Maintaining an Established Family Intervention Service

1. Maintaining an Established Family Intervention Service Mike Kelly Consultant Nurse Dorset Healthcare NHS Trust/Bournemouth University

4. History of Service • Established 1996 • Stand alone service • One day a week • 2 practitioners = 2 CMHT’s • No direct funding • More practitioners = Trust wide

5. Service Model • Kuipers, Leff & Lam (1992) • Co-working • Highly specific • Information sharing • Structured family approach • CBT strategies

6. Current Situation • 26 (14) Trained Practitioners in PSI • Family Intervention • Multi Carer Support Groups x 3 • Strong links with EDMHCF • Richmond Fellowship Course for Carers & Carers Support Group • An evening with ….

7. Barriers • Integration with workload • Time to carry out family intervention • Integration with personal commitments • Availability of time in lieu • Long term commitment to families • Crisis with other clients Kavanagh et al 1993; Fadden 1997

8. . • What Strategies have assisted in maintaining the Service?

9. Trust Service Strategy • PSI Training & Implementation Strategy • Consultation process • Agreed by management, clinicians, chief executive & Trust Board • Family Intervention one strand • Practitioners co-opted into FI service • Strategy & service co-ordinated by senior clinician

10. Practitioners • Practitioners embedded in different service settings • Occupational therapy, Psychology, Nursing, Social Care, Psychiatry • Well established in Trust • Small number with young families

11. Practitioners • 3 Senior Practitioners involved in training • Mix co-workers • Breaks from evening visits • Time in lieu – self managed

12. Supervision • Monthly Peer Supervision • Viewed as essential part of service • Detailed presentation of one family • Discuss other issues around families • Use of role play • Structured feedback

13. Role of Families/Carers • Information leaflets developed • Evaluation of sessions shapes service • Suggestions on improving the service post FI • Co-run services • Involved in interviewing, training & supervision of PSI students

14. Other Service Strategies • Regular open days • Trust Induction of new staff • Talk at SPR, SHO induction • Feedback of audit to teams i.e referral rates, outcomes etc • Attendance ward rounds, CPA reviews, MDT meetings

15. Other Service Drivers • 3 star Trust • Complimentary letters from families to Chief Executive • Features in Trust newsletter • Annual report to Trust Board • Medical Director keen supporter

16. Feedback & Evaluation • Families evaluate every session • Themes raised addressed • Annual service audit with carer • Linked in with Trust governance structures

17. Networking • Burbach, Stanbridge - Somerset • Smith, Duhig - Avon • Gamble - London • Fadden, Smith, Woodhams – West Midlands • Sin, Moone - Berkshire

19. Review with Teams Issues • Widen service beyond psychosis • More than one day per week • Take on care co-ordination role

20. Future Consultation process on future of service • Locality based? • Development of Buddy system? • Training of practitioners? • Re-define Strategy in line with agreements

21. Summary • Maintaining Family Intervention Service is multi-faceted • Service strategy has been a good framework • Service needs promoting at all levels • Involvement of families/carers is crucial