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Workshop – Update on Standards for Integrated Care Pathways

Workshop – Update on Standards for Integrated Care Pathways. Scottish Personality Disorder Network SECC, 13 September 2007. Rosie Cameron National ICP Coordinator NHS Quality Improvement Scotland. Summary of consultation comments Specific BPD comments Restructuring of the standards

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Workshop – Update on Standards for Integrated Care Pathways

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  1. Workshop – Update on Standards for Integrated Care Pathways • Scottish Personality Disorder Network • SECC, 13 September 2007 • Rosie Cameron • National ICP Coordinator • NHS Quality Improvement Scotland

  2. Summary of consultation comments • Specific BPD comments • Restructuring of the standards • Amendments to standards • Discussion Overview of Presentation

  3. Consultation on Draft Standards

  4. Supportive of approach (frequent) • ICPs require IT system for sharing information and for variance reporting (frequent) • Implementation of ICPs is a large volume of work, so should be staged (frequent) • ICPs require extra resource to implement (frequent) • ICPs are the wrong approach totally in mental health (one or two) Comments on approach

  5. Document difficult to read and too much medical jargon (frequent) • Not clear how references were selected and evaluated (occasional) • Accreditation timescale too short and needs to take into account local circumstances (occasional) • Criteria for initiating ICP need to be clear (occasional) • Should promote a stepped care model of care for all conditions (occasional) Comments on document

  6. Dividing the pathways into 5 diagnostic groups is not helpful • Best not to recommend specific outcome measure tools • Importance of comorbidity not tackled (alcohol, drugs, Learning Disability) • Psychological therapies: need a consistent approach • Too medical a model is being used • Recovery focus does not come through Standards general comments

  7. Why “borderline” only • Maybe call ICP “challenging behaviour” • Not helpful to make & give diagnosis • Bring forward appendices into standards • No evidence, so there should not be an ICP BPD standards

  8. IT systems & extra resources needed • Too medical • Difficult to read / navigate • Dividing into 5 ICPs not helpful • Concern over being too prescriptive on outcome tools • Length of time to diagnosis Overall Summary

  9. Reflecting on comments from consultation • Internal work • Restructuring to address concerns • Content of standards altered via recommendations from the subgroup The way forward

  10. BPD Dementia Bipolar Depression Schizophrenia Assessment Care Planning Care Delivery Outcomes Generic

  11. Generic Mental Health ICP standards

  12. BPD Mental Health ICP standards

  13. Service standards Level 4: National Performance Management & Governance Level 3: NHS Board and LA Level 2: Local management teams Local ICP Level 1: variance leading to individual care redesign Management of variance / decision making Process Standards Assessment Mechanism for tracking variations from plan Care standards Outcomes Care Planning Care Delivery information information

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