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Towards managing the whole system of care and improving continuity of care

  • Peter Kennedy (a1), Robert Pugh (a2) and Erville Millar (a3)
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As mental health services become more complex with additional teams, the risk of discontinuity of care for patients with complex needs may rise. Clinicians may have more difficulty in analysing the whole service picture. Hence they will be less able to contribute to the smooth running of the whole system. This paper describes how a north London trust is addressing this important challenge in straightforward and practical ways.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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British Medical Association (2004) New Roles for Psychiatrists. London: British Medical Association.
Kennedy, P. & Griffiths, H. (2001) General psychiatrists discovering new roles for a new era … and removing work stress. British Journal of Psychiatry, 179, 283285.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Towards managing the whole system of care and improving continuity of care

  • Peter Kennedy (a1), Robert Pugh (a2) and Erville Millar (a3)
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eLetters

Another meeting always answers well.

Andrew Al-Adwani, Psychiatrist
05 July 2005

Sir: I found the Kennedy, et. al.(1) article decidedly odd. Here weare painted a picture of a hyperefficient system that has brought a service from the verge of collapse two years ago to the heady hieghts of cutting edge psychiatry with the key component being a simple one hour weekly meeting. That this meeting has managed to fill 40% of its beds formore than 60 days, have patients sleeping on sun-loungers, allowed the apparently repeated unnecessary admission of patients by inexperienced SHOs and only just realised that crisis teams need out of hours cover to operate effectively, begs the question as to just what it did before the authors witnessed it's wonders of operation.

1.Towards managing the whole system of care and improving continuity of care. (2005) Kennedy P., Pugh R., and Millar E. Psychiatr Bull, 29: 252-254
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Conflict of interest: None Declared

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the Hawthorne Effect ?

David H Yates, retd psychiatrist; carer
05 July 2005

Doing something, changing something, gets early response which fades, till the next charisma comes along.That's what this paper sounds like to this domestic community carer of a family member suffering from schizophrenia.The article should wait till the changes work out - as happened before; emptying and refilling. The wheel turning.It's preventing crisis rather than responding to it that is the answer. Tomaintain improvement the longterm mentally ill need to be drawn in to theirown personal weekly diary of meaningful engagement 'outside' : say, two three sessions per week, founded on school attainment, experience and interest. It gives a direction, and basically means gathering the neurons together on a purpose, reconnecting them with outside signals to behave in sequence, confirming those habits, and holding them together. It provides breaks away from domestic tension, gives carers back a life of their own and enables carers and family to join with professionals. Aftercare of this sort is TREATMENT and should be prescribed for schizophrenia. ... More

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