Lightbulb innovation: Developing a Nurse Led Clinic and Independent Prescribing in a Specialist Mental Health and Learning Disabilities Team

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Nursing colleagues at Bassetts Resource Centre, Oxleas NHS Trust, have developed a Nurse Led Clinic within a specialist mental health and learning disabilities team.

The aim is to support service users and carers to promote and maintain good mental health by ensuring a quicker referral process and further improving the responsiveness and quality of the service.

Julie Jacobs and Morag Niven were aware of the evidence that suggested that many people with a learning disability are sent to live a long way from home (DH 2001), and also that the particular needs of people from minority ethnic communities are not served well by many learning disability service providers. "We took all this into account when we designed the nurse led clinics", says Morag. Utilising the specialist skills of the nurses, we ensure that when an individual with a learning disability experiences changes to their mental health, they are responded to quickly, efficiently and with the skill and knowledge base necessary to enable them to recover and remain in their own homes and local communities.

Every aspect of the service has been carefully considered. For instance, many nurses appear to develop nurse led clinics before considering the role of prescribing and then decide that independent prescribing would enhance the running of the clinics. "For us, prescribing went hand in hand with setting up the clinics" Julie recalls. "This was a vision we had from the beginning and therefore we began prescribing when we started the nurse led clinics".

The nursing team have developed a detailed operational policy for the Nurse Led Clinic, leaflets, nursing assessment and monitoring tools, clinical management plans for non-medical prescribing, and survey/audit tools. Importantly, these include adapted versions for service users with learning disabilities.

The result is that patients experience greater continuity by seeing the same nurse at each appointment (previously they were attended to by junior doctors, who were continually changing). Doctors have more time to attend to complex cases. Clinical decision making has speeded up, and there is greater collaborative working. Peer and professional supervision is still a key aspect of the service, but nurses now experience greater autonomy and responsibility while working in a specialist area of expertise.

The impact of this work is already being felt beyond Oxleas NHS Trust, and the nursing team have given several presentations about their experience, most recently in London and Manchester.

For more information please contact Julie Jacobs: Julie.Jacobs@oxleas.nhs.uk

Documentation

Guidance for carers (PDF, 133KB)
Guidance for service users (PDF, 212KB)

Presentations

"Setting up and running a Nurse Led Clinic in Mental Health and Learning Disabilities AND Prescribing within clinics: our experience", 17 November 2011, Nurse Clinics 2011, Manchester
"Nurse Led Clinics - The Bromley Experience", 20 March 2012, Multi-Disciplinary Academic Programme (Winter Term 2012), South London and Maudsley NHS Foundation Trust

References

Department of Health (2001) Valuing people: a new strategy for learning disability for the 21st century: a white paper, London: Stationery Office.

 

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