The State Hospital

The State Hospital, Carstairs, Lanark ML11 8RP
Phone: 01555 840293 Fax: 01555 840024 email: tsh.info@nhs.net

Health Improvement

In this section:

Photo: Skye Centre Atrium

Photo: Animals (Pet Therapy)

State Hospital patients have very significant physical health needs.  Lack of exercise, obesity, consequences of a self-selected poor diet perhaps complicated by the effects of medication, require monitoring.  

Given that patients do not have access to other services or communities, the Hospital addresses their therapeutic, vocational, social and physical wellbeing needs through a range of onsite therapies and activities including a Health Photo: Botanic HouseCentre.  The State Hospital remains a smoke free environment, and as in previous years, the management of levels of obesity and physical activity remain a significant challenge.

The Physical Health Steering Group Annual Report covering the period October 2015 to September 2016 noted the developments and progress made in Primary Care (including long term conditions); Physical Activity; Nutrition and Weight Management; Food, Fluid and Nutrition and National Guidelines and Standards against Local Delivery Plan (LDP) targets.

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Long Term Conditions & Disease Management

The State Hospital’s Health Centre meets the primary healthcare needs of patients.  Services include screening interventions, disease / condition monitoring, treatment, and management. Patients can be seen on ward if they are not able to attend the Health Centre.

All patients are offered an Annual Health Review (AHR) which involves blood monitoring, BBV screening, ECG and GP consultation.  Of the 95 patients eligible for review in the reporting period of 1 August 2016 to 31 July 2017, 82 (86.3%) patients attended with 11 refusals and two patients currently rescheduled.

Ongoing monitoring of Long Term Conditions reflects a higher incidence than the general Scottish population.  The table below shows comparative data for 2016/17:

Table showing Long-Term Conditions data for 2016/17

Health Improvement events including, stay safe in the sun, footcare awareness, testicular cancer, and cholesterol and heart disease were promoted during the year.  Information leaflets on Health Centre services and health information for patients were reviewed and updated early 2017.

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Nutrition and Weight Management

Despite continued efforts in 2016/17 to tackle obesity, 87.4% (December 2016) of patients were overweight / obese compared to 86.3% in June 2016.  This is above the national Scottish male average. 

A compliance score of 94.2% was achieved against the ‘NHSScotland Food in Hospitals National Catering and Nutrition Specification for food and fluid in hospitals in Scotland (2008)’ standards half yearly report from June to December 2016; a reduction in the last score of 99% being achieved due to a decrease in compliance with the nutritional needs of the population, menu guidance, and special and personal diets. 

Nutritional screening and care planning continues to be undertaken for all patients. An audit in October 2016 highlighted all patients had a Nutritional Screening Tool completed, however 50% of these were past the review date based on their risk score. Further developments with individual Nutritional care plans post screening are underway for 2017/18. 

A physical health module has been developed for all clinical staff supporting basic health education messages. 

Two ‘Healthy Living Groups’ have been established, supporting patients weight and overall health self management, with plans to roll these out further during 2017/18.  In addition, the Slim and Trim Group continues to be held weekly and the Occupational Therapists are running regular healthy cooking groups.

It was agreed that the Hydration Policy and the Food Fluid & Nutrition Policy will be reviewed in 2017/18, due to Hospital wide changes regarding food and nutrition channelled through the ‘Supporting Healthy Choices’ workstream.

Two ‘REHIS Food and Health for Carers of those with Learning Disability’ training courses were delivered to Nursing, Occupational Therapy and support staff.  All staff achieved the award.

Patients with a healthier BMI decreased from 15% in the previous year to 13.6%. The physical health inequality of our patient group is significant; reducing obesity and increasing physical activity are paramount in addressing this issue. In the past year we have:

  • Relocated exercise equipment in the grounds of the Hospital to improve access to same.
  • Piloted a new way of recording physical activity levels in one hub.
  • Agreed the implementation of a programme of work through the Supporting Healthy Choices workstream, including healthy lifestyle plans, and changing the approach to supermarket procurement.
  • Implemented revised stock within the Hospital shop, becoming the first NHS Board to achieve the Healthy Retail Standard.
  • Continued to invest our in Health Champions through the delivery of an ongoing programme of learning and development, and raining awareness of the role.
  • Continued to improve the healthcare environment including access to ward-based exercise equipment.

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Physical Activity

Enhancing physical activity is just one of many interventions within the Hospital geared at improving the physical health of patients.  In 2016/17:

  • Over 60 patients had planned sessions to attend the Sports & Fitness Centre each week with individual patients attending between one and 10 sessions.
  • A Sports and Fitness Pathway was introduced ensuring patients undergo a Sports and Fitness Assessment within 14 days of admission and access to the Sports and Fitness Centre within 14-21 days of admission.
  • Electronic recording and monitoring of physical activity interventions (for patients by all disciplines) was piloted and will be rolled out across the Hospital by the end of 2017.
  • Individual patient physical activity information was introduced to weekly Clinical Team meetings.   
  • A four cohort of six patients completed the Sports Leadership Course Level 1.
  • Six patients completed the Bike Ability Course.
  • Occupational Therapy Walking groups continued to be a great success with eight to 10 patients attending each session.
  • Patients continued to make use of the outside gyms, walking routes within the grounds, and exercise opportunities within the hubs / wards.

Photo: Patient Walking Path

 

 

 

 

 

 

 

 

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Education and Patient Learning

Photo: Patient Learning CentreThe Patients’ Learning Centre offers a range of learning opportunities to suit all levels of learning, both formal and informal.

2016/17 saw the introduction of two additional programmes being added to the portfolio of qualifications available for patients; these were ‘Creative Arts’ and ‘Practical Craft Skills’.

Of the patient population, 68% engaged in formal accredited learning programmes compared to 54% in 2015/16.  The curriculum framework continues to expand with a total of 122 formal qualifications being attained compared to 105 in 2015/16.

Core skills screening is offered to all patients. Year on year, there has been an increase in the number of core skill national unit completions in numeracy, communication, information technology and recently added, working with others and problem solving:

Table showing Core Skill National Unit Completions from 2013/14 to 2016/17

Several of the core skills qualifications were completed through themed learning activities.  The problem solving core skill was delivered for the first time during 2016, with the course being delivered through both themed learning activities and as part of a work-based approach within the patient library volunteer role.

The Patient Learning Achievement Awards took place in January 2017.

Patient Library - A Guide for Patients (June 2017)Opens in a new window

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Health Improvement Publications

Health Centre 'patient information' (June 2017)Opens in a new window

Podiatry Service (June 2017)Opens in a new window and Foot Care 'patient information' (June 2017)Opens in a new window

Sun Protection 'patient information' (June 2017)Opens in a new window

Vitamin D 'guide for staff' (October 2012)Opens in a new window and Vitamin D 'patient information' (June 2017)Opens in a new window

Physiotherapy Service 'guide for staff' (June 2017)Opens in a new window and (Physiotherapy Service 'patient information' - June 2017)Opens in a new window

Occupational Therapy leaflet for Patients (March 2010)Opens in a new window

Speech and Language Therapy leaflet for Patients (September 2008)Opens in a new window

Animals as Therapy booklet (August 2007)Opens in a new window

Suicidal Behaviour Awareness and Good Practice Guidelines (August 2006)Opens in a new window