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      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
      • International strategy
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
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      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
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      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
    • Events held by other organisations
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      • Health of Nation Outcome Scales
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    • Highlights from International Congress 2020 - Webinar Series
      • Registration
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      • FAQs
    • Accommodation List
    • Recruitment events
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    • International Congress 2021
      • Congress FAQs
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      • Key dates
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      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy
      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce
      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health
      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Working sustainably
      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
  • Mental health

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      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Memory problems and dementia
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Personality disorder
      • Postnatal depression
      • Physical illness
      • Postpartum psychosis
      • Problem gambling
      • Post Traumatic Stress Disorder (PTSD)
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
      • Perinatal OCD for carers
      • Postpartum Psychosis in Carers
      • Postnatal depression key facts
      • Postnatal depression: information for carers
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Memory problems and dementia
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Personality disorder
      • Postnatal depression
      • Physical illness
      • Postpartum psychosis
      • Problem gambling
      • Post Traumatic Stress Disorder (PTSD)
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
      • Perinatal OCD for carers
      • Postpartum Psychosis in Carers
      • Postnatal depression key facts
      • Postnatal depression: information for carers
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
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The CSH and RCPsych sustainability scholars

Sustainability blog

12 May, 2016

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CSH  and RCPsych have four sustainability scholars who are advanced Trainees in psychiatry. They are using their special interest day to work with their local CCG to improve the sustainability of commissioning. They are now half way through their scholarship. They have each started working in their own ways to embed sustainability principles into the redesign of mental health services commissioned by their respective CCGs. Mike Pearce at Oxfordshire CCG has undertaken a sustainability appraisal of a 'Young Person with Dementia' service, evaluating the service from an environmental, financial and social perspective. Arif Ahmed is developing sustainable outcomes for a MH liaison service in Liverpool. Oliver Bashford's work is on redesigning of City and Hackney CCG's crisis pathway and Suhana Ahmed's is working on a new mental health homeless service with Brighton and Hove CCG. Please see below for their half term reports.

Dr Daniel Maughan


Suhana Ahmed

Half term report: RCPsych scholarship and Brighton and Hove CCG

Nearly midway through the RCpsych Sustainability Scholarship, I’ve been thinking about the last 6 months and where I am at the moment. Having been paired with Brighton and Hove CCG, the first few months were getting to meet the relevant people and gain some understanding about the sustainable aspects of the CCG by reading through their sustainability plan and the progress they had made so far. It was clear from early on that they were keen for me to be involved and highlighted a new service being commissioned and piloted called ‘Mental Health Hostels Link’. The aim of the pilot was to gain a greater understanding of the mental health needs of the homeless within hostel settings and to identify barriers to mental health treatment and support.

Whilst significant progress has been made to improve health outcomes of the population as a whole, inequalities remain for many socially excluded group, one of which is the homeless population, with evidence of lower life expectancy and poorer health outcomes. In March 2014, services estimated that 132 people were rough sleeping in one night in Brighton. In addition, there are approximately 400 people in emergency accommodation and the city has 288 hostel places, with a current waiting list of 125 people.

The first few months of the scholarship involved me carving a role for myself in this project, with the 4 principles of sustainability being key in this. Various possibilities were discussed including patient related outcome measures (PROM) and focussing on the restoration of social capital, leaner, more effective pathways and training and empowering hostel staff with training.

In the last few months, after some very informative and useful meetings with individuals at the CCG, we identified an area of focus for the project which would have a sustainable basis and also be helpful in developing the service. To research the evidence around mental health intervention from the 1st stage (every contact counts) and how ‘treatment’ could be incorporated into the engagement process which can be time consuming in this complex population. How does this link into sustainability I hear you say? Improving value – by ‘treating’ from the very first contact, we are delivering interventions that provide the maximum benefit for the least cost (in theory reducing the time spent in the service by ‘treating’ and engaging side by side rather than one after the other). Prioritising prevention – aiming to prevent this population from becoming homeless again by equipping them with skills to build resilience (there is well known ‘revolving door’ phenomenon in the homeless). Empowering individuals and communities – promoting self-management and independent living.

And there you have it, the first 6 months of my scholarship. Let the final 6 months proceed…


Oliver Bashford

Half term report: Sustainability in crisis pathways and the RCPsych scholarship

The first half of the RCPsych sustainability scholarship has brought fascinating insights into the workings of a CCG, and the steps involved in the commissioning of services. I was involved in a GP members engagement event in which priorities for commissioning were discussed and ideas invited from participants. I was part of a session on waste reduction in which we spoke with local GPs to generate ideas about how local services could be improved and waste reduced. I have also been involved with a review and redesign of the crisis pathway in the local area. I looked into best practice from elsewhere around the country to identify efficient models of organising services, which led to a recommendation that a Single Point of Access could be developed in alignment with a new service in another part of London. The work with the redesign of crisis pathways has led to the current project which involves analysing data about the users of crisis services in order to inform decisions about how resources should be most effectively focussed. If we find that particular demographic groups are over-represented in the use of crisis services in this locality, this may allow for focussed intervention to support these groups. Related to this we will be looking at social sustainability in relation to crisis care, including a review of models of services such as street triage, crisis cafe and a peer-supported 'open dialogue' approach currently being implemented in other parts of the world...


Michael Pearce

The first half of the year has been a busy one so far in my role as a psychiatry sustainability scholar… As-well as collaborating and learning with the other enthusiastic scholars, attending and presenting at conferences and engaging with NHS colleagues in the ideas of sustainable healthcare, I have been undertaking 2 main projects: I have been working with Oxfordshire Clinical Commissioning Group to try to apply the principles of sustainable commissioning to the reviewing and commissioning of older adult mental health services. This involves working with the CCG team to review whether current services are sustainable, and to feed sustainability principles into the redesign to ensure all aspects are considered. Examples have included highlighting guidance on early identification of patients, generating guidance on specific risk factors and prevention strategies for functional illness in older age, helping to map which services or innovations/pilots might be best placed to tackle the risks, and others in the works. I have also been undertaking a sustainability appraisal (possibly the first of its kind!) of a young person with dementia service. This service is an innovative charity which uses sustainable methods such as group activities in natural settings, to provide respite to carers/relatives of the sufferers. The project has involved evaluating the service from an environmental, financial, and social perspective (the triple bottom line). I hope to use this as a template for other services to be able to follow… I hope to be able to provide further updates as my work progresses, and I’m looking forward to more collaborative work with the other scholars.


Arif Ahmed

The main focus of my scholarship to date has been involvement with Liverpool Clinical Commissioning Group (CCG) on their liaison service redevelopment. This has given me an insight into commissioning, business cases and the importance of networking. I have been able to attend important meetings at the CCG about the project and introduce them to the  four principles of sustainability.

I have visited a local liaison service in Liverpool which has given some useful insights into the current setup. I am helping Liverpool CCG on the outcomes section of their business case, introducing ‘sustainable liaison outcomes’. The latter has been put together as an abstract and submitted to the liaison faculty for a potential poster and stand at the conference in Birmingham in May 2016. This has involved some joined up working with my fellow scholar Oliver and expert support from Phil and Frances.

You might be thinking what benefits there are to thinking sustainably in liaison psychiatry. Actually, by looking at a service’s structure and outcomes through a lens of the 4 sustainability principles, one might expect improvements such as these:

  • Improved patient and family satisfaction with services
  • Greater patient resilience through education and linking up with community services
  • Improved access to local psychiatric inpatient beds, meaning less travel and more convenience for family
  • Better outcomes for vulnerable groups such as the homeless and asylum seekers
  • Reduction in unnecessary investigations

These are just a handful of the potential positive outcomes – keep an eye out on the Psych Susnet blog over the coming months for a more detailed report.

As well as engaging colleagues at the CCG in Liverpool, I have also given talks on sustainability in Cumbria (where I work) to the frail elderly pathway Vanguard group and at a dementia steering group meeting (given via teleconference!). I plan to further this with potential talks to trainees and medical students at educational sessions. There will hopefully be an opportunity to lead a session to my fellow higher trainees in psychiatry, which could increase awareness in sustainability and encourage others to take up future scholarships.

If time permits I would like to do a quality improvement project with Liverpool CCG on a selection of the sustainable outcomes. Another potential project is to measure the carbon footprint of the liaison service as a case study, possibly as a joint project with my fellow scholars. I am soon to work with Frances on the ‘improving value’ section of a mental health service review template.

At almost midpoint through this scholarship, I can genuinely say that I have been fortunate to have had this opportunity and enjoyed the journey so far. It has enhanced my training in psychiatry by opening my eyes to sustainability, commissioning and the impact one can have on the services we work in as psychiatrists. I look forward to the second half of the scholarship, collaborating with supportive colleagues and hopefully gaining further tools to be of greater benefit to my patients. For those doctors in training who wish to broaden their experiences and perspectives, I would recommend they consider a special interest in sustainability.

Blog Author
Dr Daniel Maughan
Dr Daniel Maughan

Associate Registrar in Sustainability

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