Content area
Full Text
Introduction
Health services fragmentation is considered to be one of the main obstacles to attaining effective healthcare outcomes in many healthcare systems around the world (World Health Organization, 2008). In order to address this problem integration of care has been promoted by international agencies and national governments (Pan American Health Organisation, 2010; World Health Organization, 2008). Plans for organisational or integrated delivery systems date back many years (Shortell et al., 1994). The concept of integration was embraced by Scottish Government who produced legislation defining managed clinical networks (Scottish Executive Health Department, 1999; 10) and subsequently promoted their development in NHS Scotland (Scottish Executive Health Department, 2002a; 69). Managed care networks extend the principles of managed clinical networks to health and social care. Managed clinical networks tend to be condition specific, and require robust quality assurance frameworks in order to be effective. Examples in Scotland can be found in the areas of diabetes as well as coronary heart disease and stroke. It is acknowledged that the model for these networks has applicability beyond health, extending more widely to a range of care services provided by various agencies for different care groups.
One further example of an integrated system developed in Scotland is the Forensic Mental Health Services Managed Care Network (Forensic Network), whose remit is to advise on policy and service development throughout Forensic Mental Health services. The Forensic Network has a crucial role in shaping Scotland’s approach to Forensic Mental Health and Learning Disabilities (LD). This paper will describe the context that led to the establishment of the Forensic Network, including the School of Forensic Mental Health (SoFMH); it outlines some successes and focuses on links to clinical practice with particular regard for LD service development, education and training, as well as multi-disciplinary and multi-agency working and quality improvement. An example of a small scale educational initiative undertaken in the high-secure services is included as an example of good practice in the LD service.
Background
NHS Scotland policy paper health, social work and related services for mentally disordered offenders (Scottish Executive Health Department, 1995; 5) set out proposals for a co-ordinated range of services and accommodation for mentally disordered offenders designed to meet the needs of the individual and public safety. It included a...