Standards and quality measures for services for people with intellectual disabilities

Current Opinion in Psychiatry

Volumn 19, Issue 5, 2006, Pages 497-501

  O'Hara, Jean ^a,b  

^a KING'S COLLEGE LONDON   (United Kingdom)

^b GUY S HOSPITAL   (United Kingdom)

Author keywords

Intellectual disabilities; Mental health; Quality; Standards

Indexed keywords

CLINICAL RESEARCH; COMMUNITY ASSESSMENT; DEINSTITUTIONALIZATION; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH PROGRAM; HEALTH SURVEY; HUMAN; INTELLECTUAL IMPAIRMENT; MEDICAL ASSESSMENT; MENTAL HEALTH SERVICE; MENTAL PATIENT; PRACTICE GUIDELINE; PRIMARY MEDICAL CARE; REVIEW;

CONTINUITY OF PATIENT CARE; GREAT BRITAIN; HEALTH SERVICES ACCESSIBILITY; HUMANS; MENTAL HEALTH SERVICES; MENTAL RETARDATION; MENTALLY DISABLED PERSONS; PHYSICIAN'S PRACTICE PATTERNS; QUALITY INDICATORS, HEALTH CARE; STATE MEDICINE;

EID: 33746758297     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.yco.0000238477.96775.16     Document Type: Review

References (44)

1. Department of Health. Building the assurance framework: a practical guide for NHS boards. London: Department of Health; 2003. Gatelog reference 1054.
2. Department of Health. Valuing people: a new strategy for learning disability in the 21st Century. London: HMSO; 2001.
3. Phillips A, Morrison J, Davis RW. General practitioners' educational needs in intellectual disability health. J Intellect Disabil Res 2004; 48 (Pt 2):142-149.
4. Kerr M. Improving the general health of people with learning disabilities. Adv Psychiatr Treat 2004; 10:200-206.
5. Wanless D. Securing good health for the whole population: final report. HM Treasury. London: RCGP; 2004. Royal College of General Practice Summary Paper 2004/02.
6. Disability Rights Commission. Equal treatment: closing the gap. Interim report of a formal investigation into health inequalities. London: Disability Rights Commission; 2005. http://www.drc-gb.org/pdf/10_752_interim_report_final. pdf [Accessed 20 June 2006] This formal investigation specifically addresses health inequalities experienced by people with disabilities, PWID, people with mental health problems and people with intellectual disabilities and mental health problems. Due out in summer 2006, it has the potential to lobby for significant change.
7. Baxter H, Lowe K, Houston H, et al. Previously unidentified morbidity in patients with intellectual disability. Br J Gen Pract 2006; 56:93-98.
8. Department of Health. New GMS contract 2003: supplementary documents; 2003. http://www.dh.gov.uk/assetRoot/04/07/88/86/04078886.pdf. [Accessed 11 March 2006]
9. Ford S. QOF now a political football, claim GPs. Doctor: working for general practitioners; 2006. p. 3.
10. Lindsay P, Burgess D. Care of patients with intellectual or learning disability in primary care: no more funding so will there be any change? [editorial] Br J Gen Pract 2006; 56:84-86.
11. Department of Health. Modernising the care programme approach. London: HMSO; 2000.
12. Roy A. The care programme approach in learning disability psychiatry. Adv Psychiatr Treat 2000; 6:380-387.
13. Department of Health. The government's annual report on learning disability 2005: valuing people: making things better. UK: HM Government; 2005.
14. Valuing People Support Team. New ways of working in health services for people with learning disabilities: a resource guide for people who commission and deliver health services for people with learning disabilities. Paper 2; 2005. http://www.valuingpeople.gov.uk/documents/HealthNewWaysResource.pdf. Explores roles and functions of dedicated professionals and teams; requires clinical governance to be at the heart of the quality agenda for local learning disabilities partnership boards; and focuses on explicit statements and expectations about meeting mental health needs.
15. Robertson J, Emerson E, Hatton C, et al. The impact of person centered planning: health. Lancaster University: Institute of Health Research; 2005. Two-year evaluation looking at quality-of-life experiences in four localities in England. Results may not be generalizable, but researchers did use multiple methods of investigation, including informant questionnaires, qualitative interviews and organizational analysis.
16. Prime Minister's Strategy Unit. Improving the life chances of disabled people. Final Report, January 2005. A joint report with Department of Work and Pensions, Department of Health, Department of Education and Skills, Office of the Deputy Prime Minister. London: HSMO; 2005.
17. Department of Health. Individual budgets - background and position paper. London: Department of Health, Older People and Disability Division; 2005.
18. Duffy S. In Control: an exploration of the advantages of individual budgets for disabled people and some of the challenges for implementation; 2005. http://www.in-control.org.uk/ic-issues.html/individual_budgets.pdf. [Accessed 29 March 2006] Currently restricted to social care, this discussion paper illustrates with case studies, how individual budgets might work in practice for people with the most complex needs.
19. Department of Health. Standards for better health. London: HMSO; 2004.
20. Healthcare Commission. Understanding the standards. London: HCC; 2004. www.healthcarecommission.org.uk.
21. Healthcare Commission. State of healthcare. London: HCC; 2005. www.healthcarecommission.org.uk.
22. Healthcare Commission. Draft three year strategic plan for adults with learning disabilities 2006-2009: consultation November 2005. London: HCC; 2005. www.healthcarecommission.org/uk/_db/_documents/04021628.pdf. [Accessed 20 June 2006] To address the lack of health targets within 'Valuing People', the HCC has published six strategic goals relevant to intellectual disabilities. It will be interesting to see if the issue of specialist mental health provision is adequately addressed in the final report.
23. Crump B, Whitty P. The 'Better Metrics' Project, Version 6, March 2005. UK: Department of Health; 2005. www.osha.nhs.uk. A pragmatic and evolving project between national clinical directors and Department of Health policy teams, aimed at developing more clinically relevant measures of performance, which will ultimately influence annual quality targets set by the HCC. Issues for PWID are addressed within specific chapters on health inequalities, intellectual disabilities, mental health and patient experience.
24. Jaydeokar S, Piachaud J. Out-of-borough placements for people with learning disabilities. Adv Psychiatr Treat 2004; 10:116-123.
25. Department of Health. Commissioning service close to home: note of clarification for commissioners and regulation and inspection authorities; 2005. http://www.dh.gov.uk/assetRoot/04/09/33/23/04093323.pdf [Accessed 22 June 2006]. Clarifies government policy so that regulatory and inspection bodies can challenge concerns given the increasing number and size of independent hospital provision for PWID, often many miles away from families and originating authorities; encourages local solutions and increased local capacity to meet needs.
26. Ritchie F, Goodman N, Nix J, Bowyer A. 'Out of Area, Out of Sight?' Review of out of area placements arrangements made by social services and health for people with learning disabilities from the West Midlands. NHS, Birmingham and the Black Country Strategic Health Authority, and West Midlands Strategic Health Authority; 2005. Does not directly compare quality of OOA to local placements, but suggests specific actions that can create cost-effective solutions and reverse the trend of increasing OOA placements, which has increased four-fold in 10 years in the area.
27. Shuwa A, Fitzgerald B, Clement C, Grant D. Children with learning disabilities and related needs placed out of borough: parents' perspective. Psychiatr Bull 2006; 30:100-102.
28. Department of Health. A National Service Framework for mental health. London: HMSO; 1999.
29. Appleby L. A new mental health service: high quality and user-led [editorial]. Br J Psychiatry 2000; 177:290-291.
30. Greig R, Valuing People Support Team. Improvement, expansion and reform: ensuring all means all. Department of Health, London: HMSO; 2002; www.valuingpeople.gov.uk/documents/AllmeansAll.doc.
31. CRD Report 21: scoping review of the effectiveness of mental health services; 2001. UK: Centre for Reviews and Dissemination, The University of York. http://www.york.ac.uk/inst/crd/report21.htm [updated 17 January 2006].
32. Department of Health/National Institute of Mental Health in England. Green light for mental health: how good are your mental health services for people with learning disabilities? A service improvement tool. Department of Health, National Institute of Mental Health in England and the Valuing People Support Team; 2004. http://www.valuingpeople.gov.uk/documents/ MentalHealthGLGuide.pdf.
33. Healthcare Commission. Key targets and performance indicators for mental health trusts and providers of mental health services. London: Healthcare Commission; 2005. For the first time, tries to close the divide between mental health trusts, primary care trusts, learning disability trusts and other organizational combinations - explicitly states that standards apply to all who provide mental health services.
34. Department of Health. Delivering race equality in mental healthcare: an action plan for reform inside and outside services, and the government's response to the independent inquiry into the death of David Bennett. London:HMSO; 2005. This includes a 5-year action plan for addressing the inequalities for black and minority ethnic patients' access to, and experience of, and outcome measures for mental health services. It focuses on achieving quality and tackling discrimination and concentrates on more appropriate and responsive services, community engagement and better informatics.
35. Mental Health Act Commission. National Mental Health and Ethnicity Census: England and Wales. Data capture protocol VI. Ref: ROCR/OR/0140/001 Mental Health Act Commission, Nottingham; 2006. http://www.mhac.org.uk/census. Originally a tool for tackling inequalities in access and outcomes for mental health service users from black and minority ethnic communities. This second dataset will include not only all inpatients in the NHS and independent mental health provision, but for the first time PWID in all mental health facilities and residential settings run by the NHS/Care Standards, thus providing a benchmark and a means of measuring change.
36. Bouras N, Holt G. Mental health services for adults with learning disabilities. Br J Psychiatry 2004; 184:291-292.
37. Royal College of Psychiatrists. Meeting the mental health needs of adults with mild learning disabilities. London: Royal College of Psychiatrists; 2004. Council Report 115.
38. National Patient Safety Agency. Listening to people with learning difficulties and family carers talk about patient safety. UK: National Patient Safety Agency; 2004. www.npsa.nhs.uk.
39. National Patient Safety Agency. Understanding the patient safety issues for people with learning disabilities. UK: National Patient Safety Agency; 2004. www.npsa.nhs.uk.
40. Health and Social Care Information Centre. Adults with learning difficulties in England 2003/4: full report. UK: NHS, Health and Social Care information Centre; 2005. The first large-scale survey of its kind in England. Although the content may not be new, the issues are powerfully presented when they come from personal experiences; the survey addresses not only the impact of intellectual disabilities, but environmental disadvantage, personal safety, ethnic minority issues, mental and physical health and high support needs.
41. Kendall T, Pilling S, Pettinari C, Whittington C. Clinical guidelines in mental health I: The National Collaborating Centre for Mental Health. Psychiatr Bull 2004; 28:156-159.
42. National Health Service. Our Health, Our Care, Our Say: a new direction for community services. Government white paper. England: HMSO; 2006.
43. Goodman M. Defending referrals between consultants. BMJ 2006; 332:371.
44. British Medical Association News. The Centers of Controversy: are referral management centers really an aid to patients and the NHS? BMA News 11 March 2006; 8-9. Referral management schemes (RMC) were established as a means of auditing GP referrals to see whether some elective treatments could be done outside of hospital care. This paper reports that these schemes are being used to ration services and delay treatments until patients are set to breach waiting time targets and that RMCs are redirecting referrals for nonclinical reasons.