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Introduction
This is the largest Clinical Effectiveness study in schizophrenia to be undertaken in Scotland. It aims to provide answers in pragmatic terms to the question of whether the introduction of national clinical standards in schizophrenia improves the outcomes and quality of clinical care, and to what extent this impacts on the costs of care to the NHS. This study furthers the aims of the recent Scottish Executive NHS Plan, the drive towards improved Clinical Governance through the Mental Health Framework and the work of the Clinical Standards Board for Scotland.
The single most important aim for the study is to make a significant contribution towards changing attitudes about outcome measures and standards.
Why is it important to participate in this study?
The study provides an excellent opportunity for your Clinical Effectiveness Department to train large numbers of health professionals in mental health outcome evaluation measures, and for these measures to become embedded in routine practice and local clinical information systems.
How many centres will enter into the study?
The entry-strategy seeks to recruit health care professionals and people with schizophrenia over a three year period. Recognising the scale of this national study, and having consideration for the workload in Primary Care Trusts from recent CSBS and SHAS initiatives, it was decided to invite all PCT’s in Scotland, as well as major Voluntary Organisations and other care providers to participate in the study.
How will the project be organised and co-ordinated?
There will be a National Advisory Group (NAG) representing participating centres, voluntary organisations and others which will meet at least twice per year.
The Project Advisory Group (PAG) will directly manage the project and consist of grant fundholders, a full time National project co-ordinator and part-time administrative grade based in the R&D directorate of the Greater Glasgow Primary Care NHS Trust. Others with a significant contribution to make will also be invited to participate as necessary. Both SAMH and NSF Scotland will be PAG members.
How will training for the project be organised?
We plan to provide on our internet website for the project, an electronic training manual for self-directed learning, which can be downloaded, and used. The website will also have an enquiries page, comments page, and provide regular feedback and monitoring reports.
Limited funding support may be available to allow Trust personnel to become trainers and to cascade this training locally to practitioners participating in the study.
What will training involve?
A resource pack will include information on the study, including national clinical standards for schizophrenia, a simple quality of life tool and a range of validated outcome measures which will be agreed with you locally. A core user derived outcome measure will be used by all participating centres. Outcome measures currently in use in Scotland include the Avon Mental Health Measure, (AVON) Camberwell Assessment Needs, (CAN) and Health of the Nation Outcome Scale (HoNOS). The resource pack will also contain data collection forms as well as participant information and consent forms.
There will be a Certificate of Participation in training and recruitment for the project, which will be awarded retrospectively to all health professionals who participate and recruit a minimum of four patients to the study. Training is expected to take up to one clinical session of professional time. This Certificate will be endorsed by the CSBS, Glasgow University’s Robertson Biostatistics Centre and Research Group.
Does your Trust need Ethical approval for the study?
The study will have M R E C approval, and participating centres and will also require to have LREC approval prior to the study commencement. The National
How can Trust Clinical Effectiveness Departments assist?
We are anticipating that all Trusts and other provider organisations will include the National study in their strategic Clinical Effectiveness plans for the next 3 years, and nominate a named person, who will liaise with the National project co-ordinator. The local contact person will be able to organise training, engage practitioners to the study, and steer ethical application through LRECs.
Data Collection Forms
The study aims to collect the minimum data required to answer questions for the study, and to limit the time spent by health professionals involved in the study. Data-collection forms will be anonymised and may be emailed, faxed or posted to the National Co-ordinating centre for quality control measures.
Telephone enquiries and specific reminders will be made by the Centre to practitioners for any essential missing data. The data will then be forwarded to the Robertson Centre for Biostatistics at Glasgow University for analysis.
Will our participation assist others?
Yes, where there are examples of good practice, and where the implementation has worked well in the study, we plan to share this information during the study.
Will I get feed back on my results?
It is our plan to provide anonymised local and national aggregated feedback information on our study website to all participating centres. This information will be updated at regular intervals so that you, your colleagues and the NHS will have comparative information on the outcomes and outputs of their work and a benchmark of participation at national level.
An electronic newsletter will also be available with regular reports on study progress being made throughout Scotland. A National Conference for dissemination of the study results, and for the agreeing of National exit strategy plans for the future care and management of people with schizophrenia in Scotland will be organised nearer the end of the study period.
Where should NHS patients be recruited from?
The study seeks to recruit people with schizophrenia representative of all ages and being cared for in the widest range of settings in hospital, clinics, day services, voluntary and private care organisations, hostels, homeless services, Mental Health Resource Centres and Primary Care.
Can any health care professional participate?
If you are providing direct care to patients, there are no restrictions for the professional disciplines that can and should become involved in this study. Experience from previous studies has shown that key workers such as psychiatric nurses and PAMs to date have been most successful and able to recruit patients.
What is the role of the key worker?
The key worker will be crucial to the success of this study. It will be the responsibility of the key worker to recruit a minimum of four patients and undertake a baseline assessment and two further assessments at 12 and 24 months. These assessments should take no longer than 35 minutes per patient.
How will patients and carers be involved?
It is our aim to ensure that users and carers are represented at all levels of planning, study design, implementation, advisory work, evaluation, and at the National conference.
Enquiries
If you would like further information about the study, please contact the National Co-ordinator, Rosie Cameron by:
E-mail: |
rosie.cameron@glacomen.scot.nhs.uk |
Fax: |
0141 211 3814 |
Tel: |
0141 211 3582 |
Mail: |
SSOS
Research & Development Directorate
Greater Glasgow Primary Care NHS Trust
1055 Great Western Road
Glasgow, G12 0XH |
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