Improving Acute Psychiatric Services ‐ What is the NPSA Contributing?
| Pages | 27-30 |
| DOI | https://doi.org/10.1108/13619322200600006 |
| Date | 01 March 2006 |
| Published date | 01 March 2006 |
| Author | Kathryn Hill |
| Subject Matter | Health & social care |
Improving Acute Psychiatric
Services – What is the
NPSA Contributing?
Kathryn Hill
Head of Safer Practice/Mental Health Lead
National Patient Safety Agency
Focus on…
Introduction
The National Patient Safety Agency (NPSA) was set
up to ensure that the NHS can learn from things that
go wrong and to develop solutions to prevent harm in
the future. It does this by working with service users,
carers and stafflocally and nationally to foster a culture
where errors can be investigated and innovative
solutions can be developed. The NPSA promotes an
open and fair culture across the health service with an
emphasis on understanding the ‘how’ rather than the
‘who’.
The NPSA works across all caresettings and has
over the last three years developed a robust
programme of work with mental health services. The
major project currently being worked on is Safer
Wards for Acute Psychiatry (SWAP), a two-year
evidence based project which aims to understand the
system issues that impact on patient safety in acute
inpatient services. This article outlines progress.
Background
Thereis a broad consensus among policy makers
(Department of Health, 2002), commentators
(SainsburyCentre for Mental Health, 1998), the
professions (Wing et al,1998) and organisations
representing service users (Barker, 2000) that acute
inpatient psychiatric wards often provide an unsafe
and non-therapeutic environment.
Anumber of reports have been recently published
including the National Audit of the Management of
Violence and Aggression,produced by the Royal College
of Psychiatrists’ research unit on behalf of the
HealthcareCommission, MIND’sWard Watch,and
Acute Care 2004 by the Sainsbury Centre for Mental
Health, all of which identify broadly the same themes:
■high vacancy levels and an over-reliance on
bank and agency staff
■lack of therapeutic and social activity
■high occupancy levels, overcrowding and rapid
turnover
■increased levels of morbidity and severity of
illness
■increased levels of substance misuse
■apoor physical environment.
A review of the pilot data for the NPSA National
Reporting and Learning System showed that 89% of
the reports related to an unsafe ward environment in
terms of violence and aggression, self-harm,
absconding and the physical environment. It was
therefore evident that improving safety on acute
psychiatric inpatient units should be a priority for the
mental health programme at NPSA.
The Safer Wards for Acute Psychiatry project
The SWAP project is a two-year evidence-based
initiative which has six distinct phases:
■reviewing the available evidence
■gaining the views from the frontline
■developing interventions
■piloting
■evaluation
■dissemination.
The project is currently piloting interventions.
The Mental Health Review Volume 11 Issue 1 March 2006 ©Pavilion Publishing (Brighton) 2006 27
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