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Service Improvement
Clinical Decision Making Skills for the Integrated Worker

This assignment will define and analyse the need for a chosen service improvement within the pathway of mental health, as well as evaluating the suggested service. Demonstrating how this service can inform and benefit integrated practice, discussing the ways in which the agency’s statutory obligations and responsibilities impact on both individual and group decision making. The chosen service improvement for this assignment is the introduction of a mental health nurse into primary care services, for example, a GP Surgery. Focusing on service users with mental health issues in the community and therefore in the care of the local Primary Care Trust (PCT).
There is an obvious need for movement towards better health and social care for individuals with mental health illnesses in primary care. No Health without Mental Health: A Guide for General Practice (Department of Health, DoH, 2012, online), sets out what General Practitioners (GPs) can do to improve mental health and enhance care and support offered to those with mental health conditions in the community. This document also states that one in four GP consultations account for mental health problems (DoH, 2012, pg8, online). Treatments for those with mental health issues cost the NHS in the United Kingdom approximately £105 Billion per year (DoH, 2012, pg8, online). Primary care plays a pivotal role in caring for those with mental health illnesses in the community and in most cases this falls into the responsibility of the local GP surgeries. Therefore GPs are ideally placed to identify signs of distress and those with risk factors for poor mental health (NHS Confederation, 2011, online). Primary care providers, more specifically GPs are usually the first point of call for an individual experiencing some form of psychological distress (DoH, 2012, pg13, online). It is essential there is early recognition and referral to any specialist mental health



References: Barbour, A. (1995); Caring for Patients: A Critique of the Medical Model. California, Sanford University Press. Estroff, J. (2010); Effective teamwork: Practical; lessons from organisational research. London: Blackwell Publishing. Hall, A. Wren, M & Kirby, S. (2010); Care planning in mental health: Promoting recovery. Blackwell Publishing. Oxford. Kettles, A. Woods, P & Collins, M. (2002); Therapeutic interventions for forensic mental health nurses. London: Jessica Kingsley Publications. Malin, N. Manthorpe, J, Race. D & Wilmot, S. (1999); Community care for nurses and the caring professions. Philadelphia: Open University Press. Nash, M Newell, R. & Gournay, K. (2009); Mental Health Nursing; An evidence based approach. Philadelphia: Churchill Livingstone Elsevier. Norman, R. & Ryrie, I. (2009); The Art and Science of Mental Health Nursing: A textbook of principles and practice. Berkshire: Oxford University Press. Trevithick, P. (2009); Social work skills: A practice handbook. (2nd Edition). England: Oxford University Press. Wilson (1997); Cited in; Handy, C Care Service Improvement Partnership (2006); Designing Primary Care Mental Health Services: Guidebook. London: DoH. Department of Health, (2012); National Service Framework: standards for mental health. London: DoH. Accessed 01/02/2013 Department of Health, (2012); No Health without Mental Health: A Guide for General Practice Department of Health, (2011); Health And Social Care Bill Factsheet. C3 London: DoH. Department of Health, (2011); No Health without Mental Health: A cross government mental health outcomes strategy for people of all ages- a call to action. London: DoH. Department of Health, (2011); The NHS Outcomes Framework 2012/13 Department of Health. (2009); Response to Consultation on the Framework for Registration of Health and Adult Social Care Providers and Consultation on Draft General Medical Council (GMC). (2009); Licensing and Revalidation. www.gmc-uk.org/about/reform/index.asp Gregory, S. (2009); General Practice in England: An overview. London: The Kings Fund. http://www.kingsfund.org.uk/sites/files/kf/General-practice-in-England-an-overview-Sarah-Gregory-The-Kings-Fund-September-2009.pdf Accessed on 28/01/2013 The Health and Social Care Act (2012) Knapp, M., MacDaid, D. & Parsonage, M. (2011); Mental Health Promotion and Mental Illness Prevention: The Economic case.London: DoH. http://eprints.lse.ac.uk/32311/1/Knapp_et_al__MHPP_The_Economic_Case.pdf Mental Health Act (2007).

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