NHS Borders. Intensive Psychiatric Care Units

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "NHS Borders. Intensive Psychiatric Care Units"

Transcription

1 NHS Borders Intensive Psychiatric Care Units Service Profile Exercise ~ November 2009

2 NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity. We have assessed the performance assessment function for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. For this equality and diversity impact assessment, please see our website ( The full report in electronic or paper form is available on request from the NHS QIS Equality and Diversity Officer. NHS Quality Improvement Scotland 2009 First published November 2009 You can copy or reproduce the information in this document for use within NHSScotland and for educational purposes. You must not make a profit using information in this document. Commercial organisations must get our written permission before reproducing this document. Information contained in this report has been supplied by the NHS board concerned, unless otherwise stated, and is believed to be reliable on publication. =

3 Contents Background 1 1 Overview of local mental health services 3 2 Intensive psychiatric care unit provision Admission to IPCU Model of care provision Discharge from IPCU 5 3 Demographics Numbers of IPCU admissions Nature of admissions Management of other population groups 6 4 Links with other secure mental health provision 7 5 Governance arrangements 7 6 Plans for service development 7 7 Other points to note 7 Appendix 1 Glossary of abbreviations 8 = =

4 Background The Scottish Government s national mental health benchmarking project (January 2008) defined intensive psychiatric care units (IPCUs) as: a multi-disciplinary team with specialised training; the ratio of nursing staff will be higher than a general psychiatric ward. The service is recovery focused; it provides intensive treatment and interventions to patients who present an increased level of clinical risk and require an increased level of observation. (Technical Appendix, January 2008). The National Mental Health Services Assessment: Towards implementation of the Mental Health (Care and Treatment) (Scotland) Act 2003 (March 2004) Report highlighted specific challenges faced by IPCUs in light of changes in mental health legislation. In particular, the report outlines the dual function often ascribed to IPCUs where they function as both a low level secure forensic unit and as an extension of general adult inpatient psychiatric services. This is further complicated by the need for appropriate care environments for females, adolescents, older adults and those with learning disabilities. The report concludes that IPCU provision is a small but important part of services and should remain central to planning decisions when implementing the [Mental Health (Care and Treatment) (Scotland)] Act. Introduction to the IPCU project There is very little published UK data about IPCUs. The NHS Quality Improvement Scotland (NHS QIS) 3-year strategic work programme, Improving the Quality of Mental Health Services, recognised this and included a commitment to undertake an audit of IPCUs in Scotland. Before undertaking any work to assess how services are delivered within IPCUs, it is important that we have a clear picture of: how many IPCUs there are across Scotland the arrangements in place in NHS board areas that do not have local IPCU provision how the IPCUs are structured and staffed the relationships between IPCUs and other mental health services, and the referral pathways both in and out of IPCUs. In order to gather this background information it was agreed that the IPCU project would be delivered in two distinct stages. Stage 1 is a national service profiling exercise covering all of the territorial NHS boards in Scotland. In a parallel piece of work during Stage 1, the views and experiences of people who have received IPCU care and their informal carers will be sought. This work is being supported by Better Together, Scotland s national patient experience programme and is being delivered in collaboration with the Mental Welfare Commission for Scotland. 1

5 This report contains the service profiling information. The user and carer experience information will be included in a national overview report alongside the service profile information. The national overview will be published in spring 2010 and will give a full representation of the national picture from both the perspective of those who provide services, and those who use them. The service profiling findings along with the views and ideas of service providers and service users and carers that have been sought and captured during Stage 1 of the project will inform the detail of Stage 2. The service profiling process has two key parts: local information gathering and follow-up meetings. Using a service profiling questionnaire produced by NHS QIS, each NHS board gathered information on the IPCUs in its local area. These data were submitted, together with supporting evidence if applicable, to NHS QIS prior to the follow-up meetings. Follow-up meetings were held with local staff between May July 2009 to discuss the responses provided by the NHS board and seek clarification on any issues. This report presents the information supplied in the service profile form and the discussions at the follow-up meeting with NHS Borders on 18 June

6 1 Overview of local mental health services The Borders is situated in south east Scotland and has a population of around 116,000. The majority of the population live in rural areas, and the largest towns in the region are Galashiels and Hawick. With approximately 350 staff and an annual operational budget of 13 million, NHS Borders mental health service provides treatment in a variety of settings including: consultant-led community mental health teams (CMHTs); a range of community, day and residential facilities; and inpatient services. Adult mental health services have undergone a period of development following the review of services previously provided at Dingleton Hospital, Melrose. The adult mental health services consist of the west, east and south CMHTs, based in Melrose, Duns and Hawick respectively. There are also day services attached to these teams. The CMHTs accept referrals of adults (16 69 years) who present with a range of acute psychiatric disorders, including major mental illness, severe adjustment disorders, and emotional and behavioural disturbances requiring psychiatric assessment. Referrals of more specialist patient groups such as dual diagnosis and eating disorders are also accepted. NHS Borders CMHTs provide an assessment and treatment service, mostly in people s own homes or a community setting of their choice. In addition, there is a crisis team which provides safe and effective community-based assessment, treatment and social interventions as an alternative to inpatient care. A range of inpatient mental health care is provided at a number of sites across the NHS board area including: Borders General Hospital, Melrose East and West Brig, Galashiels Galavale House, Galashiels, and Huntlyburn House, Melrose. Huntlyburn House provides specialist care for adults (16 years and over), who are experiencing an acute phase of their mental illness. Practice in this unit is based upon collaborative participation across all disciplines. East and West Brig provides inpatient care for adults with enduring mental health needs who require rehabilitation on a short or medium-term basis. This would include patients in the acute phase of their illness and those presenting with high risk behaviours. Galavale House also provides rehabilitation beds. 3

7 Acute mental health and rehabilitation services are provided as follows. NHS Borders East and West Brig Number of beds Mental health rehabilitation 17 Galavale House Number of beds Mental health rehabilitation 9 Huntlyburn House Number of beds Acute mental health care 30 2 Intensive psychiatric care unit provision NHS Borders does not have an IPCU. There is a service level agreement in place between NHS Borders and NHS Lothian for the provision of secure services including IPCU care. NHS Borders does not have any assigned IPCU beds within NHS Lothian. Each proposed transfer is negotiated as it arises and admission is dependent on there being an available bed at the time. Patients in need of this level of care would normally be transferred to St John s Hospital, Livingston. If St John s Hospital is unable to admit the patient due to lack of available beds, NHS Borders would next contact the IPCU at the Royal Edinburgh Hospital. Referrals from NHS Borders would be considered for admission in the same way as a referral from within the NHS Lothian board area. 2.1 Admission to IPCU Admissions to the IPCU at St John s Hospital are routed approximately 50:50 through Huntlyburn House and East and West Brig. In crisis situations, patients may also be admitted directly from other units in NHS Borders. NHS Borders follows the set protocols within the psychiatric emergency plan (PEP) and transport plan when transferring patients to St John s Hospital. Discussion would take place between the referring consultant from NHS Borders and either a member of the medical team or a suitably experienced trained nurse from NHS Lothian s IPCU. On the rare occasion that both of the NHS Lothian IPCUs are at capacity, a patient may be transferred to the nearest IPCU facility with an available bed. Within the past year, a small proportion of patients have required to be transferred to an IPCU outwith the NHS Lothian area. NHS Borders acknowledged the risks and difficulties associated with the transfer of acutely unwell patients out-of-area. The risks include disturbance and distress for the patient often sustained over significant time due to the distance between units, transfer of patients who may be heavily sedated and the additional complications of transfers at night. NHS Borders reported that it can be difficult to identify escorts to accompany patients. The requirement to provide staff to escort transfers can also cause significant staff pressures for the acute services, particularly during out-of-hours periods. 4

8 Any patients requiring admission to IPCU out-of-hours would be managed by Huntlyburn House in liaison with the crisis team. Staff in NHS Borders acknowledged that the risk management policy could be improved through greater flexibility with the organisations involved in transporting patients such as the Scottish Ambulance Service (SAS) and the local constabulary. Example of a local initiative NHS Borders staff, and staff from Lothian and Borders Police, receive joint training to ensure that anyone involved in a patient transfer is aware of the risks involved and the procedures to follow in the event of an emergency. 2.2 Model of care provision For patients who are transferred to the IPCU at St John s Hospital or to another unit out-of-area, the model of care delivery would be such as is employed by that unit. NHS Borders staff maintain regular telephone contact with staff at the receiving IPCU while the patient is a resident there. 2.3 Discharge from IPCU There is no formal policy in place for the discharge of patients from IPCU. In practice, this is managed on a case-by-case basis. Prior to discharge, a minimum of two members of staff from NHS Borders (usually the responsible medical officer and a nurse) would meet with IPCU staff and personally review the patient at St John s Hospital. The purpose of this meeting is to ensure that the final assessment is consistent with the type of care that NHS Borders is able to provide for the patient at whichever inpatient unit they will be returning to. This meeting is particularly important for patients returning to Huntlyburn House given its isolated location and the client group normally resident there, which includes potentially vulnerable patients. At the time of the service profiling exercise, NHS Lothian was developing a single operational policy to inform the admission and discharge process for patients from NHS Borders. NHS Borders will be involved in the consultation on the draft policy and the final version will be shared when complete. NHS Borders reported that more involvement and consultation around the development of IPCU policies would be welcomed, and that joint working in this area, for example around development of a shared care pathway for transfer, would be of benefit. 3 Demographics The total adult population aged in Borders is approximately 88,000. 5

9 3.1 Numbers of IPCU admissions NHS Borders reported that in 2008 there had been 11 out-of-area IPCU admissions; two patients who were admitted more then once are included in this total. The majority of these admissions were to the IPCUs within NHS Lothian; other patients had been admitted to IPCUs at Stratheden Hospital in Fife, and Leverndale and Gartnavel Hospitals in Glasgow. 3.2 Nature of admissions The 11 admissions to IPCU out-of-area can be broken down as follows. IPCU admissions to NHS Borders in 2008 Age Under Over 65 Gender Male Female Ethnicity White Scottish Not known/specified Detention status Civil law Criminal law Informal (elective) Out-of-area admissions Formal agreement No formal agreement Management of other population groups NHS Borders highlighted the particular difficulties sometimes posed by older adolescents who are too complex and/or too high risk to be managed within child and adolescent mental health services. There have been occasions where young people under the age of 18 have been admitted, via Huntlyburn House, to the IPCU at St John s Hospital. NHS Borders does not have a discrete learning disability inpatient facility. As a result, people presenting with mild learning disabilities and mental health problems may occasionally be considered for admission to Huntlyburn House if no alternative bed is available through the South East Scotland Learning Disability Managed Clinical Network. Regular communication with the learning disability nursing staff and consultants would be paramount during these periods of stay at Huntlyburn House. NHS Borders highlighted the difficulties of managing this client group. Admission to Huntlyburn House is not ideal, however there is no other inpatient facility in NHS Borders specifically for people with learning disabilities. Forensic patients stepping down from high security facilities would generally be admitted to the Orchard Clinic, Edinburgh, in the first instance. Patients stepping down from medium secure care would return directly to NHS Borders. 6

10 4 Links with other secure mental health provision Forensic patients from NHS Borders would be transferred to the Orchard Clinic. 5 Governance arrangements Clinical governance issues relating to mental health services are usually raised and discussed at clinical management level. There is a mechanism for raising governance issues at NHS board level and at the time of the service profiling exercise, wider operational transport issues relating to the SAS were being discussed. NHS Borders reported that there had been no occasions where governance issues relating directly to IPCUs had required to be discussed at the NHS board clinical governance committee. There is ongoing engagement with all stakeholders including SAS, patients and carers on the current version of the PEP, which was implemented 3 years ago and is due for review in summer Borders Voluntary Care Forum has close links to the acute in patient mental health services at Huntlyburn House. 6 Plans for service development There are plans to improve communication with transport services to ease the process of transferring patients to NHS Lothian; however, the logistical issues of transfer remains an outstanding issue for NHS Borders patients in need of IPCU care. NHS Borders is to be involved in the consultation on the NHS Lothian operational policy for IPCU. 7 Other points to note It was acknowledged that there are difficulties around the risk assessment process for both admissions to and discharges from IPCU. In particular, issues with the robustness of the risk assessment prior to transfer back to NHS Borders was identified as an area where further developments could be made. Staff identified additional support, perhaps in the form of an outreach support worker or from a regional network, to assist in developing this part of the service. 7

11 Appendix 1 Glossary of abbreviations Abbreviation CMHT IPCU NHS NHS QIS PEP SAS SLA community mental health team intensive psychiatric care unit National Health Service NHS Quality Improvement Scotland psychiatric emergency plan Scottish Ambulance Service Service level agreement 8

Intensive Psychiatric Care Units

Intensive Psychiatric Care Units NHS Highland Argyll & Bute Hospital, Lochgilphead Intensive Psychiatric Care Units Service Profile Exercise ~ November 2009 NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity.

More information

Intensive Psychiatric Care Units

Intensive Psychiatric Care Units NHS Tayside Carseview Centre, Dundee Intensive Psychiatric Care Units Service Profile Exercise ~ November 2009 NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity. We have

More information

Managing deliberate self-harm in young people

Managing deliberate self-harm in young people Managing deliberate self-harm in young people Council Report CR64 March 1998 Royal College of Psychiatrists, London Due for review: March 2003 1 2 Contents Background 4 Commissioning services 5 Providing

More information

Community Mental Health Teams (CMHTs)

Community Mental Health Teams (CMHTs) Community Mental Health Teams (CMHTs) Community Mental Health Teams (CMHTs) support people living in the community who have complex or serious mental health problems. Different mental health professionals

More information

THE ROLE OF COMMUNITY MENTAL HEALTH TEAMS IN DELIVERING COMMUNITY MENTAL HEALTH SERVICES

THE ROLE OF COMMUNITY MENTAL HEALTH TEAMS IN DELIVERING COMMUNITY MENTAL HEALTH SERVICES THE ROLE OF COMMUNITY MENTAL HEALTH TEAMS IN DELIVERING COMMUNITY MENTAL HEALTH SERVICES Interim Policy Implementation Guidance and Standards [July 2010] - 1 - CONTENTS 1. Introduction... 3 2. The guiding

More information

Grampian University Hospitals NHS Trust. Local Report ~ February Older People in Acute Care

Grampian University Hospitals NHS Trust. Local Report ~ February Older People in Acute Care Grampian University Hospitals NHS Trust Local Report ~ February 2004 Older People in Acute Care NHSScotland Board Areas 13 12 15 1 Argyll & Clyde 2 Ayrshire & Arran 3 Borders 9 7 4 Dumfries & Galloway

More information

THE STATE HOSPITALS BOARD FOR SCOTLAND. The Care Programme Approach (CPA) A policy for the care and treatment planning of patients.

THE STATE HOSPITALS BOARD FOR SCOTLAND. The Care Programme Approach (CPA) A policy for the care and treatment planning of patients. THE STATE HOSPITALS BOARD FOR SCOTLAND The Care Programme Approach (CPA) A policy for the care and treatment planning of patients. Policy Reference Number Lead Author Contributing Authors CP12 Issue: 2

More information

Child & Adolescent Mental Health Services in NHS Scotland

Child & Adolescent Mental Health Services in NHS Scotland Publication Report Child & Adolescent Mental Health Services in NHS Scotland Workforce Information as at 31 st December 2014 24 th February 2015 A National Statistics Publication for Scotland Contents

More information

Child & Adolescent Mental Health Services in NHS Scotland

Child & Adolescent Mental Health Services in NHS Scotland Publication Report Child & Adolescent Mental Health Services in NHS Scotland Workforce Information as at 31 st March 2015 26 th May 2015 A National Statistics Publication for Scotland Contents Contents...

More information

Child & Adolescent Mental Health Services in NHSScotland

Child & Adolescent Mental Health Services in NHSScotland Publication Report Child & Adolescent Mental Health Services in NHSScotland Workforce Information as at 31 December 2015 23 February 2016 A National Statistics Publication for Scotland Contents Contents...

More information

CARERS WELCOME PACK COMMUNITY MENTAL HEALTH DIVISION

CARERS WELCOME PACK COMMUNITY MENTAL HEALTH DIVISION CARERS WELCOME PACK COMMUNITY MENTAL HEALTH DIVISION Contents WELCOME CARE, TREATMENT AND SUPPORT FOR SERVICE USERS CARER S SUPPORT NATIONAL AND LOCAL CARERS SERVICES CARING IN A CRISIS INFORMATION SHARING

More information

Integrated Care Pathways for Child and Adolescent Mental Health Services. Final Standards June Evidence

Integrated Care Pathways for Child and Adolescent Mental Health Services. Final Standards June Evidence Integrated Care Pathways for Child and Adolescent Mental Health Services Final Standards June 2011 Evidence Healthcare Improvement Scotland is committed to equality and diversity. We have assessed these

More information

The Community Crisis House model

The Community Crisis House model An evaluation of Wales first crisis house If it had not been for the Crisis House staff I honestly don t think I would still be here. I can t thank you enough for all your help. I now feel that I actually

More information

A Participation Standard for the NHS in Scotland Standard Document

A Participation Standard for the NHS in Scotland Standard Document A Participation Standard for the NHS in Scotland Standard Document Scottish Health Council Scottish Health Council 2010 Published August 2010 ISBN 1-84404-916-7 You can copy or reproduce the information

More information

Table of Contents. ...ensure carers are recognised and treated as key partners... Foreword Introduction... 3

Table of Contents. ...ensure carers are recognised and treated as key partners... Foreword Introduction... 3 DUNDEE CARERS STRATEGY 2008-2011 ...ensure carers are recognised and treated as key partners... Table of Contents Page Foreword... 2 Introduction... 3 Who is a Carer?... 3 Partnership Working... 3 Carers

More information

Mental Health Crisis Care: Essex Summary Report

Mental Health Crisis Care: Essex Summary Report Mental Health Crisis Care: Essex Summary Report Date of local area review: Onsite 16-17 December 2014 Date of publication: June 2015 This inspection was carried out under section 48 of the Health and Social

More information

Child & Adolescent Mental Health Services Workforce in NHSScotland

Child & Adolescent Mental Health Services Workforce in NHSScotland Publication Report Child & Adolescent Mental Health Services Workforce in NHSScotland Workforce Information as at 31 March 2016 Publication date: 07 June 2016 A National Statistics Publication for Scotland

More information

Meadows Male, Meadows Female, Balcarres Male and Balcarres Female wards; Royal Edinburgh Hospital, Morningside Terrace, Edinburgh, EH0 5HF

Meadows Male, Meadows Female, Balcarres Male and Balcarres Female wards; Royal Edinburgh Hospital, Morningside Terrace, Edinburgh, EH0 5HF Mental Welfare Commission for Scotland Report on announced/unannounced visit to: Meadows Male, Meadows Female, Balcarres Male and Balcarres Female wards; Royal Edinburgh Hospital, Morningside Terrace,

More information

Unless this copy has been taken directly from the Trust intranet site (Pandora) there is no assurance that this is the most up to date version

Unless this copy has been taken directly from the Trust intranet site (Pandora) there is no assurance that this is the most up to date version Policy No: MH27 Version: 2.0 Name of Policy: Care Programme Approach & Care Co-ordination Effective From: 25/08/2015 Date Ratified 24/07/2015 Ratified Mental Health Committee Review Date 01/07/2017 Sponsor

More information

SUBJECT: MONITORING OF HEALTH CARE CONTRACTS WITH INDEPENDENT SECTOR PROVIDERS

SUBJECT: MONITORING OF HEALTH CARE CONTRACTS WITH INDEPENDENT SECTOR PROVIDERS Meeting of Lanarkshire Board Lanarkshire Board Kirklands 28 th September 2011 Fallside Road Bothwell G71 8BB Telephone 01698 855500 www.nhslanarkshire.org.uk SUBJECT: MONITORING OF HEALTH CARE CONTRACTS

More information

Decision-making and mental capacity

Decision-making and mental capacity 1 2 3 NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE DRAFT GUIDELINE 4 5 Decision-making and mental capacity 6 7 8 [Issue date: month/year] Draft for consultation, December 2017 Decision-making and

More information

AIMS Rehab Annual Report Editors: Hannah Rodell and Kanza Raza. Published: May Publication Number: CCQI 230

AIMS Rehab Annual Report Editors: Hannah Rodell and Kanza Raza. Published: May Publication Number: CCQI 230 AIMS Rehab Annual Report 2016 Editors: Hannah Rodell and Kanza Raza Published: May 2016 Publication Number: CCQI 230 Contents Foreword... 5 Introduction... 6 Network Activity... 7 Membership... 7 Accreditation...

More information

GREATER MANCHESTER MENTAL HEALTH NHS FOUNDATION TRUST. Job Description for NHS Locum Full Time Consultant in. Learning Disability Psychiatry

GREATER MANCHESTER MENTAL HEALTH NHS FOUNDATION TRUST. Job Description for NHS Locum Full Time Consultant in. Learning Disability Psychiatry GREATER MANCHESTER MENTAL HEALTH NHS FOUNDATION TRUST Job Description for NHS Locum Full Time Consultant in Learning Disability Psychiatry 10 programmed Activities for Community Post in Salford This is

More information

Item No. 9. Meeting Date Wednesday 6 th December Glasgow City Integration Joint Board Finance and Audit Committee

Item No. 9. Meeting Date Wednesday 6 th December Glasgow City Integration Joint Board Finance and Audit Committee Item No. 9 Meeting Date Wednesday 6 th December 2017 Glasgow City Integration Joint Board Finance and Audit Committee Report By: Contact: Sharon Wearing, Chief Officer, Finance and Resources Allison Eccles,

More information

Final Version Simple Guide to the Care Act and Delayed Transfers of Care (DTOC) SIMPLE GUIDE TO THE CARE ACT AND DELAYED TRANSFERS OF CARE (DTOC)

Final Version Simple Guide to the Care Act and Delayed Transfers of Care (DTOC) SIMPLE GUIDE TO THE CARE ACT AND DELAYED TRANSFERS OF CARE (DTOC) SIMPLE GUIDE TO THE CARE ACT AND DELAYED TRANSFERS OF CARE (DTOC) 1. UNDERPINNING PRINCIPLES Across the whole system, our common aims are to: Improve services for patients by avoiding situations where,

More information

Luton Psychiatric Liaison Service (PLS) Job Description & Person Specification

Luton Psychiatric Liaison Service (PLS) Job Description & Person Specification Luton Psychiatric Liaison Service (PLS) Job Description & Person Specification Job Title: Psychiatric Liaison Nurse Practitioner Grade: Band 6 Hours: Responsible To: Accountable To: Location 37.5 Hours

More information

Delayed Discharge Definitions Manual. Effective from 1 st July 2016 (supersedes May 2012 version)

Delayed Discharge Definitions Manual. Effective from 1 st July 2016 (supersedes May 2012 version) Delayed Discharge Definitions Manual Effective from 1 st July 2016 (supersedes May 2012 version) NHS National Services Scotland/Crown Copyright 2016 Brief extracts from this publication may be reproduced

More information

THE PROVISION OF PLACE OF SAFETY AND ASSESSMENTS UNDER SECTIONS 135 AND 136 OF THE MENTAL HEALTH ACT

THE PROVISION OF PLACE OF SAFETY AND ASSESSMENTS UNDER SECTIONS 135 AND 136 OF THE MENTAL HEALTH ACT CP 6 SOLENT HEALTH NHS TRUST SOUTHERN HEALTH NHS FOUNDATION TRUST SURREY AND BORDERS NHS FOUNDATION TRUST ISLE OF WIGHT NHS TRUST HAMPSHIRE CONSTABULARY HAMPSHIRE COUNTY COUNCIL SOUTHAMPTON CITY COUNCIL

More information

Adult Therapy Services. Community Services. Roundshaw Health Centre. Team Lead / Service Manager. Service Manager / Clinical Director

Adult Therapy Services. Community Services. Roundshaw Health Centre. Team Lead / Service Manager. Service Manager / Clinical Director THE ROYAL MARSDEN NHS FOUNDATION TRUST Job Description Job Title Specialist Neuro Physiotherapist - Community Neuro Therapy Service Area of Specialty Adult Therapy Services Directorate Community Services

More information

Meeting people s needs A Wales Cancer Alliance Policy Paper Summer 2017

Meeting people s needs A Wales Cancer Alliance Policy Paper Summer 2017 Meeting people s needs A Wales Cancer Alliance Policy Paper Summer 2017 Meeting people s needs: overview More work needs to be done to meet the needs of patients, both as they undergo treatment for cancer

More information

Health Services. in Scotland

Health Services. in Scotland FINAL DRAFT DRAFT FOR CONSULTATION 20 June 19 August 2005 Resolving Clinical Conflicts Between Forensic Mental Health Services in Scotland Resolving Clinical Conflicts Page 1 of 10 CONTENTS: Page 1 Introduction

More information

Hospital Managers Appeal and Renewal Hearings

Hospital Managers Appeal and Renewal Hearings Standard Operating Procedure 10 (SOP 10) Hospital Managers Appeal and Renewal Hearings Why we have a procedure? It is the Hospital Managers (Managers) who have the power to detain patients who have been

More information

For details on how to order other Age Concern Factsheets and information materials go to section 9.

For details on how to order other Age Concern Factsheets and information materials go to section 9. Factsheet 76 December 2010 Intermediate care About this factsheet This factsheet explains intermediate care a range of health and social care services that can be offered in order to avoid unnecessary

More information

Mental Health Crisis Pathway Analysis

Mental Health Crisis Pathway Analysis Mental Health Crisis Pathway Analysis Contents Data sources Executive summary Mental health benchmarking project (Provider) Access Referrals Caseload Activity Workforce Finance Quality Urgent care benchmarking

More information

Open Door Policy (replacing policy no. 030/Clinical)

Open Door Policy (replacing policy no. 030/Clinical) A member of: Association of UK University Hospitals Open Door Policy (replacing policy no. 030/Clinical) THIS POLICY IS CURRENTLY UNDER REVIEW WITH THE POLICY AUTHOR POLICY NUMBER 138/Clinical POLICY VERSION

More information

HOSPITAL AUTHORITY MENTAL HEALTH SERVICE PLAN FOR ADULTS

HOSPITAL AUTHORITY MENTAL HEALTH SERVICE PLAN FOR ADULTS HOSPITAL AUTHORITY MENTAL HEALTH SERVICE PLAN FOR ADULTS 2010-2015 Introduction The Hospital Authority (HA) has developed the HA Mental Health Service Plan for Adults 2010-2015 (the Plan) as a framework

More information

NHS Ayrshire and Arran. 1. Which of the following performance frameworks has the most influence on your budget decisions:

NHS Ayrshire and Arran. 1. Which of the following performance frameworks has the most influence on your budget decisions: A: Budget setting process Performance budgeting 1. Which of the following performance frameworks has the most influence on your budget decisions: National Performance Framework Quality Measurement Framework

More information

Care Programme Approach (CPA)

Care Programme Approach (CPA) Care Programme Approach (CPA) The Care Programme Approach (CPA) is a package of care that may be used to plan your mental health care. This factsheet explains what CPA is, when you should get and when

More information

Care Programme Approach Policies and Procedures. Choice, Responsiveness, Integration & Shared Care

Care Programme Approach Policies and Procedures. Choice, Responsiveness, Integration & Shared Care Care Programme Approach Policies and Procedures Choice, Responsiveness, Integration & Shared Care Worcestershire Mental Health Partnership NHS Trust Information Reader Box Document Type: Document Purpose:

More information

Inspection Report. Royal Infirmary of Edinburgh. NHS Lothian 18 and 19 January February 2010

Inspection Report. Royal Infirmary of Edinburgh. NHS Lothian 18 and 19 January February 2010 Inspection Report Royal Infirmary of Edinburgh NHS Lothian 18 and 19 January 2010 2 February 2010 qüé=eé~äíüå~êé=båîáêçåãéåí=fåëééåíçê~íé=áë=~=é~êí=çñ=kep=nì~äáíó=fãéêçîéãéåí=påçíä~åç= The Healthcare Environment

More information

JOB DESCRIPTION. Clinical Nurse Specialist (Chronic Pain Management) Chronic Pain Service Department of Anaesthetics, Borders General Hospital

JOB DESCRIPTION. Clinical Nurse Specialist (Chronic Pain Management) Chronic Pain Service Department of Anaesthetics, Borders General Hospital 1 Job Identification Job Title: Job Reference: Department & Base: Hours of Work: JOB DESCRIPTION Clinical Nurse Specialist (Chronic Pain Management) NM1703 Chronic Pain Service Department of Anaesthetics,

More information

Policy for the use of Leave under Section 17 of the Mental Health Act 1983 (as amended) Version: 9

Policy for the use of Leave under Section 17 of the Mental Health Act 1983 (as amended) Version: 9 SH CP 52 Policy for the use of Leave under Section 17 of the Mental Health Act 1983 (as amended) Version: 9 Summary: Keywords (minimum of 5): (To assist policy search engine) Target Audience: Policy for

More information

Victorian Labor election platform 2014

Victorian Labor election platform 2014 Victorian Labor election platform 2014 July 2014 1. Background The Victorian Labor Party election platform provides positions on key elements of State Government policy. The platform offers a broad insight

More information

End of Life Care. LONDON: The Stationery Office Ordered by the House of Commons to be printed on 24 November 2008

End of Life Care. LONDON: The Stationery Office Ordered by the House of Commons to be printed on 24 November 2008 End of Life Care LONDON: The Stationery Office 14.35 Ordered by the House of Commons to be printed on 24 November 2008 REPORT BY THE COMPTROLLER AND AUDITOR GENERAL HC 1043 Session 2007-2008 26 November

More information

The UK s European university. Inpatient Services for People with Intellectual Disabilities and/or Autism

The UK s European university. Inpatient Services for People with Intellectual Disabilities and/or Autism The UK s European university Inpatient Services for People with Intellectual Disabilities and/or Autism Peter @p_langdon Aims To briefly review the available literature about outcomes from inpatient services

More information

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Interim Process and Methods of the Highly Specialised Technologies Programme

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE. Interim Process and Methods of the Highly Specialised Technologies Programme NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Principles Interim Process and Methods of the Highly Specialised Technologies Programme 1. Our guidance production processes are based on key principles,

More information

Western Isles Health Board. Patient Travel Policy. Version 2.5

Western Isles Health Board. Patient Travel Policy. Version 2.5 Western Isles Health Board Patient Travel Policy Version 2.5 Date of issue SECC approval Next review due date Reviewers/review team xx September N/A September 2015 PTC, HF&P, FD,CEO 2014 Document Control

More information

Page 1 of 18. Summary of Oxfordshire Safeguarding Adults Procedures

Page 1 of 18. Summary of Oxfordshire Safeguarding Adults Procedures Page 1 of 18 Summary of Oxfordshire Safeguarding Adults Procedures Page 2 of 18 Introduction This part of the procedures sets out clear expectations regarding the standards roles and responsibilities of

More information

Overall rating for this location. Quality Report. Ratings. Overall summary. Are services safe? Are services effective? Are services responsive?

Overall rating for this location. Quality Report. Ratings. Overall summary. Are services safe? Are services effective? Are services responsive? John Munroe Hospital Rudyard Quality Report Horton Road Rudyard Leek Staffordshire ST13 8RU ST13 8RU Tel:01538 306244 Website:www.johnmunroehospital.co.uk Date of inspection visit: 11th January 2016 Date

More information

The Care Programme Approach

The Care Programme Approach Barnet, Enfield and Haringey Mental Health NHS Trust The Care Programme Approach Information for service users and carers In partnership with: Barnet Council Enfield Council Haringey Council The Care Programme

More information

TITLE PAGE. Title: Determining Nursing Staffing Levels for Stroke Beds in Scotland. Authors: Scottish Stroke Nurses Forum:

TITLE PAGE. Title: Determining Nursing Staffing Levels for Stroke Beds in Scotland. Authors: Scottish Stroke Nurses Forum: TITLE PAGE Title: Determining Nursing Staffing Levels for Stroke Beds in Scotland Authors: Scottish Stroke Nurses Forum: 1 Any comments or correspondence please contact the following SSNFC members: Anne

More information

OCCASIONAL PAPERS SERIES: HOW ARE WE DOING? MEASURING SHORT BREAKS

OCCASIONAL PAPERS SERIES: HOW ARE WE DOING? MEASURING SHORT BREAKS About The purpose of our Occasional Papers series is to promote new thinking around how we plan and deliver better outcomes from short break services. Papers will consider different issues affecting people

More information

CSAR. GUIDANCE DOCUMENT To assist practitioners in the completion of the Common Summary Assessment Report (CSAR).

CSAR. GUIDANCE DOCUMENT To assist practitioners in the completion of the Common Summary Assessment Report (CSAR). Page 1 of 11 CSAR COMMON SUMMARY ASSESSMENT RECORD (FORM: CSAR/PV3a) NHSS (2009) GUIDANCE DOCUMENT To assist practitioners in the completion of the Common Summary Assessment Report (CSAR). Page 2 of 11

More information

Evaluation of the Links Worker Programme in Deep End general practices in Glasgow

Evaluation of the Links Worker Programme in Deep End general practices in Glasgow Evaluation of the Links Worker Programme in Deep End general practices in Glasgow Interim report May 2016 We are happy to consider requests for other languages or formats. Please contact 0131 314 5300

More information

Consultant psychiatrist job description and person specification

Consultant psychiatrist job description and person specification Consultant psychiatrist job description and person specification The following job description is provided as a resource to the recruiting trust and may be used as a template. It is not designed to be

More information

Scottish social services sector: report on 2010 workforce data

Scottish social services sector: report on 2010 workforce data Scottish social services sector: report on 2010 workforce data Scottish Social Services Council December 2011 1 Contents: Executive Summary... 3 1. Introduction... 4 2. National Picture... 5 3. Sub-national

More information

Mental Health (Wales) Measure Implementing the Mental Health (Wales) Measure Guidance for Local Health Boards and Local Authorities

Mental Health (Wales) Measure Implementing the Mental Health (Wales) Measure Guidance for Local Health Boards and Local Authorities Mental Health (Wales) Measure 2010 Implementing the Mental Health (Wales) Measure 2010 Guidance for Local Health Boards and Local Authorities Januar y 2011 Crown copyright 2011 WAG 10-11316 F6651011 Implementing

More information

Announced Inspection Report care for older people in acute hospitals

Announced Inspection Report care for older people in acute hospitals Announced Inspection Report care for older people in acute hospitals Glasgow Royal Infirmary NHS Greater Glasgow and Clyde Healthcare Improvement Scotland is committed to equality. We have assessed the

More information

Supporting the acute medical take: advice for NHS trusts and local health boards

Supporting the acute medical take: advice for NHS trusts and local health boards Supporting the acute medical take: advice for NHS trusts and local health boards Purpose of the statement The acute medical take has proven to be a challenge across acute hospital trusts and health boards

More information

The Royal College of Emergency Medicine. A brief guide to Section 136 for Emergency Departments

The Royal College of Emergency Medicine. A brief guide to Section 136 for Emergency Departments The Royal College of Emergency Medicine A brief guide to Section 136 for Emergency Departments December 2017 Summary of recommendations 1. When a patient is brought to the ED under section 136 of the Mental

More information

Child and Adolescent Mental Health Services Waiting Times in NHSScotland

Child and Adolescent Mental Health Services Waiting Times in NHSScotland Publication Report Child and Adolescent Mental Health Services Waiting Times in NHSScotland Quarter ending 30 June 2017 Publication date 5 September 2017 A National Statistics Publication for Scotland

More information

Monitoring the Mental Health Act 2015/16 SUMMARY

Monitoring the Mental Health Act 2015/16 SUMMARY Monitoring the Mental Health Act 2015/16 SUMMARY Foreword The work of monitoring the Mental Health Act 1983 (MHA) is a distinct but supportive role to CQC s wider regulatory task. It is distinct, in part,

More information

Bedfordshire and Luton Mental Health Street Triage. Operational Policy

Bedfordshire and Luton Mental Health Street Triage. Operational Policy Bedfordshire and Luton Mental Health Street Triage Operational Policy 1 1. Introduction Mental Health Street Triage (MHST) is a collaborative service between mental health professionals (MHPs) paramedics

More information

CLINICAL PROTOCOL FOR THE IDENTIFICATION OF SERVICE USERS

CLINICAL PROTOCOL FOR THE IDENTIFICATION OF SERVICE USERS CLINICAL PROTOCOL FOR THE IDENTIFICATION OF SERVICE USERS RATIONALE All Professionals/healthcare workers are personally accountable for their practice and, in the exercise of their professional accountability,

More information

NHS Borders Feedback and Complaints Annual Report

NHS Borders Feedback and Complaints Annual Report NHS Borders Feedback and Complaints Annual Report 2016-17 1 Introduction NHS Borders Feedback and Complaints Annual Report 2016-17 is a summary of the feedback provided by the complaints, comments, concerns

More information

Submission to the South Australian Child and Adolescent Mental Health Service Re: CAMHS Review. August 2014

Submission to the South Australian Child and Adolescent Mental Health Service Re: CAMHS Review. August 2014 Submission to the South Australian Child and Adolescent Mental Health Service Re: CAMHS Review August 2014 Australian Association of Social Workers National Office Canberra Level 4, 33-35 Ainslie Place

More information

Reports Protocol for Mental Health Hearings and Tribunals

Reports Protocol for Mental Health Hearings and Tribunals Reports Protocol for Mental Health Hearings and Tribunals Reports Protocol for Mental Health Hearings and Tribunals Document Type Clinical Protocol Unique Identifier CL-037 Document Purpose This policy

More information

Serious Incident Reviews

Serious Incident Reviews Criminal Justice Social Work Serious Incident Reviews Annual Report 2012-13 August 2013 OPS-0813-242 Contents Introduction 1 Statutory supervision in Scotland 2 Background 2 Classifying serious incidents

More information

Short Break (Respite ) Care Practice and Procedure Guidance

Short Break (Respite ) Care Practice and Procedure Guidance Short Break (Respite ) Care Practice and Procedure Guidance 1 Contents 1. Introduction 2. Definition 2.1 Definition of a Carer 3. Legislation 3.1 Fair Access to care Services and the Duty to Provide 4.

More information

Services for older people in Falkirk

Services for older people in Falkirk Services for older people in Falkirk July 2015 Report of a joint inspection of adult health and social care services Services for older people in Falkirk July 2015 Report of a joint inspection of adult

More information

An Official Statistics Publication for Scotland. Scottish Social Services Sector: Report on 2013 Workforce Data

An Official Statistics Publication for Scotland. Scottish Social Services Sector: Report on 2013 Workforce Data An Official Statistics Publication for Scotland Scottish Social Services Sector: Report on 2013 Workforce Data Published: 30 September 2014 TABLE OF CONTENTS Executive summary... 4 1 Introduction... 5

More information

Patient survey report 2004

Patient survey report 2004 Inspecting Informing Improving Patient survey report 2004 - young patients The survey of young patient service users was designed, developed and coordinated by the NHS survey advice centre at Picker Institute

More information

Mental Health Crisis Care: The Five Year Forward View. Steven Reid Consultant Psychiatrist, Psychological Medicine CNWL NHS Foundation Trust

Mental Health Crisis Care: The Five Year Forward View. Steven Reid Consultant Psychiatrist, Psychological Medicine CNWL NHS Foundation Trust Mental Health Crisis Care: The Five Year Forward View Steven Reid Consultant Psychiatrist, Psychological Medicine CNWL NHS Foundation Trust Overview Parity of esteem What are the challenges for people

More information

Patient survey report Survey of adult inpatients in the NHS 2009 Airedale NHS Trust

Patient survey report Survey of adult inpatients in the NHS 2009 Airedale NHS Trust Patient survey report 2009 Survey of adult inpatients in the NHS 2009 The national survey of adult inpatients in the NHS 2009 was designed, developed and co-ordinated by the Acute Surveys Co-ordination

More information

abcdefghijklmnopqrstu

abcdefghijklmnopqrstu Healthcare Policy and Strategy Directorate Quality Division Dear Colleague INTRODUCTION AND AVAILABILITY OF NEWLY LICENSED MEDICINES IN THE NHS IN SCOTLAND Dear Colleague This guidance sets out the policy

More information

Patient survey report Inpatient survey 2008 Royal Devon and Exeter NHS Foundation Trust

Patient survey report Inpatient survey 2008 Royal Devon and Exeter NHS Foundation Trust Patient survey report 2008 Inpatient survey 2008 Royal Devon and Exeter NHS Foundation Trust The national Inpatient survey 2008 was designed, developed and co-ordinated by the Acute Surveys Co-ordination

More information

PPI in Evaluation. Examples of Good Practice taken from the Survey

PPI in Evaluation. Examples of Good Practice taken from the Survey Respondent # 70 Sector NHS or other health-care provider Evaluation Title Using the 15 Steps Challenge in Mental Health Evaluation The 15 Steps Challenge originated from acute care when a carer said she

More information

Food, Fluid and Nutritional Care in Hospitals

Food, Fluid and Nutritional Care in Hospitals National Overview ~ April 2010 Food, Fluid and Nutritional Care in Hospitals NHS Quality Improvement Scotland (NHS QIS) is committed to equality and diversity. We have assessed the performance assessment

More information

Informal Patients to take Leave from Adult Mental Health Inpatient Wards. Standard Operating Procedure

Informal Patients to take Leave from Adult Mental Health Inpatient Wards. Standard Operating Procedure Informal Patients to take Leave from Adult Mental Health Inpatient Wards Standard Operating Procedure DOCUMENT CONTROL: Version: 1 Ratified by: Quality Committee Date ratified: 16 June 2016 Name of originator/author:

More information

Quality Indicators for Primary Care Out-of-Hours Services. July Evidence

Quality Indicators for Primary Care Out-of-Hours Services. July Evidence Quality Indicators for Primary Care Out-of-Hours Services July 2012 Evidence Healthcare Improvement Scotland is committed to equality. We have assessed these quality indicators for likely impact on equality

More information

Equality and Diversity strategy

Equality and Diversity strategy Equality and Diversity strategy 2016-2019 DRAFT If you would like this document in a different format, please telephone 0117 9474400 or e-mail getinvolved@southgloucestershireccg.nhs.uk Executive Summary

More information

Thinking about a career in nursing or midwifery?

Thinking about a career in nursing or midwifery? Thinking about a career in nursing or midwifery? cancer travel What is nursing? What is midwifery? page 2 Where can I study? page 9 What qualifications do I need? page 4 How much will it cost me to go

More information

Chest Heart & Stroke Scotland Stroke Nurse (Lothian) Job Description

Chest Heart & Stroke Scotland Stroke Nurse (Lothian) Job Description Chest Heart & Stroke Scotland (Lothian) Job Description Position: Responsible to: Responsible for: Location: Contacts: (Internal) Contacts (external) (Lothian) Lead None Royal Infirmary of Edinburgh Rehabilitation

More information

Creating viable options

Creating viable options Creating viable options A tool for identifying key education content areas to support progressive development in tissue viability for health care staff July 2009 Creating viable options A tool for identifying

More information

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Implementation Policy for NICE Guidelines

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Implementation Policy for NICE Guidelines The Newcastle upon Tyne Hospitals NHS Foundation Trust Implementation Policy for NICE Guidelines Version No.: 5.3 Effective From: 08 May 2017 Expiry Date: 02 March 2019 Date Ratified: 23 February 2017

More information

Adult Mental Health Services. A National Service Framework for Wales

Adult Mental Health Services. A National Service Framework for Wales Adult Mental Health Services A National Service Framework for Wales April 2002 National Service Framework for Mental Health Wales 1. The National Service Framework for Mental Health in Wales (NSF) has

More information

The Contract Register

The Contract Register Appendix 1 The Register ` Lanarkshire Health Providers and the contract monitoring arrangements The is responsible for regulating the independent healthcare sector and securing quality of care. However,

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Laureate House Laureate House, Wythenshawe Hospital, Southmoor

More information

JOB DESCRIPTION. Specialist Looked After Children s Nurse

JOB DESCRIPTION. Specialist Looked After Children s Nurse JOB DESCRIPTION Job Title: Division/Department: Responsible to: Accountable to: Looked After Children Nurse Womens & Children Division / ESCAN Specialist Looked After Children s Nurse Specialist Looked

More information

JOB DESCRIPTION JOB DESCRIPTION

JOB DESCRIPTION JOB DESCRIPTION JOB DESCRIPTION JOB DESCRIPTION Medical Director GOSH Profile Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) is a national centre of excellence in the provision of specialist children's

More information

Patient survey report Survey of adult inpatients in the NHS 2010 Yeovil District Hospital NHS Foundation Trust

Patient survey report Survey of adult inpatients in the NHS 2010 Yeovil District Hospital NHS Foundation Trust Patient survey report 2010 Survey of adult inpatients in the NHS 2010 The national survey of adult inpatients in the NHS 2010 was designed, developed and co-ordinated by the Co-ordination Centre for the

More information

STUDENT NURSE: Practice Placement Information

STUDENT NURSE: Practice Placement Information STUDENT NURSE: Practice Placement Information Patients were very approachable and made me feel welcome. They were confident about sharing their experiences with student nurses. ABOUT THE STATE HOSPITAL

More information

OCCUPATIONAL THERAPY JOB DESCRIPTION. Community Mental Health Rehabilitation & Enablement Team (CMHRES)

OCCUPATIONAL THERAPY JOB DESCRIPTION. Community Mental Health Rehabilitation & Enablement Team (CMHRES) OCCUPATIONAL THERAPY JOB DESCRIPTION Job title: Clinical Occupational Therapist Band: 6 Directorate: Service: Adult Mental Health and Learning Disabilities Community Mental Health Rehabilitation & Enablement

More information

CLINICAL COMMISSIONING GROUP RESPONSIBILITIES TO ENSURE ROBUST SAFEGUARDING AND LOOKED AFTER CHILDREN ARRANGEMENTS

CLINICAL COMMISSIONING GROUP RESPONSIBILITIES TO ENSURE ROBUST SAFEGUARDING AND LOOKED AFTER CHILDREN ARRANGEMENTS MEETING DATE: 14 March 2013 AGENDA ITEM NUMBER: Item 8.6 AUTHOR: JOB TITLE: DEPARTMENT: Sarah Glossop Designated Nurse Safeguarding Children NHS North Lincolnshire Clinical Commissioning Group REPORT TO

More information

DRAFT FOR CONSULTATION

DRAFT FOR CONSULTATION DRAFT FOR CONSULTATION Code of Practice for Pastoral Care of International Contents Part 1 Introduction Page 1 Introduction 3 2 Commencement 3 3 Previous version revoked replaced 3 4 Code is legislative

More information

POLICY AND PROCEDURES FOR THE JOINT AGENCY PANEL FOR CHILDREN WITH COMPLEX, MULTIPLE AND HIGH LEVEL NEEDS 27/01/09

POLICY AND PROCEDURES FOR THE JOINT AGENCY PANEL FOR CHILDREN WITH COMPLEX, MULTIPLE AND HIGH LEVEL NEEDS 27/01/09 POLICY AND PROCEDURES FOR THE JOINT AGENCY PANEL FOR CHILDREN WITH COMPLEX, MULTIPLE AND HIGH LEVEL NEEDS 27/01/09 UNDER REVIEW CONTENTS Page FOREWORD 1 1 INTRODUCTION 3 2 CHILDREN AFFECTED BY THIS POLICY

More information

Patient survey report Survey of adult inpatients 2012 Sheffield Teaching Hospitals NHS Foundation Trust

Patient survey report Survey of adult inpatients 2012 Sheffield Teaching Hospitals NHS Foundation Trust Patient survey report 2012 Survey of adult inpatients 2012 The national survey of adult inpatients in the NHS 2012 was designed, developed and co-ordinated by the Co-ordination Centre for the NHS Patient

More information

NHS DUMFRIES AND GALLOWAY ANNUAL REVIEW 2015/16 SELF ASSESSMENT

NHS DUMFRIES AND GALLOWAY ANNUAL REVIEW 2015/16 SELF ASSESSMENT NHS DUMFRIES AND GALLOWAY ANNUAL REVIEW 2015/16 SELF ASSESSMENT Chapter 1 Introduction This self assessment sets out the performance of NHS Dumfries and Galloway for the year April 2015 to March 2016.

More information

Scottish Ambulance Service. Our Future Strategy. Discussion with partners

Scottish Ambulance Service. Our Future Strategy. Discussion with partners Discussion with partners Our values Glossary of terms We will: put the patient at the heart of everything we do. treat each and every person well, with respect and dignity. always be open, honest and fair.

More information