Delivering for Mental Health: plan

Better management of long-term mental health conditions

The management and organisation of care has a direct impact on health outcomes. Service users should get the right care and treatment at the right time. In Delivering for Health we committed to developing standards by the end of 2007 for Integrated Care Pathways ( ICPs) for schizophrenia, bi-polar disorder, depression, dementia and personality disorder. NHS Quality Improvement Scotland ( NHSQIS) is taking this work forward in conjunction with clinicians, social care professionals, service users and others and it is expected to be complete in the Summer of 2007, ahead of schedule.

An ICP sets out the process of assessment, care and treatment for service users with similar diagnoses or symptoms. It lets service users know what they should expect from services. It should set expectations for the local management and organisation of care and act as a point of comparison for treatment and care provided. A good ICP will look beyond treating the disorder and will focus on the full range of needs and capabilities of the individual.

NHSQIS are not writing national ICPs, but are describing the functions of the services and setting standards which individual boards will need to meet to be accredited. Those standards will address the process of developing and implementing an ICP, handling information, treatment, outcomes. They will look at both research evidence and good practice in respect of each of the condition specific ICPs.

NHSQIS will work together with the implementation programme for the Delivery Plan, and in particular the improvement programme to support NHS Board areas in the preparation and implementation of local ICPs and will accredit that process. The ICP standards will have three elements: process standards for developing an ICP, care standards for the content, and the service standards for demonstrating quality improvements. These will be in place by the end of 2007.

Commitment 6:NHSQIS will develop the standards for ICPs for schizophrenia, bi-polar disorder, depression, dementia and personality disorder by the end of 2007. NHS Board areas will develop and implement ICPs and these will be accredited from 2008 onwards.

In addition to the condition specific ICPs, NHSQIS is looking at the generic elements of an ICP, in particular risk management and patient safety. A journey of care may also include an admission and discharge from hospital. This element of the work will be informed by the acute in-patient forums we are developing so that service users, carers and staff can influence the shape of their local service.

This work will be of value to the target that has been set for 'reducing the number of re-admissions (within one year) for those that have had a psychiatric hospital admission of over 7 days by 10% by the end of December 2009'. As well as this, and working alongside it will be the establishment of Acute Inpatient Forums which will help to drive the agenda around improving the therapeutic and physical environment into which people are admitted.