Learning Note for question 1

•1. Analyse within a selected community the services and resources available to
promote mental health, prevent mental ill-health, and support people experiencing a
range of challenges that may impact on their wellbeing.

•Why is community profiling relevant to mental health nursing?

•How might it influence nursing care and decision making?
•What could go wrong/be done poorly?
 
Analysis and discussion of the profile of a designated geographical community in the
context of health promotion

•The key focus of the assignment is to identify, analyse, (not describe), and discuss:
•the range of services and resources that are available within the designathed
geographical area and the key focus is analysis and discussion of the resources,
services and partnership working that promote mental health, prevent ill-health and
are supportive of people within the community.

The purpose of developing a community profile is to collect baseline data for

understanding health and health-related problems in your community. 
 
 
 

Factors for consideration

1.Basic introduction to the community and it’s health care issues – are these
specific or endemic?
2.What are you going to focus on and cover?
3.How will you mention partnership working and which services are working
in this community?
4.How does
wellbeing/health/infrastructure/employment/culture/heritage/deprivation/crime
compare in your community to others?
 
 
5. Does what's documented match what you experience? If not – evidence and argue.
6. What services are available? Day centres/GP/maternity services/hospitals/harm
reduction/respite/social clubs/parenting clubs and how do these aim to improve health
outcomes? If they are absent, what impact may this have?
7. How do services promote mental health, prevent mental ill-health, and support people?
Challenges can be mentioned however focus is on promotion, prevention and support.
 
Some potential resources
•https://campusmoodle.rgu.ac.uk/pluginfile.php/5440170/mod_resource/content/2/
Community Profile Additional Information.m4v
•Community Profile 
•Public Health Scotland
•Acts, Laws or Legislation
•Community Profile websites
•Documents from Health and Social Care Partnership
•Community centre timetables
 
•Fairer Aberdeen
•National Records Scotland
•Place Standard website
•Community Wellbeing Index
•Office for National Statistics
•Scottish Government reports
 

My Community
Describe the community
What are the key issues for the community?
What are the priority needs to be addressed and why?
How was the information gathered?
What is happening locally to address the health needs?
What is/isn’t working to address the health needs?
What interventions are needed to address the health needs?
Who needs to be involved?
 
Adapted from: Jack K, Holt M. 2008. Community profiling as part of a health needs
assessment.
Nursing Standard. 22, 18, 51-56.b
 •What causes wellness | Sir Harry Burns | TEDxGlasgow – YouTube

•Analyse, critique and discuss the meaning of Society, Health and Wellbeing

References
•COMMUNITIES EVIDENCE PROGRAMME. 2015. Voice of the user
report. London: What Works Wellbeing Centre
•DAHLGREN G AND WHITEHEAD, M .1993. Tackling inequalities in health:
what can we learn from what has been tried? Working paper prepared for the
King’s Fund International Seminar on Tackling Inequalities in Health, September
1993, Ditchley Park, Oxfordshire. London, King’s Fund
•OFFICE FOR NATIONAL STATISTICS. 2013. Reflections of measuring national
wellbeing. London: Office for National Statistics
•OPENSTAX, 2017, Introduction to Sociology, Edition 2e, Houston: Rice
University
•Smith, Valerie & Daly, Deirdre & Lundgren, Ingela & Eri, Tine & Benstoem,
Carina & Devane, Declan. (2013). Salutogenically focused outcomes in systematic
reviews of intrapartum interventions: A systematic review of systematic reviews.
Midwifery. 30. 10.1016/j.midw.2013.11.002.
•WARLINGHAM PARK
HOSPITAL: https://museumofthemind.org.uk/learning/your-hospital/resources
•WHO. 1946. Constitution. Geneva: WHO
 Jack, K and Holt, M. 2008. Community profiling as part of a health needs
assessment

Partnership working notes

Discuss how partnership working across services and agencies promotes mental health,
prevents mental ill-health and supports people experiencing a range of challenges that
impact their wellbeing.

Aims 
•Develop an understanding of integrated health and social care (IHSC),
including aims and objectives, legislative basis and structures.
 
•Build up a picture of IHSC in Grampian within context of mental health care.
 •Existing fragmented and medically-focused services
•Ageing population and multi-morbidities
•Increasingly complex care needs
•Elevated risk of hospital admissions
•Interdisciplinary working key
What is Integrated Care?

•Globally recognised concept

 
•The International Foundation for Integrated Care
 
•Increasing number of definitions (> 175)
 
•Complex phenomenon- multiple levels, interventions, stakeholders, contextual
factors
 

What is Integrated Care?

Care that is:  

 
•Holistic
•Co-produced
•Continuous
•Coordinated
•Equitable
•Sustainable

The Six Core Values of Integrated Care

Key Challenges Faced
•Variation across Integration Authorities in relation to population size,
socioeconomic and geographical characteristics, population health and care
needs
 
•Delays in accessing services when needed; addressing early intervention to
reduce admissions; delayed discharges

•Planning around individuals not institutions; the promotion of health and

quality of life rather than just treatment.

1999
Scottish Devolution
2002
Community Care and Health (Scotland) Act
2010
Reshaping Care for Older People Programme
2014
Public Bodies (Joint Working) (Scotland) Act

Policy and Legislation (Scotland)

Public Bodies (Joint Working) (Scotland Act) 2014

•31 statutory H&SC partnerships - 'Integration Authorities'

•Responsibility for funding for urgent care, mental health care, community
services, and social care
 
•Strategic Integration Plans
 
•Highland- only IA where NHS 'lead agency'

Funding and Accountability in Scotland

 
Ref: Nuffield Trust (2021)

Integration Joint Boards (IJB)

IJB

Health Board

Local Authority
Planning of integrated arrangements and onward services delivery
Delegate functions & responsibilities

Strategic Planning Group

Strategic Plan

CSWO
GP
Nurse
Staff-Side
Third Sector
Carer
Service User
s.95 Officer
Chief Officer
Secondary Care
Stakeholder Representatives
Professional Representatives

•Aberdeen City
•Aberdeenshire
•Moray

Why does all this matter?

National Health and Wellbeing Outcomes

People are able to look after and improve their own health and wellbeing and live in good
health for longer
Patients/service users have positive experiences of those services, and have their dignity
respected

HSC services are centred on helping to maintain or improve the quality of life of people
who use those services

Health and social care services contribute to reducing health inequalities

Unpaid carers are supported to look after their own health and wellbeing

People using health and social care services are safe from harm

Health and social care workers feel engaged with the work they do and are supported

Resources are used effectively and efficiently in the provision of health and social care
services

People able to live, as far as reasonably practicable, independently and at home or in a

homely setting in their community

Triple/Quadruple Aim

Improve Population Health

Improve Patient Experience
Cost Reduction
Improve Experience  of Providing Care
Ref: Sikka, Morath & Leape (2015)
Measuring Impact
•System-level measures of community wellbeing and population health
•Service proxies for improved health outcomes
•Personal health outcomes of people and communities
•Resource utilisation
•User and carer experiences
 
Ref: SCIE (2019)

Mental Health Services

Before Integration
•Separate buildings
•Immersed in own professional cultures
•Faceless workers
•Lack of relationships
•Referrals
•Lack of trust
 
•Anxiety about sharing info
•Info sent or taken to other agencies
•Different processes
•Separate teams
•Lots of appts in different places
•People having to share story many times

Following Integration
•Co-located
•Exposed to other professional cultures
•Real people
•Relationships– understanding
•Shared caseloads
•Building of trust
 •Sharing info common practice
•Some sharing of info easier
•Some common processes
•One team
•Appts in same place
•Care coordinated by 1 person – less need to share story many times

IHSC and Mental Health

 
Think about cases you may have encountered in practice and refer to the principles of
integration which can be found here:
 
https://www.gov.scot/publications/ministerial-strategic-group-health-community-care-
review-progress-integration-health-social-care-final-report/

Principles of Integration for Reference

1.   Be integrated from the point of view of service-users
 
2.   Take account of the particular needs of different service-users
 
3.   Take account of the particular needs of service-users in different parts of the area in
which the service is being
     provided
 
4.   Take account of the particular characteristics and circumstances of different service-
users
 
5.   Respect the rights of service-users
 
6.   Take account of the dignity of service-users
 
7.   Take account of the participation by service-users in the community in which service-
users live
 
8.   Protect and improve the safety of service-users
 
9.   Improve the quality of the service
 
10. Be planned and led locally in a way which is engaged with the community (including
in particular service-
     users, those who look after service-users and those who are involved in the provision
of health or social care)
 
11. Best anticipate needs and prevents them arising
 
12. Makes the best use of the available facilities, people and other resources.

Impact
•Implementation has been regarded as 'slow and piecemeal' across Scotland
•High level of turnover of the first cohort of Chief Officers and IJB Chairs
•Volatility and uncertainty brought about by the pandemic
•Widening of relative inequalities over the past decade
•Underepresentation of people with lived experiences
Ref: Hendry et al. (2021)

Further Change is Afoot

•Independent Review of Adult Social Care in Scotland (2021)
•Development of a National Care Service (NCS)
•Responsibility for the commissioning and procurement of adult social care to
be given to Integration Authorities- directly accountable to Scottish
Government via NCS

•Nurture creative, flexible and resilient leaders

•Be prepared to cede power and control to other organisations, communities
and individuals
•Involve citizens and people who use services in co-designing future models of
care
•Accepting new ways will only make sense if anticipated improvements can be
evidenced and any unintended consequences managed
•Adopting technology and new ways of working is complex
 •Integration is a marathon not a sprint

Lessons Learned
Examples taken from: Thompson et al. 2021, pp. 871-872

References 
HENDRY, A. et al., 2021. Health and Social Care Reform in Scotland- What Next?
International Journal of Integrated Care, 21(4), pp. 1–14
SIKKA, R., MORATH, J.M. and LEAPE, L., 2015. The Quadruple Aim: care, health,
cost and
meaning in work. BMJ Quality & Safety, 24, pp. 608-610.
SOCIAL CARE INSTITUE FOR EXCELLENCE (SCIE), 2019. Selecting the right
measures to understand and measure impact [online]. London: SCIE. Available from:
https://www.scie.org.uk/integrated-care/better-care/guides/measure-impact/measures
[Accessed 18/05/22].
THOMPSON, M., HENDRY, A. and MEAD, E., 2021. Three Horizons of Integrating
Health and Social Care in Scotland. In: V. AMELUNG et al., eds. Handbook of
Integrated Care. 2nd Edition. Switzerland: Springer Nature. pp. 851-879.
Seminal paper on Triple Aim:
BERWICK, D.M., NOLAN, T.W. and WHITTINGTON, J., 2008. The Triple Aim: Care,
Health and
Cost. Health Affairs. 27(3), pp. 759-769
I also mentioned this paper at one point:
CONNOLLY, J. et al., 2022. The Leadership of Co-Production in Health and Social Care
Integration in Scotland: A Qualitative Study. Journal of Social Policy. First View, pp. 1-
20.
Partnership working
Positives
•Improved communication
•Improved access to services
•Bringing together skills and resources

Negatives
•Competing institutional norms and priorities.
•Difficult to implement
•Little known on impact – further research required.

•Which stakeholders would be involved?

•How would they work together to achieve the best outcome for those involved?
•What potential barriers might there be?

•31 Health and social care partnerships

•Working towards national health and wellbeing outcomes.
•Shared vision: A Scotland where health and social care services are delivered in a
sustainable and integrated way
 
Locally….
•Aberdeen City Health & Social Care Partnership
•ACHSCP – Strategic plan (2019 – 2022): Outlines how improvements will be
delivered to existing services with the aim of improving health and wellbeing of
people living and working within Aberdeen city.

References
•ALDERWICK, H., et al, 2021. The impacts of collaboration between local health
care and non-health care organisations and factors shaping how they work: a
systematic review of reviews. BMC Public Health 21(273), pp. 1-16. BMC Public
Health.
•Adult Support and Protection (Scotland) Act 2007
•Adults with Incapacity (Scotland ) Act 2000
•Community Care and Health (Scotland) Act 2002
•Children and Young People (Scotland) Act 2014
•Mental Health Care and Treatment (Scotland) Act 2003
•MELTAL WELFARE COMMISSION. 2019. Person centred care plans: Good
practice guide. Mental Welfare Commission.
 •NHS EDUCATION FOR SCOTLAND. 2019. Mental Health Improvement &
Suicide Prevention Framework. NHS Education for Scotland.
•Public Bodies (Joint working) (Scotland) Act 2014
•THE SCOTTISH GOVERNMENT. 2017. Mental Health Strategy: 2017-
2027. The Scottish Government.

Prevention
Resilience
Personalisation
Connection

   Writing Analytically
Descriptive v. Analytical Writing: What’s the difference?
Descriptive and analytical (critical) writing both have their place in student assignments.
Descriptive content is needed, for example, to give essential background information and
context.
Without analytical writing, however, it is difficult to demonstrate your understanding of
the material. Writing descriptively when they should have been writing critically is a
common reason for students to receive lower grades than they expected.
The table below outlines some of the main differences between descriptive and analytical
writing (adapted from Cottrell 2003):
  Descriptive Writing
States what something is like
Says how to do something
Explains how something works
Analytical (critical) writing
Evaluate its strengths and weaknesses
Argues a case to do something a certain way, based on the evidence
Indicates why something will work (best) or wont work under varying conditions
    1

    Notes the method used

 Says when something occurred
States options
Lists in any order
Gives information
Writing analytically in practice
Identifies why the timing is important or relevant
Gives reasons for selecting these particular options (and why others were excluded)
Structures information in order of importance
Draws conclusions based on an analytical critique of the information or evidence
States the different components
Weighs up the importance of component parts in relation to each other
     Lists details
Examines whether the method was appropriate or suitable
  Evaluates the relative significance of these details
   States the links between items
Shows the relevance of links between items of pieces of information
     It is important to maintain a clear line of reasoning from your introduction to your
conclusion without going off topic or introducing irrelevant pieces of information.
You can apply many of the same principles used for the critical analysis of your sources
to writing analytically (Cottrell 2003):
- Offer evidence to support your reasoning.
- Make sure any assumptions are fully justified and backed up with reliable evidence.
2

- Think critically about your sources of evidence before using them. Do they stand up to
closer scrutiny, or are there flaws in the methodology or reasoning?
- Ensure your conclusion is based on solid evidence, follows a logical thread developed
through the text, and is free from false reasoning.
- Avoid using emotive language.
Useful phrases for writing analytically
The following phrases can help structure your thoughts coherently and link information
to give a logical flow to your argument (Gillet 2006):
Presenting your point of view
- There are many reasons why...
- It is important to point out that...
Presenting another point of view
- In a study of X, Y claims that...
- It has been suggested that...
- According to X...
Commenting on another point of view - negatively
- These views are open to doubt...
- Reservations can be raised against this...
- One objection to this argument is...
Commenting on another point of view - positively
- One of the main arguments in favour of X is that...
- Another point in favour of X is that...
3

Indicating a lack of knowledge in a particular area

- Little research has been done...
- Research has focused on X; less attention has been paid to Y...
Drawing conclusions
- In short...
- On the whole...
- Altogether...
- It may be concluded that...
Comparing/contrasting
- Similarly
- Correspondingly - Whereas