Government policy, changing demographics, epidemiology, health inequalities and increasing public expectations services, requires NHS Scotland to flex and bend to meet healthcare needs of the Scottish public.
The challenges faced by NHS Dumfries and Galloway Mental Health Service Directorate are no different from the national perspective, and have required innovative thinking which have seen the development of better ways of working.
The demographic changes facing Scotland are well documented, with the number of people in Scotland aged over 65 projected to increase by 22% by 2020, and by 63% by 2035. The over 75 population is predicted to increase by 23% and 82% over the same period and the over 85 population will increase by 39% by 2020 and 147% by 2035. Our current service will need to adapt to meet the healthcare needs of this growing population
We all recognise the benefits of keeping people at home, or within a homely setting, as close to their family, friends and local community. The Mental Health Service works closely with patients, carers, statutory and third sector colleagues to provide services that, wherever possible, prevent unnecessary hospital admission. There are, however, times when admission to a hospital is necessary and with this in mind, we have been developing our services over a number of years, and have seen a huge shift from hospital based care to community settings. We need to capitalise on our previous successes and have identified ways in which we plan to move ahead over the coming years.
The Mental Health Service Directorate comprises of four large component service teams (Mental Health, Learning Disability, Substance Misuse and Psychology) and within these teams there are a range of individuals from different professional backgrounds (nurses, AHPs, administrative staff, HCSW, Medical Staff, Psychology, and workforce business partners from Workforce Directorate, Finance). We have 2 in patient units based in Midpark, and in Darataigh in Stranraer, and have numerous community bases across all 4 localities
Over the next few years, the Mental Health Directorate will continue to strive to provide care that aligns with contemporary healthcare policy and legislation, and do this in a collaborative way with our stakeholders. In order for us to ensure appropriate services are being delivered, and that will meet the health needs of the general public of Dumfries and Galloway, we will continue to focus on a number of specific areas.
We will consider ways in which our inpatient beds are configured and consider opportunities to improve individual’s experience of in patient care, whilst developing inpatient services in line with our changing demographics. Services will be based on patient need rather than age.
We will support and evaluate the current 24/7Crisis Assessment and Treatment Pilot Service (CATS), based in the Out of Hours/Accident and Emergency Unit
We will develop our IDEAS (Interventions for Dementia, Education, Assessment & Support ) Service, a team designed to enhance skills in statutory and non statutory services specifically for individuals with a diagnosis of dementia.
We will develop a model of care that takes into account the challenges associated with our more remote and rural areas.
We will develop services which provide early interventions for people with memory problems, and develop Health Care Support Workers to work with families living with dementia.
This is an exciting time with significant challenges to face. We think, however, that we can offer a modern and effective service, within budget, but that such successes will inevitably rely on continuing to build strong working relationships with our service users, carers, and families, colleagues from all health and social care settings, and third sector partners.
Ian Hancock is the General Manager for the Mental Health, Learning Disability, Substance Misuse and Psychological Services Directorate