With the recent rise of consumerism within health care, the views of service users are becoming increasingly important. The National Service Framework for Mental Health (DoH 1999) identifies assertive outreach as a strategy to engage people with severe and enduring mental illness, who traditionally lose contact with services. Assessing the views of service users is not a new strategy for service evaluation, but in relation to assertive outreach in the United Kingdom is relatively untested. A postal client satisfaction survey was undertaken as a means of enquiry, in order to ascertain the effectiveness of the Preston Assertive Outreach service from a service user perspective after its first year of operation. The team offers a service based upon the PACT (Program of Assertive Community Treatment) model. An evaluation study of 36 questionnaires produced a return rate of 56% (21 returns). The results showed a fairly high level of client satisfaction with the service provided. Client involvement in treatment was the area of service evaluated least favourably by the service users, with General satisfaction showing the highest level of client satisfaction. From the outcome of the study it appears there are potential benefits in utilizing feedback from service users' to inform future service provision.
Can group counselling help patients who present with symptoms that cannot be explained medically? Preliminary results of working with one such group are reported. Six patients in a primary care practice were offered weekly sessions for half a year. The findings suggest that the patients attended all group sessions. The patients reported experiences known to be related to group counselling, and when the group ended, patient reports show that the severity of their problems was reduced significantly (p<.001). Furthermore, during the six months after the group ended patients significantly (p<.025) reduced their visits to their general practitioners. These results seem to call for wider use of humanistic group counselling with somatising patients and further research into the impact of such form of counselling.
Although the government of the United Kingdom strives to address the needs of individuals engaged in mental health services, its policies must, by their nature, reflect a utilitarian approach. When a client chooses to disengage from services, mental health professionals can find themselves in an ethical dilemma in which adhering to policies can lead them to hyperactive conduct, whereby the client may experience what feels more like stalking behavior than therapeutic care.
Background New European guidelines for the physiotherapy management of patients with Parkinson's disease were published in 2014. Following on from this publication it was decided to review the current physiotherapy service delivered to our patients with Parkinson's disease across both counties and develop a new pathway of care in line with the guidelines. Methods A working group of physiotherapists was selected representing acute, primary care and disability services. This group initially met to review current practice. Once the service was evaluated, the group created a new assessment form for use across all physiotherapy services in both counties using validated outcome measurements as recommended in the guidelines. A training program was put in place to improve staff's skill level in using the new assessment form and treatment methods for this client group. It was decided that a yearly assessment would now be carried out on each patient with Parkinson's disease. Feedback was sought from therapists and any issues were addressed by the working group. As part of the pathway a new Parkinson's exercise group was created which runs twice yearly in both counties. Results In 2018, 18 patients attended an exercise class in Cavan, 16 attended in Monaghan while yearly assessments were also completed. Patient feedback from the classes has been very positive and outcome measurements have shown an improvement. Patients enjoy the class setting immensely and physiotherapy staff feel their patients are benefiting from receiving a more prolonged period of intervention. Conclusion This new pathway of care has been an effective and efficient way of treating patients with Parkinson’s disease. It has led us to identify changes in disease progression in a more timely fashion. Outcome measurement is audited yearly to monitor quality of classes and benefit to patients. We will continue to highlight the pathway with new staff and monitor staff satisfaction with its use.
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