Service Context. Lifecycle Management 7 5 Responsibilities 10
Service Context. The MHOA Lewisham Psychology & Psychotherapy Service deliver CBT for carers groups approximately twice per year. Participants Data has been gathered from 67 participants attending a CBT for Carers Group in the MHOA Lewisham Psychology & Psychotherapy Service from Dec 2005 to Dec 2012. Thirteen groups have been run to date – although one group had several early dropouts leaving just one participant so the majority of the programme was delivered on a 1:1 basis. All the groups had the same content and structure but this became more standardised over time i.e. by group 13 comprehensive handouts had been prepared to complement the group content. The groups were always conducted by one Clinical Psychologist/Psychotherapist and one other member of staff from the CMHT which may have been another Clinical Psychologist/Psychotherapist or another professional from the CMHT such as an Occupational Therapist or Community Psychiatric Nurse. Data is available for 55 women and 12 men. Relationship to the person being cared for is known for 50 participants – 17 people were caring for their husband, 3 for their wife, 27 for a parent and the remainder for a neighbour, sister and father-in-law. Although data on the participants age was not routinely collected approximately 30% of this sample were caring for a spouse so likely to be over 65 years of age. Assessment session The intention to run a group would be circulated to the CMHT by email and via MDT meetings. Potential referrals would be contacted to undertake a general assessment of their suitability and to explain the nature and aims of the group, and the commitment required. If the participant was deemed suitable and decided they would like to take part, this would be confirmed in writing. At this stage quantitative outcome measures would also be sent. Quantitative Outcome Measures The group was evaluated using two standardised measures; one focused on general well-being and another measure more specifically focussed on carer burden. Carer Burden The 22 item Xxxxx Xxxxxx Interview measures perceived carer burden (Xxxxxx, Xxxxx, & Xxxxxxxx, 2000). The original 29-item questionnaire (Xxxxx et al., 1980) was reduced to 22 items with a five-point scale ranging from 0 (never) to 4 (always) with total score ranging from 0 to 88. The 22 item measure has been shown to have good inter-item reliability and convergent validity (Xxxxxx, Haut, Xxxxxxxx, & Xxxxxxx, 1994). Guidelines for interpreting the scores have been suggested by ...
Service Context. The locations where cash releasing HRA savings are most deliverable are those which have • Large number of staff of same discipline in one location • 24/7 roster • Additional hours available via HRA • Significant Agency and/or overtime The types of staff/locations with the lowest probability are where there are: • No additional hours from HRA • No or low agency/overtime • Small numbers of staff of same discipline • Caseload working with mitigates against inter changeability of staff • No 24/7 rosters Fig.1 Summary of MHD staff by care setting Services No. of Units WTES % Community Teams 195 3515 39.1% Residential 7 day Acute Unit 38 2669 29.7% High Support Hostel 116 1223 13.6% Residential 7 day Continuing Care Unit 41 801 8.9% Day Hospitals 78 351 3.9% Day Centres 161 259 2.9% Low Support Hostel 158 93 1.0% Medium Support Hostel 89 83 0.9% Overall 876 8,994 In summary: • 65% of MHD staff are required to work additional hours under HRA as 35% were already at the HRA maximums • 54% MHD staff work in residential settings ranging from small hostels with 10/11 staff up to large acute units – 46% of MHD staff work in the community (no rosters) • Of our AHP’s 90% or 765 work across 179 teams in the community and given we have 3 main disciplines (PSYCH, OT and SW) most are the only member of their discipline in each team • Less than 60% of our nurses work in the larger residential settings i.e. approximately 30% of total MHD staff are nurses working in the larger rostered sites where this a high probability for cash releasing hours. • See Appendix 2 – Service Setting and Usage of HRA Additional Hours, which shows in Table 3 that 90% of additional hours in rostered settings are cash releasing and developed further in section 3 below.
Service Context
