Mais les résultats doivent être attendus longtemps et il n'y a généralement pas de temps metronidazole prix L'autre cas, c'est que l'achat d'un ou d'un autre antibiotique dans une pharmacie classique nécessite des dépenses matérielles considérables et pas toutes les personnes ne peuvent acheter des produits pharmaceutiques aussi coûteux.
GETTING THE MOST FROM GLENVALE
FEEDBACK ON THE CONSULTATION REPORT
The Day Hospital Manager has made arrangements to meet with
staff, service users and carers from 10th July 2003. A letter has
also been prepared for service users and carers to explain that
they will continue to receive a service and to ask their views about
the developments. Service Users and carers will also be able to
receive copies of this report and staff will be able to provide
support if required to discuss the report with them. The trust is
working with staff side to ensure that all staff are briefed and
supported through this process.
A briefing will be provided for all Trust staff on the consultation
process for both Glenvale and the Langton and Orchard Day
Hospitals. The Glenvale report will disseminated widely within
the Trust after the meetings with staff, users and carers. It
will also be sent to key stakeholders in primary care, social
services, the user movement, the voluntary sector and the
community health council.
The Langton and Orchard reports will
be available following a similar process in the week beginning 14th
July. The timescale for all comments and feedback for all
three day hospitals will end on 27th August 2003
The Trust will receive reports early in September setting out the
results of the Consultation and the decisions that will be made. If
changes to the Day Hospitals are confirmed in early September,
the process of implementation will also begin in September.
You may find this feedback form helpful to record your comments.
All comments about Glenvale in writing, using this form or by email should be returned to:
Mr Andy Stanley
Service Manager Primary Care Liaison City West
Bradgate Mental Health Unit
Glenfield General Hospital
Or email them to: [email protected]
Consultation Point - the CHI review and improving services
The CHI review in 2002 recognised the valuable work of the staff at Glenvale
Day Unit. It recommended that there should be a review of how the Trust
provides activities for in-patients in order to improve the experience on the
What is your experience of the activities provided by Glenvale?
What would you like to keep and what would you like to change?
The Trust has made a commitment to improve activities for in-patients. Service Users report that boredom is a major factor affecting recovery and the perceived benefit of an in-patient stay. The experience at Glenvale is that groups are focused on user’s needs, have better access to resources and a more conducive environment if they are held in the day unit and open to in-patients across all wards.
It is important that people know they can keep occupied on the ward; our experience is that it is a poor use to ask the day unit staff to do this. Ward staff working with volunteers is a better approach. Day unit staff can engage users on the ward, on a one to one basis if it forms a stepping-stone towards a day unit treatment programme.
What do you think?
Consultation Point – specialist clinics currently run from Glenvale
Clozaril is an ‘atypical antipsychotic drug’. People who take this also need
access to blood testing and monitoring as well as offering other support. The
Trust would need to continue to provide this service. It could be provided in
the community, CMHT bases, and resource centres.
All Trusts must ensure that ECT services meet the new national guidelines
that are effective from 2003. E.C.T. If we are to make cash releasing
efficiency savings from the Day Hospital it will not be possible for the Gelnvale
team to run these clinics. ECT is a clinic that the Trust needs to continue to
provide. There will need to be further consideration on how to do this,
including the requirements for medical input.
Are there different or better ways to provide these clinics?
Consultation Point – what we think that Glenvale should continue to be:
ü A place where you can immediately choose from activity and social
groups, get a meal and drinks, find quiet space, company professional advice and support from other service users.
ü A place providing a comprehensive activity programme 8.30-4.30 Monday-
Friday and an informal evening programme.
ü A secure and supportive environment to develop a personal programme to
get the most out of an admission and prepare for of leave and discharge.
ü A ‘same day’ response for assessment, care and treatment in a crisis. ü A light comfortable well resourced building. ü Offer comprehensive mental state assessment and positive monitoring of
physical and mental well-being – helpful for people who are changing medication, or who are working to reduce or prevent risk of relapse.
ü Transport and confidence building to use public transport or drive. ü Daily respite for carers and for people who are acutely unwell. ü A highly skilled and established multi-disciplinary team who work closely
together to provide a wide variety of evidence-based groups using a mixture of resources and mediums.
What do you think?
Consultation Point - new groups and services
Plans are being discussed for the development of an education group
focusing on specific mental health difficulties such as schizophrenia and bi-
polar illness (adapting the successful programme used by Re-think for carers,
the Family Education Training Programme). Also being explored is a
Medication Discussion group to inform people about medication management,
discussing side effects and long-term use.
Staff plan to pilot an on-call system or same-day response to urgent referrals, so that care is given immediately. Users assessed could attend the ‘Open Access’ groups, available Monday – Friday, in the first instance and could then quickly be offered an ‘Assessment group’ if required.
People will have a choice of activities, some discreetly for in-patients only, others available to all users of the day unit. The day unit staff and volunteers will facilitate a programme of social, physical and creative activities morning and afternoon throughout the week.
Supporting recovery will focus around the collaborative development of a ‘Wellness Plan’, designed between the user and day unit keyworker in liaison with the multi-disciplinary team, carers and significant others.
Pottery and art groups are a way to do a detailed assessment of cognitive ability, motivation, mood and social skills. The ‘Breakfast Club’ has a similar role as well as assessing and building daily living skills. The ‘Outlook group’ is a way to get away from the unit and be back in a community environment.
What do you think?
Consultation Point – monitoring to ensure that what we do helps
Current groups have outcome measures incorporated into their design, where
possible. These often form self-rating scales that are completed before and
after the group. Treatment groups are currently reviewed every 6 months.
The Glenvale User Forum now supports informal and formal consultation with
users in this process. There is currently no system of consultation or
evaluation specifically for carers, we need to look at this with carers.
All Groups will be closely evaluated over time and adjusted to ensure that the needs of users continue to be met and the links with community services are put to best effect. Wellness plans devised by the client and keyworker will have specific goals, identifying how many are attained.
A system for identifying how the day unit service impacts on length of stay in unit is needed. The number of users who attend the service as an alternative to admission and the outcome needs to be collated. It would also be useful to explore ways in which the prevention of relapse could be monitored.
We would welcome your views about these proposals.
Consultation Point - Further development proposals
Engagement, assessment and treatment would be offered. Close links with the Crisis Team would be maintained by the keyworker working collaboratively with the service user (and carer).
Service users could have their daytime meal if needed and could have their personal care needs met if they were unable to do this at home. Transport would be arranged in the first instance, to encourage engagement. People can also be supported to make their own way to the Unit.
Intervention at Glenvale would usually be short-term and discharge to community resources would be considered from the point of admission to hospital. This will have an impact upon the community teams, day services, and potentially the voluntary sector who will be asked to provide more support earlier in people’s care.
A specific ‘Assessment group’ is currently being planned. A nurse and an OT will work with people to assess in detail over 4-6 sessions their mental health and recovery. Following the completion of the assessment a detailed report,
incorporating a range of standardised and evidence-based assessment tools, will be available to the service user (and carer if appropriate). It will also be presented to the multi-disciplinary team. This new group is planned because people’s needs are not always clear and a detailed assessment over a period of time, in a range of social and task-orientated settings can help to agree constructive next steps.
We would also welcome your comments on these proposals.
Consultation Point – staffing, management and clinical leadership
Combining management resources from the previous City Social Services
structure and the previous Day Hospital structure post has created the Team
Manager, reducing the number of managers for these services overall. All the
Team Managers are clinical management posts – this means that they can
undertake some clinical work. The nature of that work depends upon the
Team Manager post.
Do you have any views on the clinical role of this Team Manager post?
Do you think that there should be additional clinical leadership to
support all the services managed by this Team Manager?
How do you think that referrals should come into the Day Unit?
The consultation report describes small changes to the numbers of skilled
assistants, the nursing staff and occupational therapy staff at Glenvale. It also
proposes a strengthened administrative role. The new integrated
management arrangements will also bring together the management of day
services staff who have been seconded to the Trust from Social Services as
well as the management of volunteers. Do you think that there should be any other changes to staffing
Consultation Point - Your comments overall
Do you have any other comments or advice on any aspect of the report
or on the development of day services?
When my children were little, we would regularly watch PBS and Those were the questions they were wondering. Have you ever the morning shows. We watched Barney (anyone know the song?). We wondered about similar questions? I know I have. watched Sesame Street. We watched Mr. Rogers Neighborhood. And occasionally we watched Lamb Chop with Shari Lewis. Isaiah has heard his people. Maybe he has
Scary Diagnosis, Alan Geller, Scary Diagnosis -Alan Geller, , . . The Maker's Diet for Weight Loss , Jordan Rubin, Dec 8, 2008, Health & Fitness, 305 pages. A new way ofthinkingÐ²Ð‚Â¦ A new way of dietingÐ²Ð‚Â¦ A new way of livingÐ²Ð‚Â¦ The MakerÐ²Ð‚â„¢s way! Buildingon the principles of his New York Times best seller, The MakerÐ²Ð‚â„¢s Diet, Jordan .