More on Policy and Service Development, Practice Guidance and Commissioning

 

This section gives further literature on the development of values-based practice and related approaches to service development in health and social care

The section includes readings on

  • Person-centered care and multidisciplinary teamwork
  • The service user voice, co-production and recovery
  • Leadership and management
  • Models of commissioning
  • Assessment and compulsion
  • Values in particular areas of mental health and other areas of healthcare
  • On-going development
  • Help us improve this page

As with other sections of the Reading Guide the examples given are intended to be illustrative of the range of resources available rather than exemplary. We welcome further and more detailed reading guides on these and related topics – see Help us Improve this Website

Person-centered care and multidisciplinary teamwork

Examples of Department of Health publications on person-centered care and multidisciplinary teamwork building on those listed on the main page include

  • Department of Health (2005) New ways of working for psychiatrists: Enhancing effective, person-centred services through new ways of working in multidisciplinary and multi-agency contexts. (Final report ‘but not the end of the story’.) London: Department of Health.
  • Department of Health (2005) Delivering race equality in mental health care: an action plan for reform inside and outside services and The Government’s response to the independent inquiry into the death of David Bennett. London: Department of Health
  • Department of Health (2007) Mental Health: New Ways of Working for Everyone: Developing and sustaining a capable and flexible workforce. London: Department of Health.
  • Department of Health (2008) Putting People First: A shared vision and commitment to the transformation of Adult Social Care. London: Department of Health.
  • Department of Health (2011) No Health Without Mental Health: A Cross Government Mental Health Outcomes Strategy for People of All Ages. London: Department of Health

The capabilities approach set out in The Ten ESCs, has been developed further by Ian McGonagle and colleagues at Lincoln University

  • McGonagle, I., Jackson, C.S., and Kane, R (2015) The Ten Essential Shared Capabilities: Reflections on education in values based practice: A qualitative study Nurse Education Today Volume 35, Issue 2, Pages e24–e28 http://dx.doi.org/10.1016/j.nedt.2014.12.001

Other values-related publications on person-centered care include

  • Fulford, K.W.M., Ersser, S., and Hope, T., (1996) (eds) Essential practice in patient-centred care. Oxford: Blackwell Science.
  • Cox, J., Campbell, A.V. and Fulford, K.W.M. (2006) (eds) Medicine of the Person: Faith, Science and Values in Health Care Provision. London: Jessica Kingsley Publishers.
  • Van Staden, C. W. (2011). African approaches to an enriched ethics of person-centred health practice. International Journal of Person-Centered Medicine, 1:11-17.
  • Van Staden, C. W. (2013). Desirable objects of evaluation for measuring person-centered medicine: conceptual considerations drawing on African insights. International Journal of Person-Centered Medicine, 3:187-190.

An important area of people’s individual values is their religious and spiritual beliefs. As the Department of Health Lead for Spirituality in the early years of this century Peter Gilbert played a leading role in pushing forward collaborative work on values and spirituality in mental health and social care

  • NIMHE/Mental Health Foundation (Gilbert, P. and Nicholls, V.) (2003) Inspiring Hope: Recognising the Importance of Spirituality in a Whole Person Approach to Mental Health. Leeds: NIMHE, November 2003.
  • Gilbert, P.D. (2007) Spirituality and Mental Health: A Very Preliminary Overview. Current Opinion in Psychiatry¸20:594-598.
  • Coyte, M.E., Gilbert, P. And Nicholls, V. (eds) (2007) Spirituality, Values and Mental Health: Jewels for the Journey. London: Jessica Kingsley Publishers.

A sample of other publications on values and spirituality include

  • Department of Health (2003) Inspiring Hope: Recognising the importance of spirituality in a whole person approach to mental health. National Institute for Mental Health in England.
  • Cox, J., Campbell, A.V., and Fulford, K.W.M. (eds) (2006) Medicine of the Person: Faith, Science and Values in Health Care Provision. London: Jessica Kingsley Publishers. Note in particular
  • Fulford, K.W.M., Campbell, A.V. and Cox, J. (2006) Introduction: At the Heart of Healing. Introductory Chapter, pp17-29
  • Atwell, R. and Fulford, K.W.M. (2006) The Christian Tradition of Spiritual Direction as A Sketch for a Strong Theology of Diversity. Chapter 6, pp 83-95
  • Fulford, K.W.M. (Bill) and Woodbridge, K. (2007) Values-based Practice: Help and Healing within a Shared Theology of Diversity.       Chapter 2, pps 45-57 in Coyte, M.E., Gilbert, P. and Nicholls, V. (eds) Spirituality, Values and Mental Health: Jewels for the Journey. London: Jessica Kingsley Publishers.
  • Cornah, D. (2006) The impact of spirituality on mental health: a review of the literature. Mental Health Foundation

The Janki Foundation for Global Healthcare in London runs a program on Values in Healthcare exploring links with spirituality

  • http://www.jankifoundation.org/values_in_healthcare/index.jsp

The service user voice, co-production and recovery

Further examples of Department of Health publications in these areas building on those listed on the main page include

  • Department of Health (2006) From values to action: The Chief Nursing Officer’s review of mental health nursing. London: Department of Health.
  • Department of Health (2006) Our health, our care, our say: a new direction for community services. London: Department of Health.
  • Department of Health (2006) Direct payments for people with mental health problems: a guide to action. London: Department of Health
  • Care Services Improvement Partnership (2007) Our Choices in Mental Health: A framework for improving choice for people who use mental health services and their carers. London: Department of Health.

Many aspects of the service models developed over this period remain important in contemporary practice (see main page).

Strengthening the service user voice

A sample of values-related publications in these areas include

  • Appleby, L. (2000) A new mental health service: high quality and user-led. British Journal of Psychiatry, 177: 290-291
  • Department of Health. (2005) Creating a Patient-led NHS: Delivering the NHS Improvement Plan. London: Department of Health; 2005.
  • Department of Health. (2005) Commissioning a patient-led NHS. London: Department of Health; 2005.

First-hand narrative resources for work in this area include

  • The Oxford Health Experiences Institute (HEXI) includes personal narratives of illness experience in a wide range of areas of healthcare
  • http://hexi.gtc.ox.ac.uk/
  • A review of Personal Narratives of Madness compiled by Jayasree Kalathil and colleagues is available on-line in the website resource supporting the Oxford Handbook of Philosophy and Psychiatry
  • www.oup.co.uk/companion/fulford

Recent work by David Crepaz-Keay, the National Service User Network and others, has focused on defining robust criteria of service user involvement

Peer support is proving a powerful resource for developing self-management skills. See for example

  • Crepaz-Keay, D. and Cyhlarova, E. 2012. A new self-management intervention for people with severe psychiatric diagnoses. Journal of Mental Health Training, Education and Practice, 7, 89-94.
  • Crepaz-Keay, D. (2015) Self-management and peer support: what makes it different, what makes it work. Chapter 12: pages 129-138, in Crepaz-Keay, D. (Ed) Mental health today and tomorrow. Pavilion Publishing and Media., ISBN: 978-1-910366-33-2
  • Lemmi, V., Crepaz-Keay, D., Cyhlarova, E., and Knapp, M. (2015) “Peer-led self-management for people with severe mental disorders: an economic evaluation”, The Journal of Mental Health Training, Education and Practice, Vol. 10 Iss: 1, pp.14 – 25
  • Cyhlarova, E., Crepaz-Keay, D., Reeves, R., Morgan, K., Lemmi, V., and Knapp, M. (2015) “An evaluation of peer-led self-management training for people with severe psychiatric diagnoses”, The Journal of Mental Health Training, Education and Practice, Vol. 10 Iss: 1, pp.3 – 13

Relatively neglected until recently has been the role of carers. Though see Lu Duhig’s role in the 3 Keys; and on co-production generally

  • Worthington, A., and Hannan, R., (Second edition, 2013) The Triangle of Care – Carers Included: A Guide to Best Practice in Mental Health Care in England. London: Carers Trust (www.carers.org)
  • The ‘Open Dialogue’ approach to psychosis care http://opendialogueapproach.co.uk/

Co-production

Co-production remains an important policy priority in the UK with many publications from both the Department of Health and SCIE (Social Care Institute for Excellence). See for example

In addition to those given on the main page values-related publications relevant to co-production include

  • Amering, M. Hofer, H. and Rath, I. (2002) The “First Vienna Trialogue” – Experiences with a new form of communication between users, relatives and mental health professionals. In Lefley, H.P., Johnson, D.L. (Eds) Family Interventions in Mental Illness: International Perspectives. Westport, CT, London: Praeger.
  • Ahmad, N., Ellins, J., Krelle, H., and Lawrie, M. (2014) Person-centred care: from ideas to action – bringing together the evidence on shared decision making and self-management support. London: Health Foundation
  • Hicks, J., Keeble, J., and Fulford, K.W.M. (2015) Mental Health Co-production in Bristol: Seeking to Address the Challenges. Pps 18 – 19, January/February, Mental Health Today
  • Crepaz-Keay, D., Fulford, K.W.M., van Staden, W., (forthcoming, 2015) Putting both a person and people first: interdependence, values-based practice and African Batho Pele as resources for co-production in mental health. Ch 4 in Sadler, J.Z., van Staden, W., and Fulford, K.W.M., (Eds) The Oxford Handbook of Psychiatric Ethics. Oxford: Oxford University Press

Being at the heart of values-based practice, co-production is important for many of the Centre’s collaborating partners: see for example The Bristol Co-production Group working on the assessment in mental health and Yvonne Anderson’s work on co-production with children and young people.

Recovery and wellbeing

A sample of values-related publications on recovery and wellbeing includes

  • Allott, P., Loganathan, L and Fulford, K.W.M. (Bill), (2002) Discovering Hope For Recovery. In: Innovation in Community Mental Health: International Perspectives. Special issue of the Canadian Journal of Community Mental Health, 21(2), pps 13-33.
  • Buffington, E. (2003) Wellness Recovery Action Plan: WRAP evaluation, State of Minnesota. Minneapolis, MN: Mental Health Consumer/Survivor Network of Minnesota.
  • Department of Health (2004) NIMHE Guiding Statement on Recovery. NIMHE: Department of Health.
  • Davidson, L. (2005) Recovery, self-management and the expert patient – changing the culture of mental health from a UK perspective. Journal of Mental Health, Feb 2005, vol 14.1:25-35.
  • Care Services Improvement Partnership (CSIP) (2006) Pathways to Recovery Paper 1. Core Vision and Values for a Modern Health System. London: Department of Health.
  • Cloninger, C. R. (2006) The science of well-being: an integrated approach to mental health and its disorders. World Psychiatry, 5:2, 71-76.
  • Slade, M (2009) Personal Recovery and Mental Illness: A Guide for Mental Health Professionals (Values-Based Medicine) Cambridge: Cambridge University Press
  • Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., and Whitley, R. (2014) Uses and Abuses of Recovery: Implementing Recovery-oriented practices in mental Health Systems. World Psychiatry, 13: 12-20.

For further sources on values-based practice and recovery see

Leadership and management

Values-related publications on leadership and management include links developed by Peter Gilbert and others with values and spirituality

  • Pendleton, D. and King, J. (2002) Values and leadership. BMJ, volume 325, pps 1352-1355
  • Peter Gilbert and Fulford, KWM, Guest co-Editor of Special Issue of The International Journal of Leadership in Public Services, on Spirituality, Values and Leadership, Vol. 6, No. 2, June 2010
  • Van Staden, C. W. (2010). Spiritual and other diversities at the heart of invigorating leadership: a South African spark. International Journal of Leadership in Public Services, 6:73–77.

Business studies is an important resource of ideas and experience for working with complex and conflicting values

  • Fulford, K.W.M. and Benington, J. (2004) VBM²: A Collaborative Values-Based Model of Healthcare Decision-Making Combining Medical and Management Perspectives. In R.Williams and M. Kerfoot (eds) Child and adolescent mental health services: strategy, planning, delivery, and evaluation. Oxford: Oxford University Press. pps 89-102.

Models of commissioning

In addition to the resources noted on the main page a wealth of materials on values-based commissioning is now available on-line. Examples include

Assessment and compulsion

Background literature on the importance of values in assessment and diagnosis is included Ordinary Language Philosophy beyond the Oxford School.

Additional readings on the links between values in assessment and involuntary treatment include

  • Fulford K. W. M., Smirnoff A. Y. U., and Snow E. (1993) Concepts of Disease and the Abuse of Psychiatry in the USSR. British Journal of Psychiatry, 162, 801-810.
  • Fulford, K.W.M. (1995) Psychiatry, Compulsory Treatment and the Value-based Model of Mental Illness. Chapter 10 in Introducing Applied Ethics, Almond, B. ed., Oxford: Blackwell Publishers.
  • Care Services Improvement Partnership (CSIP) and National Institute for Mental Health in England (NIMHE) (2008) Living Through the Act. DVD produced by A word in Edgeways
  • Fulford, K.W.M. and King, M. (2008) A values-based perspective on good practice in compulsion. Commentary on Roberts, G., Dorkins, E., Wooldridge, J., and Hewis, E. ‘Detained – What’s my choice? A discussion paper’, 14:172-180. Advances in Psychiatric Treatment, 14:183-184.
  • Fulford, K.W.M., King, M. and Dewey, S. (2009) Values Based Practice and Involuntary Treatment: A new training programme in the UK. Advances in Psychiatric Treatment, Volume 3 (Editors: G.N. Christodoulou, M. Jorge, J.E. Mezzich), Beta Medical Publishers, 2009, pp 185-195
  • Fulford, K.W.M., King, M. and Dewey, S. (2009) Values Based Practice and Involuntary Treatment: A new training programme in the UK. Advances in Psychiatric Treatment, Volume 3 (Editors: G.N. Christodoulou, M. Jorge, J.E. Mezzich), Beta Medical Publishers, 2009, pp 185-195
  • Hicks, J., Keeble, J., and Fulford, K.W.M.       (2015) Mental Health Co-production in Bristol: Seeking to Address the Challenges. Mental Health Today, January/February, 18 – 19

See also The Oxford Handbook of Psychiatric Ethics in Read More about Teaching and Learning

Alternatives to compulsion is an area of active development in values-based practice – see Research and On-going Issues

Values in particular areas of mental health and other areas of healthcare

Mental health

There is a growing literature on the importance of values in particular areas of mental health. Examples include

  • Fulford K W M, (1991) Evaluative Delusions: their Significance for Philosophy and Psychiatry British Journal of Psychiatry, Volume 159, pps 108-112, Supplement 14, Delusions and Awareness of Reality
  • Jackson, M.J. and Fulford, K.W.M. (2002) Spiritual Experience and Psychopathology Chapter 20 pps 141-149 in Fulford, K.W.M., Dickenson, D. and Murray, T.H. (eds) Healthcare Ethics and Human Values: An Introductory Text with Readings and Case Studies. Malden, USA, and Oxford, UK: Blackwell Publishers. (Shortened version of paper with same title in PPP)
  • [This is based on Jackson, M J and Fulford, K W M (1997) Spiritual Experience and Psychopathology. Philosophy, Psychiatry and Psychology, 4, 41 – 65]
  • Scott, S., Jones, D., Ballinger, R., Bendelow, G., and K.W.M. Fulford. (2011) The slide to pragmatism: a values-based understanding of ‘dangerous’ personality disorders Health Sociology Review 20 (2): pps 157 – 171
  • Giovanni Stanghellini, Derek Bolton, and William K. M. Fulford (2013) Person-Centered Psychopathology of Schizophrenia: Building on Karl Jaspers’ Understanding of Patient’s Attitude Toward His Illness Schizophrenia Bulletin ; 39 (2):287-94. doi: 10.1093/schbul/sbs154. Epub 2013 Jan 11

For current work on values-based child and mental health see Royal College of Psychiatrists Commission for Values-based CAHMS. An early review covering current issues is

  • Fulford, K.W.M., and Williams, R. (2003) Values-based child and adolescent mental health services? Current Opinion in Psychiatry, 16, 369-376 Also reproduced in the electronic bulletin of IIMHL (International Initiative for Mental Health Leadership)  http://radio.weblogs.com/0108660/categories/iimhl/ (2003)

Areas of Healthcare

A key aim of the Collaborating Centre is to extend values-based approaches from mental health more widely across health and social care. Examples from primary and end of life care are

  • Petrova, M., Dale, J., and Fulford, K.W.M. (2006) Values-Based Practice in primary care: easing the tensions between individual values, ethical principles and best evidence. British Journal of General Practice, September 2006, Vol:56, 703-709.
  • Fulford, K.W.M., and Cooper, J. (2013) ‘Why me?’ and ‘Whose good death?’: anger and values-based practice in end of life care. Chapter 3 (pps 61 – 70) in Gilbert, P., (Ed) Spirituality and End of life Care. Hove, UK: Pavilion House and Media Ltd.

The significance of diversity of cultural values for healthcare has been widely recognized. A small sample of relevant publications includes

  • Bracken, P. (2002) Meaning, culture and mental illness. Openmind, 117, 14-15.
  • Bracken, P. (2002) Trauma: Culture, Meaning and Philosophy. London: Whurr Publishers.
  • Schwartz, S.H., (2006) Basic Human Values: Theory, Measurement, and Applications. Revue française de sociologie, 47/4 https://scholar.google.co.uk/scholar?q=Basic+Human+Values:+their+content+and+structure+across+countries&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=8SCHVcOLJbGU7Qa-uJn4BA&ved=0CB8QgQMwAA
  • Fulford, K.W.M., Sallah, D. and Woodbridge, K. (2007) Philosophical Tools for Cultural Psychiatry. Chapter 5 In Bhui, K., and Bhugra, D. (eds) Culture and Mental Health: A comprehensive textbook, pp37-46. London: Hodder Arnold
  • King, C., Bhui, K., Fulford, K.W.M., Vasiliou-Theodore, C and Williamson, T. (2009) Model Values? Race, Values and Models in Mental Health. London: The Mental Health Foundation.
  • Van Staden, C. W. (2010). Stuck in the past or heading for flourishing people in diversity. South African Journal of Psychiatry, 16:4-6.

See also The Oxford Handbook of Psychiatric Ethics in Read More about Teaching and Learning for the potential for cross-learning between cultures

On-going development

Among other areas of on-going development values-based approaches are finding application in areas beyond health and social care

Peace Building