Appendix IV. Proforma used to guide discussions and data collection.
Review of Adolescent Intensive Psychiatric Care Units (IPCU) in Scotland - NHS Scotland Regional Consultation Pro forma
- Current inpatient units
- Please tell us about the inpatient service you work in and your role within that.
- What age are you patients?
- How many beds in the unit?
- What mix of professionals currently work in your inpatient service?
- What would prompt your decision to refer a patient to a more intensive unit?
- What organisations can make a referral? (Where do referrals come from?
- What criteria do patients need to meet to be admitted to an IPCU?
- Once a referral is accepted, what's the process for new admissions?
- What needs to be considered in relation to transferring patients to an IPCU?
- Barriers to admission
- What would exclude a patient from being admitted?
- What happens when a patient is not suitable for an IPCU? Or if a bed can't be found?
- Are there any other barriers to patients accessing an IPCU if they require it?
- When does planning for discharge begin?
- What is the pathway for discharge?
- What type of barriers could prevent patients from being discharged?
Current Adolescent IPCU Options
- IPCU Service Options in your region
- Currently in your region, what are the options for a patient who requires more intensive psychiatric care?
- How well does this match the need for adolescent intensive psychiatric care?
- What staff disciplines are present in the IPCU in your region?
- What mix of staff would you want to see within an adolescent IPCU?
- Patient Management
- Are there any patient management issues specific to adolescents who require intensive psychiatric care? (e.g. restraint procedures, risk assessment, observation)
- What guidelines would you refer to for this? (Are these sufficient?)
- How well are these issues currently provided for in your region?
- What facilities need to be in place for adolescents who require intensive care? (e.g. access to schooling, anything treatment specific?)
- What else could be provided to facilitate their care? (e.g. violence reduction options; meaningful activities)
- How well are these facilities currently provided in your region?
Relationships across Services
- How do intensive care services and CAMHS/Community Services communicate generally?
- How do you maintain communication with intensive psychiatric care services regarding specific patients?
- How do intensive care services and CAMHS/Community Services communicate with social work regarding specific patients?
- National Secure Adolescent Inpatient Service:
- What do you anticipate the relationship being between your service and the new National Secure Adolescent Inpatient Service?
Future Adolescent IPCU Options
- Current unmet need (if not already covered in above discussion)
- What is lacking in current adolescent intensive psychiatric provision?
- What are they key unmet needs?
- Future options
- Would it be possible to adapt current services to meet need?
- What would be the preferred option in your region? (e.g. current arrangement / adapt beds in an adult IPCU / have a dedicated unit adjacent to an adolescent inpatient unit / other)
- What are the benefits of your preferred option?
- What are the disadvantages of your preferred option? (On patient care? / On staff? / On families?)
- What clinical considerations need to be taken into account for these options?
- Admissions to open inpatient adolescent psychiatric units by Health Board?
- Duration of stay of patients in these units.
- Referral/Admission rate - (How many are referred vs accepted and admitted) to open units but also to IPCU services from open units.
Patient Profile (for patients requiring intensive psychiatric care)
- Diagnosis/Conditions - prevalence of conditions existing in patients in the wards.
- Age of patients admitted.
- Level of deprivation - (SIMD)
- Location - Admitted from/discharged to.
- Detention status - how many patients were informal/detained?
- Patients placed on observation - and varying levels of this?
- Core Team - Nursing and Medical Staff required to run the ward? Number of sessions? Daily staffing levels per shift?
- Allied Health Professionals/MDT - Clinical Psychology, Occupational Therapy, SLT input etc. Number of sessions?
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