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Accountability agreement

Agreement between the Strategic Health Authority and local health systems on the action and success criteria needed to meet agreed national and local targets. All parties to the agreement are responsible for ensuring the targets are met. 

Accountable officer

Usually the Chief Executive who is responsible for maintaining sound internal controls to support the achievement of the Trust’s objectives and to review Trust effectiveness.

Acute

Services (usually in-patient) which treat patients for a certain condition for a short time.

ADHD

Attention Deficit Hyperactivity Disorder

Advocacy

A dictionary definition of ‘advocacy’ tells us that an advocate is:
Citizen Advocacy: means speaking up for someone else. Unpaid volunteers who try to represent the interests and concerns of their partner as if they were their own, but do not make decision for their partner. They must be independent of people providing care or services for their partner.
Legal Advocacy: possibly a solicitor or a barrister or an advice worker. They give advice so that people can speak up for themselves.
Collective advocacy: a group of people working together to speak out for what they want. Some organisations undertake collective advocacy - eg, MENCAP, Mind, Cambridgeshire Independent Advocacy Service, trade unions.
Peer advocacy: help and support from people with a similar background or experience to your own.
Professional advocacy: someone who is paid to provide support and advice, independent of any services used. They will have professional skills and knowledge and a good knowledge of local services.

Anglia Support Partnership

Shared support services organisation. Delivers support services to Cambridgeshire NHS Trusts and Primary Care Trusts including clinical governance support, facilities management, finance services, modernisation and human resources and information management and technology.

Anti-psychotic drugs

Drugs used to treat psychosis, including schizophrenia and mania. They also have tranquillising effects reducing agitation. 

Approved Social Workers (ASWs)

Social workers specifically approved and appointed under Section 114 of the Mental Health Act 1983 by a local social services authority ‘for the purposes of discharging the functions conferred upon them by this Act’. One of the most important is to carry out assessments under the Act and to function as applicant in cases where compulsory admission is deemed necessary. Before being appointed, social workers must undertake post-qualifying training approved by the Central Council for Education and Training in Social Work (CCETSW). 

Area Child Protection Committee (ACPC)

Members from all local statutory agencies working with children, with an independent chair who must ensure that all children are protected from significant harm, including responsibility for establishing good local policies and practices and ensuring they are adhered to.

Assertive outreach /assertive community treatment /intensive case management

Ensuring those most in need of specialist mental health care remain in touch with services.

Atypical (novel) antipsychotic drugs

Range of newer and more expensive antipsychotic drugs used in the treatment of psychosis, most commonly schizophrenia.

Audit Commission

Appoints and regulates the external auditors of statutory authorities, including the NHS. Role to promote proper stewardship of public finances and helping managers to achieve economy, effectiveness and efficiency.

Audit Committee

Trust’s own committee monitoring Trust’s performance, probity and accountability.

Auditors

Undertake detailed examinations of all aspects of health care performance, including financial performance.

Benchmarking

A process to examine how results are achieved in order to bring an organisation’s performance in line with the best.

Caldicott Guardian

Each NHS organisation has a nominated ‘Caldicott Guardian’ responsible for ensuring the Trust complies with the Caldicott principles. These aim to ensure the protection of patient’s right to privacy, dignity and confidentiality.

Cambridgeshire Children's Trust

Cambridgeshire Children's Trust is a partnership that brings together all organisations that work with children, young people and families in a shared commitment to improving children's lives and life chances, through working collaboratively or collectively to achieve improvements.

Cambridgeshire Independent Advocacy Service (CIAS)

Local organisation covering Peterborough and Cambridgeshire providing a full range of free and independent advocacy services. (See advocacy)

CAMEO

Cambridge early intervention service

Care co-ordinator/key worker

A team member with responsibility for co-ordinating care programme (CPA) reviews for mental health service users with complex needs and for communicating with others involved in the service user’s care. Care co-ordinators usually have the most contact with the service user.

Care pathway

Patient’s journey through primary care, specialist and community services to discharge/continuing care.

Care Programme Approach (CPA) / care management

The CPA provides a framework for care co-ordination. The main elements are a care co-ordinator, a written care plan, and at higher levels regular reviews by the multi-disciplinary team and integration with the care management system. Involves assessment of need, care planning and the organisation of care packages within available resources.

Care Quality Commission

The independent regulator of health and social care in England. It regulates care provided by the NHS, local authorities, private companies and voluntary organisations. It aima to make sure better care is provided for everyone - in hospitals, care homes and people's own homes. It also seeks to protect the interests of people whose rights are restricted under the Mental Health Act

Care Records Project

Implementing a single care record system to replace current disparate legacy systems

Carers

Relatives or friends who voluntarily look after individuals who are sick, disabled, vulnerable or frail.

Change for Children

Improving the well-being of children and young people across Cambridgeshire and Peterborough through a programme of reform of children’s services involving all organisations responsible for the delivery of children’s services

Choose and Book

Enabling patients to book appointments at point of referral with a choice of time and date

Clinical governance

How we make sure we carry out treatments safely and effectively and encourage a culture of excellence in our staff to continuously improve quality of care.

CNST

Clinical Negligence Scheme for Trusts - independent assessment of how well we meet standards in relation to risk management

Cognitive behaviour therapy

A form of psychological therapy based on learning theory principles used mostly in depression but increasingly shown to be a useful part of the treatment for schizophrenia.

Commissioning

Identifying health needs of local people, planning and purchasing health services which respond to their needs. Primary Care Trusts are responsible for deciding what services their local residents need from the NHS and buy these services with public money from the most appropriate providers.

Community care

A network of services provided by the NHS, social services and volunteers designed to keep people independent, and to support elderly people or people with mental health problems or learning disabilities who might previously have been in hospital.

Community mental health team

Multi-disciplinary team offering specialist assessment, treatment and care to people in their own homes and the community.

Community mental health nurse

Nurse with specific expertise in working with patients in the community. Works within multi-disciplinary community mental health team.

Co-morbidity

The simultaneous presence of two or more disorders, often refers to combination of severe mental illness, substance misuse, learning disability and personality disorder. The term dual diagnosis or complex needs may also be used.

Compliance therapy

The frequent finding of poor compliance with prescribed treatments in people with severe mental illness has led to the development of cognitive-educational treatment which aims to improve the service user’s understanding of their illness and to identify and tackle reasons for non-compliance.

Complementary therapies

A wide range of treatments which can add something to conventional treatment - eg, Reiki, Indian head massage, aromatherapy, dance and movement etc. 

Connecting for health

See Care Records Project 

Continuing health care

Care provided over an extended period of time for people with long-term needs or disability.

Controls assurance

Process designed to provide evidence that NHS organisations are doing their ‘reasonable best’ to manage themselves in order to meet their objectives, and protect patients, staff and the public and other stakeholders against risks of all kinds. Also a process for Trusts to be able to reassure the public they operate an effective system of internal control covering key risk areas.

Corporate governance

The system by which organisations are directed and controlled. The principles of corporate governance are openness, integrity and accountability.

Controls assurance

Process designed to provide evidence that NHS organisations are doing their reasonable best to manage themselves in order to meet their objectives, and protect patients, staff and the public and other stakeholders against risks of all kinds. Also a process for Trusts to be able to reassure the public they operate an effective system of internal control covering key risk areas.

CPD

Continuing Professional Development

Crisis resolution/home treatment service

New models of care for people with severe and enduring mental illness

DAAT

Drug and Alcohol Action Teams (multi-agency)

Depression

A negative mood state which involves a feeling of sadness. Severe depression can reach the criteria for an affective disorder and require treatment.

DoH

Department of Health

DiP

Drug Intervention Programme (multi-agency)

Directory of services

Directory of all Trust services as part of choose and book (see above)

Disengagement

Loss of contact with services by the service user.

Dual diagnosis

See Co-morbidity above

Early intervention service

Services offering prompt interventions to young people experiencing their first episode of psychiatric illness. Earlier interventions are associated with better outcomes.

Eating disorders

(Include anorexia and bulimia nervosa.) Tend to have early onset in childhood or adolescence. Anorexia nervosa involves a distortion of body image - people carefully restrict intake of calories, and are markedly underweight. Bulimia nervosa involves episodic binges of over-eating, self-induced vomiting and can lead to severe physical complications.

Equal opportunity

Aims to ensure the workforce is representative of the local community.

Every Child Matters

See Change for Children

Forensic Service

Specialist health services for offenders with mental health problems.

Foundation Trust status

A new kind of public service organisation. Based on mutual traditions, they are established as ‘public benefit corporations’ with new freedoms to innovate and forge partnerships in the public interest and governance arrangements designed to help trusts better reflect the needs of the communities they serve.

Health and Social Care (HASC) Scrutiny Committees

Local Authority scrutiny committees made up of councillors and members – responsible for reviewing local services. Specifically health overview and scrutiny committee reviews performance of local health services

Health Impact Assessments (HIAs)

A combination of procedures, methods and tools by which a policy, programme or project may be judged on its potential effects on the health of a population.

Health promotion

Giving people and communities the resources and information they need to make choices about their help and to make their environment safer.

Healthcare governance

How we make sure we carry out treatments safely and effectively and encourage a culture of excellence in our staff to continuously improve quality of care

Home treatment

Treatment may be offered in user’s home rather than in a clinic. Frequent home visits by a Community Mental Health Team (CMHT) can avoid some hospital admissions and provide support to informal carers. Should be available at weekends and during evenings.

ICT

Information, Communication and Technology

Improving Working Lives (IWL)

An NHS accolade recognising achievement of a set of national standards focusing on implementation of modern employment practices and providing staff with a flexible work/life balance.

Incidence

The number of people who get a particular illness or suffer a particular disability.

Independent sector

Voluntary sector, charitable and private care providers.

Intermediate care

Care provided as an alternative to in-patient carer. Also allows patients to be safely discharged from hospital and complete their recovery at home or other suitable place.

Investor in People (IIP)

Recognition of commitment to training with objectives and personal development plans for all staff.

Joint finance

Annual sum of money allocated for use in encouraging joint working with other agencies.

Joint Investment Plans

Mechanisms for health and social care organisations, with key partner agencies, to improve inter-agency working and set out their investment intent together.

Learning Disability Partnerships (LDPs)

Responsible for commissioning and providing health and social care services for all adults with a learning disability. The LDP Boards in Peterborough and Cambridgeshire were set up in 2001. They bring together a range of partners, including people with a learning disability and their family carers, with a responsibility for implementing the programme of developments from the White Paper Valuing People

Local Strategic Partnerships

A single body bringing together at local level the different parts of the public sector, private, business, community and voluntary sectors to support each other and work together to improve the economic, social and environmental well being of the local population.

Management costs

Measure defined by the Audit Commission and approved by the NHS – includes the pay costs of senior managers, staff engaged in clinical management as well as providing clinical services, and all staff engaged in corporate management functions, together with costs for contracted out services and financial audit.

MAPPA

Multi-Agency Public Protection (Panel) Arrangements

Mental disorder

Mental Health Act 1983 definition: “mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind”.

Mental health

An individual’s ability to manage and cope with the stresses and challenges of life.

Mental Health Act 1983

Concerns the reception, care and treatment of mentally disordered persons, the management of their property and other related matters.

Mental Health Act Committee

This body ensures the compliance with the Mental Health Act 1983 throughout the Trust encompassing advice on policies and procedures.

Mental health grant

Central funds allocated to Social Services to support planned joint investment in mental health services.

Mental health organisations

Health and social care commissioners and providers of specialist mental health care, including independent sector providers.

Mental illness

The Mental Health Act 1983 does not define mental illness, which is a matter for clinical judgement.

Modern Matron

The Modern Matron role is a new nursing role that was announced in the NHS Plan. A Modern Matron is a skilled, clinically experienced nurse who is empowered to bring about improvements to the patient experience in inpatient settings. The Modern Matron role provides nursing and multi-disciplinary leadership to a ward or a small group of wards and will build on the strengths and good practice within inpatient nursing care. Modern Matrons will be visible, accessible and focused on improving the experience of service users.

Morbidity

Illness or disability

NHS Direct - 0845 46 47

24 hour nurse-led service providing confidential health care advice and information. Works collaboratively with other health organisations. Its number is 0845 46 47.

NHS Trusts

Provide most NHS services, through annual agreements with Primary Care Trusts.

National Institute for Health and Clinical Excellence (NICE)

The Institute is responsible for promoting clinical excellence and cost-effectiveness and producing and issuing clinical guidelines to ensure that every NHS patient gets fair access to quality treatment.

National Service Frameworks (NSFs)

Bring together the best clinical and cost-effective evidence to determine the best ways of providing particular services. They set national standards and define service models for a specific service or care group, support implementation of the standards and establish timescales for development.

Non-recurring

One-off funding available for a specific period of time.

NVQ

National Vocational Qualifications

Outline Business Case

Provides information on a bid for capital investment, including detailed planning assumptions and revenue and capital costings.

Overview and Scrutiny Committees

See Health and Social Care Scrutiny Committees

Patient Advice and Liaison Service (PALS)

Complementary to existing services, the Patient Advice and Liaison Service (PALS) provides service users, their carers and families with help, information and support to resolve concerns quickly and efficiently. Every NHS organisation will have a PALS to support patients and the public.

Patient Environment Action Teams (PEAT)

These teams are part of a national programme to assess and improve cleanliness, safety, privacy and dignity of inpatient care areas within NHS services. All Trusts are assessed and scored by these teams as part of an annual programme. These scores form part of the performance framework for Trusts. Services that pass at a certain level can move on to environmental self-assessment.

Performance Assessment Frameworks

Give a general picture of NHS and social care performance, measuring health improvement, fair access to services, effective delivery of health care, efficiency, service user and carer experience and the health outcomes of NHS care.

Performance Indicators

Measures of achievement, particularly in clinical and managerial areas used to assess the performance of a Trust. Focus on health outcomes rather than inputs.

Personality disorder

Covers a variety of clinically significant conditions and behaviour patterns which tend to be persistent from childhood or adolescence. May co-exist with other mental disorders.

POhWER

This is the new provider of Independent Complaints Advocacy Services (ICAS) for the NHS in our region. They provide independent information advice and support for those wishing to make a formal complaint under the NHS complaint's procedure. 

Primary care

Care provided through Primary Care Trusts.

Primary Care Trusts (PCTs)

Groups of local doctors and community services with resources for commissioning health care for their practices’ populations.

Private Finance Initiative (PFI)

A government-led programme to enable the private sector to become involved in the provision of facilities which will then be run by the NHS

Providers and providing

Hospital trusts, GPs, voluntary organisations and sometimes private institutions that provide the health according to contract with the Strategic Health Authority or Primary Care Trust

Psychological therapies

Talking therapies, including psychotherapy, counselling, family therapy and cognitive-behaviour therapy.

Psychosis

A period of illness when people suffer from thought disorder, hallucinations or delusions.

Psychotropic drugs

Medication used in the treatment of mental disorder.

R&D

Research and Development

Regional Secure Units (RSUs)

Medium-secure units for people who are thought to pose special risks, particularly violence to others.

Return to practice

The Government sets NHS organisations targets for encouraging ex-staff to work within the NHS.

Risk management

Risk management places special emphasis on identifying circumstances which put users, carers and staff at risk of harm and then acting to prevent or control those risks. This helps us to improve the quality of care we provide.

Root Cause Analysis (RCA)

Systematic process to analyse the causes of incidents, learn from them and where possible reduce the risk of recurrence

RPST

Risk Pooling Scheme for Trusts – assesses how the Trust manages risk.

Secondary care

Health care provided in hospital setting

Sections of the Mental Health Act 1983

Formal powers to allow compulsory admission of patients for observation – subject to meeting relevant criteria.

Service and Financial Framework (SaFF)

Annual agreements drawn up between all health service commissioners and providers to provide the resources and activity needed to deliver national and local targets (now superseded by Annual Accountability Agreements - see above).

Service user/s

People who need health and social care for their mental health problems. They may live in their own home, stay in care, or be cared for in hospital.

Social care

Personal care for vulnerable people, including people with special needs which stem from their age, physical or mental disability and children who need care and protection.

Stakeholder

All parties within and interest in the organisation, services, etc.

Strategic Health Authority/ies (SHA)

Responsible for developing a strategic framework for the health systems within their area and for performance managing Primary Care Trusts and NHS Trusts. 

Strategic Outline Case

High-level document providing information that will enable the assessment of a bid for capital investment, with emphasis on the strategic context, case for need and affordability. (Usually next stage following outline business case.)

Supervised discharge

Under the 1995 Mental Health (Patients in the Community) Act consultant psychiatrists may apply for powers of supervision of service users following discharge from hospital. A ‘supervisor’ (care co-ordinator) has the power to ‘take and convey’ the service user to a place of treatment, but not to treat them.

Support Time Recovery (STR) workers

Staff within community teams who have dedicated time to support service users to access resources in the community and thus promote their independence

Teaching Trust

Strengthens the Trust’s links with higher education institutions. Trust receives extra funding to support the teaching of psychological medicine to doctors from the Cambridge University School. The Teaching ethos influences all staff groups and education programmes.

Tertiary care

Specialist care, usually for less common illnesses.

‘Two ticks’

An award recognising employers’ innovative work on disability and implementing the Disability Discrimination Act 1995.

Voluntary Sector

See Independent Sector above

White Paper

Government document which outlines the way policy and services will operate in the future.

 

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