by all nurse educators - who are interested in maintaining and promoting the vital moral characteristics of nursing now and in the future.'
- Dr. Martin Woods, Senior Lecturer, School of Health and Social Services, Massey University, New Zealand

In recent years, the human values at the heart of the nursing profession seem to have become sidelined by an increased focus on managerialist approaches to health care provision. Nursing's values are in danger of becoming marginalised further precisely because that which nursing does best – providing care and helping individuals through the human trauma of illness – is difficult to measure, and therefore plays little, if any, part in official accounts of outcome measures.

Reducing Expenditure on Low Clinical Value Treatments

The UK audit commission have just published a report entitled “Reducing Expenditure on Low Clinical Value Treatments”

It’s available from here:

http://www.audit-commission.gov.uk/nationalstudies/health/financialmanagement/lowclinicalvalue/Pages/Default.aspx

It is based on a list of low value treatments that the NHS Croydon PCT have put together and which has been adapted by other PCTs and has widespread acceptance among NHS commissioners.

There is an online tool which helps organizations identify savings opportunities against the 'Croydon list'. The online tool is available from here:

http://www.audit-commission.gov.uk/nationalstudies/health/financialmanagement/lowclinicalvalue/Pages/lowclinicalvaluetool.aspx

Frustrating delays facing special kids - The Independent

Frustrating delays facing special kids

Concern: Deirdre Carroll of Inclusion Ireland has commented on the assessment delays.

• Related Articles

• Worst areas for long waits

Monday April 11 2011

Parents of children with special needs are facing long delays to have the services they require assessed by the Health Service Executive (HSE) in some parts of the country, new figures reveal.
Currently, all children with special needs under five years of age are entitled by law to have an independent examination carried out to determine what health or education services they should be provided with.
It may mean they are found to need services such as special education to deal with learning difficulties or speech and language therapy.
However, the HSE revealed that the number of applications overdue for completion at the end of January increased by 33, bringing the number up to 898.
The worst affected area was the Dublin/mid-Leinster region, where 70pc of the children on the list live.
By the end of February, 110 of these 898 assessments within Dublin/mid-Leinster had been addressed.

HSE Publishes its National Audiology Review

Wednesday, 13^th April 2011

- International expert leads initiative to raise standards and reduce waiting lists
- Road map for the development of high quality audiology services nationwide
The HSE today, Wednesday 13^th April, 2011 published the report of its National Audiology Review Group.  The Review was chaired by Professor John Bamford, Honorary Professor of Audiology, University of Manchester. The work undertaken by the Review Group constitutes the most extensive examination to date of audiology services in Ireland.
The Review Group examined audiology services currently provided to children and adults nationwideand undertook an extensive public consultation and assessed the needs of the population. It found that better use of existing resources, coupled with additional funding, improved education and training, and that integration of services across hospital and community settings will deliver better value for money and represent a long term investment in providing the best possible care, with improved health and social outcomes for clients.
The Group has developed a comprehensive set of recommendations to address the inconsistencies and inadequacies in audiology services. Arising from the recommendations of the Review Group, work is now underway to improve access and deliver high quality, consistent audiology services around the country.
Click here to view or download the HSE National Audiology Review.

Chest Pain - NHS Clinical Knowledge Summary

Chest pain

In the right clinical topic?

Age from 18 years onwards
This CKS topic covers the management of adults presenting with chest pain in primary care. It includes recommendations on who should be admitted as an emergency, interim treatment if emergency admission is required, and investigations to determine the underlying cause if admission is not required.
This CKS topic does not cover the long-term management of the underlying causes of chest pain.
There are separate CKS topics on Angina, Asthma, Chest infections - adult, Chronic obstructive pulmonary disease, Heart failure - chronic, and Palpitations.
The target audience for this CKS topic is healthcare professionals working within the NHS in England, and providing first contact or primary healthcare.

BILD - TRAINING MATERIALS

BILD produced a series of books and a trainer's pack for the LDQ qualifications, for which registration has now expired.

However, the books still contain a wealth of information, advice and good practice that could be of great use as learning materials for those providing support.

Each book, a bundle of all four, and the trainer's pack are offered now at significant discount on the original price.

Principles of learning disability support John Brooke Includes chapters on: promoting person-centred values respecting diversity, cultures and values understanding personal history and preferences working in a person-centred way the right to take risks risk assessment principles and practice of confidentiality ISBN 978 0 435500 01 6 Original price £11.99 Special offer price: £7 plus p&p. All BILD books can be bought by telephoning 0845 370 0067 or online from the BILD website

Protecting people who have a learning disability from abuse Jackie Pountney Includes chapters on: understanding the nature of abuse and neglect what makes people with learning disabilities vulnerable to abuse and neglect policies and procedures relating to abuse and neglect responding to suspected abuse and neglect responding to a disclosure of abuse blowing the whistle on bad practices getting further information and advice ISBN 978 0 435500 03 0 Original price £11.99 Special offer price: £7 plus p&p. All BILD books can be bought by telephoning 0845 370 0067 or online from the BILD website

Your role as a learning disability worker

Learning Difficulties and Sexual VulnerabilityA Social Approach Andrea Hollomotz People with learning difficulties are considerably more likely to experience sexual violence than those without, and for this reason they are often described as 'vulnerable'. However, the use of this label can in fact increase risk. This book argues that the act of treating adults with learning difficulties as 'vulnerable' and in need of protection strips them of their autonomy and leaves them with fewer of the skills which are needed to protect themselves from harm. Actions, such as segregation and over-protection, can increase 'vulnerability'. The author discusses a range of social processes, including sex education, self-determination, friendships, sexual relationships and social inclusion, and examines the risks and benefits associated with each. Drawing on the everyday experiences of 29 adults, the author illustrates how people with learning difficulties can be capable of safeguarding themselves from harm, and makes a range of suggestions for enabling them to become better equipped at managing risk themselves. This is an essential book for practitioners working with people with learning difficulties, as well as students and academics in the fields of disability and social work. March 2011, ISBN: 978-1-84905-167-5, 192 pages, paperback, £19.99 / US$32.95

CUH Pathology User Handbook

Contact the library to order articles, borrow books, help with research.

Under the tab (above) Best Medical Information Sites I've added a link to this handbook.
Thanks to Mary Hinchcliffe for this recommendation.