NÃ|røy: – Given that we are highly critical of the process and argumentation regarding proposals and stubborn struggle Management in Health Nord-Trøndelag to lay down ward by DPS Kolvereid, we find it necessary to complain to the State Board of Health.
Spotlight
This is to put the spotlight on the process and to assess the health trust and county physician’s interpretation of the guidelines for the operation of DPS with regard to proper staffing. Furthermore, we want to shed light on both the health trust and county physician very negative range on the use of telemedicine in the treatment and assessment of arbeidetsom been made to recruit professionals.
It writes NÃ|røy mayor Steinar Aspli on behalf of municipalities.
Here is the letter
In his letter to the Board of Health writes municipalities following:
Affected municipalities will this letter do Board of Health note that we are strong contrary Helse Nord-Trøndelag its proposal closure of ward at DPS-one on Kolvereid.
How we interpret this in municipalities, is the reason for the closure proposal to find a long-term development, where Nord-Trøndelag Health has created uncertainty about the operation of DPS Kolvereid. Initially the focus was on operating tightening due to the economy, while in the later process is the difficulty in staffing and recruitment which is the main reason.
Leka, Bindal, Nærøy and Vikna, which is municipalities DPS Kolvereid to operate, is very concerned at developments in the DPS one. This applies to the closure, but also the process that led to this conclusion. Municipalities are finding that we are not adequately been heard with our arguments. We also question whether the distance between Helse Nord-Trøndelag County Medical sufficiently objective.
The specific situation of shutdown is triggered with guidelines issued by the clinic manager Kathinka Meirik and on the basis of supervision conducted by the county medical in Nord-Trøndelag.
The report that Fylkeslegen provide for supervision, it is revealed that Helse Nord-Trøndelag not sufficiently ensure necessary specialized expertise in the provision of specialist services to inpatients at DPS Kolvereid. But when one goes specifically into what the discrepancy is based, it is difficult to see where the workforce fails. Fylkesmannen mentions procedures are not followed and rota does not. It mentions specifically that there is no present psychologist and a physician specializing in psychiatry in the afternoon, evening, night and weekend. This meets Helse Nord-Trøndelag with agreement from 1/9/15
The most serious discrepancy is admitting patients with elevated suicide risk over time. And that the admission of coercion has increased. This discrepancy has Helse Nord-Trøndelag closed by the evaluation of all patients are added to Namsos, and by not entered patients forced by DPS Kolvereid.
From the municipalities we will remark that there exists diffuse mandatory staffing of the DPS is – the closest we get are such staffing provided in supervisor IS-1388. We assume that staffing must be proportionate to the tasks to be solved. How we read the guide so we question whether it is up to the county medical officer to determine staffing norm for special coverage.
The municipalities are experiencing so that Helse Nord-Trøndelag pushes Fylkeslegen and supervision in front of him instead to grasp the real challenge.
How the four municipalities perceive the situation, it is both the Management documents given to Helse Nord-Trøndelag and in national guidelines, given signs of a strengthening DPS- one in Norway. Among other points to the introduction of mobile teams, which by municipalities perception also conditional on the continuation of the current operational at DPS Kolvereid so that it is possible to get out the good synergies here are thoughtful. Evaluation of mobile teams, mainly ACT, shows that the most vulnerable patients still needed hospitalization in a ward, but that mobile teams contributed to the patients hospitalized in fewer days per. admission
By having access to a ward locally have access to a complete and coherent chain of measures – which will help prevent fractures in a patient care and prevent a deterioration of a Case History. Staff at DPS Kolvereid and municipal employees in BYN has “specialist knowledge” about how patients work in their community, which new research emphasizes a far greater extent than in the past to succeed in treatment. This type of treatment, known as Recovery oriented practice, assumes that effective action is taken closely and in cooperation with the user, their families and local communities. “Internationally recovery highlighted as guidelines for mental health and drug policy, and defines a number of practices in a number of countries”. In a new note from the Directorate of Health National health and hospital plan, District Psychiatric Centres (DPC) in the future Specialist, dated 15th April 2015, described the CMO recommendations and assessments of the need for decentralized services were more likely to integrate substance abuse treatment, user-controlled beds and sleeps with “rapid response”.
The four municipalities directly affected by the closure, has been a process over a longer period in which we have worked well together to improve the services for the population now being affected. We have from the Nord-Trøndelag Health received a Board decision that there should be dialogue with a view to municipal takeover of operations, where the concrete is hanged on a formulation of mission document on municipal pilot scheme. Municipalities together with Nord-Trøndelag Health conducted a checkout of this pilot project and clarified that this is something that at best the earliest can be implemented in 2016/17. This should indicate that the operation of DPS Kolvereid continue as at present until national guidelines and policies are in place.
The municipalities believe that the deviations at DPS Kolvereid not of such a nature that it is not possible for Health North Trøndelag to close these. The reference to the term “prudence” is also diffuse, all the time there are no exact requirements for staffing.
From municipalities we have tried to look at other DPS is and how these resolve staffing challenges. We have also seen the use of telecommunications in a completely different way than what health Nord-Trøndelag is willing to consider.
Our joint collaboration project “Local healthcare – psychiatry, substance abuse and somatic in Bindal and Outer Namdal “resulted in 18 new different measures, all of which were adopted in the four municipal councils and the Board of Health Nord-Trondelag. One of the 18 measures, “Instant help- crisis, substance abuse and mental,” project received 2,2 mil. in grants. This is a pilot project, where the aim is precisely to strengthen the opportunities for rapid response. This measure required municipalities to add ward as they both have available resources to give this audience a good appropriate offer. In the health trust’s board resolution issue 07/2015 Board of Directors requests that the administration cooperates with local authorities for the realization of the outlined measures. We must unfortunately conclude the opposite. Municipalities proposed solutions have been met with critique instead of a real willingness and aggressive approach to identify opportunities. This attitude has unfortunately also marked the last process. Also municipalities understand the seriousness of the situation and have the same recruitment challenges that health authority. Instead of being equal partners who together assess and discuss what measures can be taken, experiencing municipalities that administration in Helse Nord-Trøndelag have used their positions to prevent such solution attempts. Municipalities recruitment experience and input are consistently rejected by the administration. It may therefore appear that the closure of the ward is more a political matter of principle where the solution is predetermined.
In conclusion, we express our strong concern about the treatment as a vulnerable patient group now will get, reduced its offer of Kolvereid. The missing also a justifiable assessment monitor. this patient group. We firmly believe that the offer will be poorer and are contrary to national guidelines. We also show here the impact assessment of Namdal Psychiatry which concludes the same.
We therefore request the State Board of Health to consider this matter. Der The board can affect the Helse Nord-Trøndelag are good future solutions that strengthen services for this target group, and which is in accordance with the national guidelines for community mental health centers.
Wednesday, June 3 2015
The Working Group on the municipalities involved.
Steinar Aspli Pål Sæter Eiden Gudrun Marie Fossum Helge Thorsen
Nærøy Kommune Vikna Municipality Bindal Municipality Leka Municipality
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