Care Setting
Community care, In-Patient Setting
Care Group
Adults, Later Life
Evidence Base for Practice
Demonstrating a commitment to the delivery of Rights, Relationships & Recovery, the National Review of Mental Health Nursing in Scotland (SEHD, 2006) and influenced by the Best Practice Statement (NHS Quality Improvement Scotland, 2009) it is hoped that MyRAP will assist in improving outcomes for service users, carers and staff. This can be achieved by applying values based practice principles with a particular emphasis on promoting recovery and providing service user led and person-centred care (NHS Education for Scotland, 2006).
Quality assurance/impact of practice
As MyRAP is fairly new a full evaluation is unachievable at this stage. Informal feedback suggests that staff and service users find it a useful tool which is supported by a demand for more copies from various disciplines across Lanarkshire. There are plans for My RAP to be made available in the library of the Dementia Centre in Stirling and much interest from addictions as to how this can be developed for addiction services.
We plan to incorporate the questionnaire into the next print run to encourage feedback and utilise this to inform an evaluation by the end of 2010 and thereafter evaluate annually.
Practice Summary
MyRAP is the result of a successful collaboration between service users, carers and representatives from partnership agencies whose shared aim was to develop a self-help/self-management tool that would enhance individuals experience by having the opportunity to take control over their own wellbeing and recovery.
The belief that self-management tools should be readily available and easily accessible alongside that we all have a role in enabling and supporting self direction were important drivers in the booklet’s development.
Practice Detail
A small multi-agency working group consulted to develop a self-help management tool, considered materials already available and identified two key influencers:
The Wellness Recovery Action Plan (WRAP) developed by the Scottish Recovery Network was found to be the biggest influence nationally; and The Shared Action Recovery Plan (SARP) developed at local level by Monklands Hospital, Acute Admissions Mental health was recognised to demonstrate good practice.
Collaborative working resulted in the production of the MyRAP booklet now widely circulated in both the mental health in-patient and community settings throughout NHS Lanarkshire. The aim was for a generic tool and we have 2 print versions The larger print being influenced by older adult service input. Both versions are also available for free public download on at http://www.lanarkshirementalhealth.org.uk/Lanarkshire_Recovery_Network/Links_and_resources.aspx.
Photographs from The Clydesdale Resource Network Camera Group and quotes from the Lanarkshire Links Song Writers and Lyrics Club were included in the booklet to inspire and instil hope.
Challenges
It was important to ensure that:
• The document was user friendly, attractive and readable without being too academic with numerous references
• It would demonstrate a shift in focus from a prescriptive and paternalistic approach to one that promotes safety and positive risk taking
• The contribution from users and carers was sought at every stage
• Patience was needed when conflicting diaries and time constraints led to an overly lengthy consultation due to the number of agencies represented
• Differences of opinions were considered along with reference to ‘Guide to developing written information for the public, patients, their relatives and carers’ (NHS Lanarkshire) when finalising and formatting the document
• Ownership remained collective with an understanding that individual recognition and acknowledgement would be minimal
• Ongoing funding opportunities would be sought to secure ongoing publication
• A questionnaire was created and distributed as part of the evaluation process
Additional Comments
MyRAP is an effective example of multi-agency working that service users and carers. The successful development of MyRAP supports and evidences the delivery of recovery focused care that can make a difference by empowering and enabling people in managing their lifestyle and wellbeing.
Theresa Watson, Practice Improvement & Development Nurse Theresa.watson@lanarkshire.scot.nhs.uk
Avril Cutler, Project Officer
Avril.cutler@lanarkshire.scot.nhs.uk
Practice Improvement & Development (Mental Health & Learning Disabilities), Level 0, Wishaw General Hospital, ML2 0DP