Contemporary Issues In Healthcare Policy And Practice

This report examines the quality and effectiveness of CAMHS services, both nationally and in a chosen local borough. It evaluates the key features of this issue for practitioners and managers, and outlines areas for change. The report applies various frameworks and concepts to analyze the issue and suggests improvements to enhance the quality of service.

Contemporary Issues In
Healthcare Policy And Practice

Table of Contents
INTRODUCTION ..........................................................................................................................3
MAIN BODY ..................................................................................................................................3
Examines the quality and effectiveness of CAMHS services, both nationally and in a chosen
local borough..........................................................................................................................3
Evaluating the key features of this issue for practitioners and managers, and outlining areas
for change...............................................................................................................................4
Apply at least two of a range of frameworks and concepts regarding the issue....................6
CONCLUSION..............................................................................................................................11
REFERENCES..............................................................................................................................12

INTRODUCTION
Mental health is the steadiness and level of psychological welfare. It is the way an
individual's function at a satisfactory level of behavioural and emotional adaptation. The way a
human being feel, think and act all depends upon its mental health. It also handles the stress
related problem and make correct choices. Mental health plays a very crucial role in life and
present at every phase, from childhood, adolescence and throughout adulthood (Cherry and
Jacob, 2016). Mental health disorders refers to a wide extent of mental health problems which
affect the thinking, moos and behaviour of an individual. Mental health problems are formed at
early and between ages of 5-15 and three quarter is brought up at 24 years of age.
This report is based on Child and Adolescent Mental Health Services (CAMHS) in
United Kingdom is a NHS provided services especially for children and adolescent who face
trouble with their behavioural or emotional welfare. CAMHS in UK has been established by four
tier system. Tier 1 provide common advice for less severe mental health trouble by non health
specialist. Tier 2 generally involves CAMHS specialist for counselling in schools, clinics. Tier 3
has multi dimensional team of specialist for treating more severe mental health illness and tier 4

consists of the most highly skilled specialist including very serious mental health disorder
patient.
This essay will cover the efficiency and quality of CAMHS services both nationally and
locally providing to children and adolescent having mental health issues. The major concern of
practitioners and way to alter the conditions of provided service will also be addressed (Cutcliffe
and et. al., 2016). To critically analyse the working of given organisation various approaches of
ethical, leadership, management, performance and organisational models will be applied to check
the effectiveness of the organisation. The key issues of CAMHS will also be outlined to improve
and screen the servicing quality.
MAIN BODY
Examines the quality and effectiveness of CAMHS services, both nationally and in a chosen
local borough
Mental health care systems are now a days under alarming pressure to provide more care
with the available technology and resources. CAMHS has been seen to provide best quality care
to the children and adolescent facing day to day mental health problems by efficiently using
restricted service resources. The effectiveness of CAMHS is due to the organised four tier
system which provide and considerate each and every children and adolescent having slight
issue in behavioural and emotional state. Tier 1 involve non mental health practitioners who
works in National Government Organisations, schools or as a general specialist which give
general advice to less severe mental problems. Tier 2 has CAMHS specialists employed in
primary care as a counsellors in youth services and clinics. Tier 3 and tier 4 consists of highly
skilled multi dimensional team of specialist having specialisation in different domain of mental
health. Both tier 3 and 4 is collectively known as specialist CAMHS. The key aim is to have a
team lead by professional and clinical psychiatrists who treats patients having severe depression,
anxiety, eating and sleeping disorders (Hope, 2016). These tier not only provide residential
services but it also delivers domestic and outreach services to specific children and adolescent
patients having complex mental psychiatric illness or impaired.
Inpatient care services is also provided by CAMHS in local mental health services of
Barnet like Spring well centre and Barnet Adolescent services, which includes such medical
treatment provided in CAMHS and necessitate at least a overnight stay of patient for proper

observation and care. Since services are provided at local, regional and national level the
inpatient service has been further intensified and much more widely available. Proper facilities
and treatment is provided to the mental patient making sure that the personal information are
kept confidential. National Centre For Mental Health (NCMH) has been seen to overcome
anxiety, panic attacks, autism, hyperactive, bipolar, schizophrenia, self harm disorders in
children and adolescent. Both national and local organisation services are very effective in
combating mental health disorders (Hooker, Cawley and Everett, 2017). Many early intervention
care providers support and give primary health service to young and children before their mental
health issue has become severe, such services lower the need for bigger tier services.
Evaluating the key features of this issue for practitioners and managers, and outlining areas for
change
The Health Select Committee stated that there are some contemporary serious issues and
deep rooted problems with the provision of CAMHS. Less Priority is given to the children and
young mental health which will prove to be a liability for country. As children and youths are the
emerging future of country, more concern and care should be provided to them on priority basis.
The prime problem in accessing inpatient service of mental health where confidentiality about
children and adolescent is not maintained. This can somehow change by attaching every detail of
patient digitally and setting privacy to the files having such informations. The beds are often not
available so patients have to wait in long queues and sometimes they get a bed in distant part of
area leading to travelling and extra expenditures. This problem can be overcome by increasing
the number of beds and staffs in each service unit and discharging the less severe patients so that
the space can be occupied by more serious patient.
There are some areas where advance intervention services are not provided due to lack of
funding. Thus NHS should audit for such services in local areas and better measures should be
provided to provide funding and stability. The education received by the children and adolescent
during inpatient service is not enough to deal them with their health problem later, so audit has to
be conducted to check educational provisions in such units (Rushton, 2016). Auditing should
also be carried to 2 and 3 tier to set out what expectations can be made regarding their services.
Perinatal mental health services provide mental health services to infants and perinatal, which is
a very crucial time to diagnose any mental health condition as it can be treated quickly as
compared to the one's diagnosed later with the same condition. Such infant health services is not

accessible in every areas. National and local committees must recommend for setting such
services in every possible areas.
There are many benefits proposed by national commission regarding the safety and care
of children and youth but still inpatient services and benefits are not perceived by CAMHS and
all mental health care services. The practitioners and specialist who treat the mental patients by
diagnosing and assessing help to them and provide a solid support to the base of any health care
services. Child & adolescent practitioners and psychiatrists sometimes fail to give proper
medication and treatment for diagnosed condition due to lack of communication among staff and
over crowdedness (Willis and et. al., 2017). This can be altered by making a proper
communication and setting guidelines to be followed by every staff member. Variability has
been observed between the outpatient and inpatient services of CAMHS availability and the gap
has been seen in the quality of care being provided to the patients. This can be amended by
improving the mechanism and arrangements of commission.
From last many years CAMHS has been running without being surveyed, it seems like
the planning and operation of whole organisation is in fog, which resulted in lack of updated and
reliable information regarding the management and patients. Policy makers and commissioners
should ensure and check the data base of CAMHS as a priority. Prior mental health training as a
chapter or module should be given in school for making them learn and teach the problems and
symptoms for bringing awareness in society and world.
Kurt lewin's change model is majorly based upon three step process that allow a huge
level concept to change. It gives an opportunity to the manager to implement a change according
to the framework and in a sensitive way. This model involve: unfreezing, changing and
refreezing steps. Unfreezing is a first step of Kurt lewin model which involve setting up a new
status by breaking the previous one, so that a fresh way of operating can be established. The aim
is to show that the existing practice of mental health care service is not compelling enough to
make a positive change in patient satisfaction, thus new way has to be attained to achieve
meaningful change (Roux and Halstead, 2017). Changing is the next step of model which
addressed by implementing the change. During this people gain knowledge about new practices,
processes and measures in mental health sector.
The change which has been made may influence the way of thinking if it has clearly
executed and planned. Communication and time is two essential factors to successfully establish

change. Refreezing is the last step of Kurt Lewin model, which stabilizes the new act after the
change. The changes made to the management and operational structure of mental health
services may refroze when new norm has been taken stable shape and group of people have
grasp the new style of working effectively (Pilgrim, 2019). Refreezing signs are positive
feedbacks of service quality by patients, consistent delivery of therapies and so on. This step
make sure that the change which have been taken during unfreezing step has been effectively
accepted by people and also has a positive impact on the organisation.
Apply at least two of a range of frameworks and concepts regarding the issue
In context of London Borough of Barnet, it is necessary for staff members of CAMHS to
utilise effective frameworks and theories of leadership, management and change gentleman. It
will provide support to improve clinical procedures and activities in terns of delivering desired
medical facilities for well-being of people in selected area.
Management and organisational approaches
Management and organisational approaches consist of basic rules and operations which
are developed to run an organisation to achieve its desired goals and objectives in London
Borough of Barnet. There are number of approaches which CAMHS can implement to analyse
the risks of mental health which are generally being arising in adults and children. Such
management theories include:
Fayol theory: Implementation of this theory in CAMHS suggests that managers of the
organization should maintain and develop a professional team with a team spirit. They should
also ensure division of labours in order to deliver best services to their patients in London
Borough of Barnet.
Taylor theory: According to this theory, respective organisation should motivate their
employee by paying them according to their skills and abilities to improve economic efficiency
and productivity. It will helps to deliver better care facilities to children and adults in London
Borough of Barnet.
System theory: System theory in CAMHS can be implemented to analyse the present
conditions of respective organisation. However, there are many challenges which has been facing
by them such as shortage of mental healthcare practitioners, shortage of beds in hospitals,
shortage of funding etc. These issues should be solved in order to deliver effective service to
fulfil needs of selected population in London Borough of Barnet.

Policy frameworks
Policy frameworks give directions to the organisation by setting basic rules and principles
in order to achieve goals. CAMHS mental health policy focus on improving mental health of
adults and children. Policies for CAMHS framework tends to improve the way of care
practitioners to treat mental issues of patients in London Borough of Barnet. It include promotion
and awareness of mental health within society. They set benchmarks for providing best
treatments, prevention and rehabilitation of mental patients (Fisher and et. al., 2017). Respective
organisation services include four tiers such as targeted services, universal services, high
specialist services and specialist community to treat mental health of targeted population.
Best practice approaches
CAMHS provide services to improve mental disorders faced by children and adolescence
in London Borough of Barnet. They support children and young people who may need help with
wide range of issues at some point in their life.
Services of CAMHS consist of social workers, care practitioners, therapist, nurses,
support workers etc. Respective organisation undergo different approaches for improving patient
mental health condition such as creating websites which contain information about all CAMHS
specialists along with their contact numbers in London Borough of Barnet. They involve several
resources for conveying helpful information about respective organisation which include e-
sessions, video interviews, and necessary information for parents, teachers and guardians of
patients (Healy and Reynolds, 2019).
Ethical approaches
Ethics involve analysis of moral obligations. There are different approaches considering
mental healthcare of individuals and society. There are various principles of ethics such as
anatomy which refers to right of the patient to recover his health condition. Beneficence which
means that care practitioners should provide their best service in order to benefit their patient.
Non-Maleficence is a ethical principle which means that decision of health practitioners should
not put any negative impact other individuals and society even when it is beneficial for patient.
Justice states that there should be fair medical decisions. Theory for ethical approaches include:
Virtue ethical theory:
This theory involve virtues of an individual in decision making process (Ellis and
Alexander, 2017). CAMHS can implement this theory understand that what virtues are necessary

for the good of public mental health issues in London Borough of Barnet and then decide
accordingly.
Value based approaches:
Value based approaches made by the respective company in order to deliver quality care
for their patients. Under this approach, CAMHS seek to provide better care for adults and
children at lower cost. They ensure that healthcare practitioners are providing right care to their
patients at right time in London Borough of Barnet. Hence, a value based approach cause service
providers to co-ordinate with each other and avoid to make decisions separately. Value based
approaches takes values as well as evidences when making decisions about care. Therefore,
value based care help in to reshape the healthcare organisation and improve surgical outcomes.
Systems thinking:
A system consist of elements, interrelation and a purpose. It is method to identify the
relationships between different parts of the system in order to make better decisions. CAMHS is
a complex system with inter-related operations and outcomes which should be modified to
deliver effective facilities in London Borough of Barnet. System thinking helps in to analyse
how changes effect all parts of system.
Cost consequence tool provides a series of diagrams that relate to internal scenarios of
organization. This tool helps respective organisation to implement a change in their system
which helps in to analyse wide range of effect of changes (Bajpai, 2018). It will help them to
consider which part of the organisation will be effected by changes made.
Equalities approaches
It is necessary for the respective organisation to ensure that each and every individual
who need medical advice in terms of mental healthcare are need to be treat equally. It is the duty
of mental healthcare practitioners to ensure that equal treatments are to be given to their patients
and there should be no discrimination. They should provide proper treatment regardless of skin
colour, gender and economical capabilities. The key process for this is to give commitment to
governing organisational body and management. Hence, respective organisation should also put
efforts to develop approaches which brings equality in their system and to bring fair treatments
in London Borough of Barnet.
Leadership approaches

Leadership is the ability of manger to guide, influence and direct the behaviour of other
employees in order to achieve organisational goals in London Borough of Barnet. Different
leadership theories are available in order to achieve organisational goals such as:
Transformational theory: Implementation of transformational theory will help
organisation to build a healthy relationship between leaders and other healthcare practitioners. It
will help employees of the organisation get motivated and brings satisfaction and commitment to
the organisation (Steel, Rapport and Adams, 2018).
Transactional theory: In this theory managers of the respective organisation give reward
and punishment to their employees for improving their performance in London Borough of
Barnet. In this theory managers constantly analyse staff performance.
Public health frameworks:
Public health refers to the actions which are taken into account to prevent diseases,
promote health and prolong life of whole population. Public health framework identifies heath
and social problem of public. It takes approaches for promoting health and prevention diseases.
Frameworks for public health include:
Health belief model: CAMHS uses this model in order to analyse health behaviours of
their patients by focusing on beliefs and attitudes of individuals in London Borough of Barnet.
Socio-ecological model: Respective organisation uses this model in analysing links and
relationships between multiple factors effecting mental health of adults and children London
Borough of Barnet.
Wagner’s chronic care model:
It is a organizational approach for caring people and creates practical, supportive and
evidence based links between patients and service providers. Respective organisation should
follow this model in order to deliver high quality of care to their patients. It will help them to
build strategies in order to improve mental conditions of patients (Khamisa and et. al., 2016). It
encourage and motivates handling of errors and problems to improve services. This model helps
in building support strategies such as action planning, problem solving, goal setting and follow
ups. CAMHS should use this model to distribute tasks among healthcare practitioners and to
deliver quality care to their patients in London Borough of Barnet.
Integrated care concepts

It is an effective clinical practice which uses creative treatment concepts to deliver
different types of care solutions for individuals, society, family, community etc. Respective
organisation should use integrated care concepts in order to improve services in respect of
quality, efficiency and user satisfaction. It is essential for positive health outcomes. By giving
integrated care to patients of CAMHS, children and adults will come up with better outcomes
and satisfaction at desirable cost in London Borough of Barnet. However, primary care providers
need to come up with alternative and advance treatments for their patients because providing
only medication is not enough for them.
Change management approaches
Change management can be define as a process to deal with organisational changes. In
order to manage change and implementation of change strategies it is necessary to avoid random
and irrelevant plans and try to focus on plan of action (Ahmed and Wolf, 2018). There are many
change management approaches model available such as:
Lewis's Change Management Model:
It involves three basic steps which is freezing, changing and refreezing. In order to
implement this model respective organisation should first realise the need of change and should
aware their staff members about it. The second step is to apply real change and transformation.
And at last, organization need to stable again and should accept the changes made in order to run
organization in more efficient manner. It will helps to deliver better quality of services to mental
health patients including children and adults in London Borough of Barnet for remaining well-
being.
CONCLUSION
From the above study, it can be concluded that proper care and appropriate measures are
need to be implemented in order to reduce the ratio of mental health condition within the
population. Management and organizational approaches in various non profitable organisations
are made to deliver best quality of treatment to the individuals. Tools and approaches are
implemented in the organisation to improve health condition of patients and services of
organization. Hence, it is mandatory to focus on health conditions of adults and children these
days as their mental condition is effecting every other day and they are facing mental disorders
such as depression, anxiety,dementia and many other.

Involvement of professional healthcare practitioners is must so that correct and
appropriate treatment can be done. Integrated care concepts are need to be implemented in such
organisations to improve services in respect of quality, efficiency and user satisfaction. Change
management approaches are also helpful in order to bring advance and new technologies for
service providers.

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