Framing Value Based Healthcare in Practice: Introducing the Complex Case and Recovery Management Framework (The CCaRM).

Introduction: There is a gap between aspiring to co-produce and co-create value in integrated healthcare and realising that in practice, particularly with complex needs and multiple stakeholders. Key principles from literature on value-based healthcare offer a conceptual framework for building suitable care platforms to support practice. This paper outlines the Complex Care and Recovery Management Framework (CCaRM) as an example of co-platforming value-based healthcare within case level practice.

Large minimally symptomatic iatrogenic urinoma presenting three years after abdominal aortic aneurysm repair.

We describe a case of a large, minimally symptomatic, urinoma presenting 3 years after emergent repair of a ruptured abdominal aortic aneurysm. We discuss the symptoms and signs, as well as the imaging, treatment and prevention options, for this rare complication. Because of the high mortality associated with delayed diagnosis of ureteral injury, a high index of suspicion should be maintained in patients who had surgery adjacent to the ureters.

Should women be a special case when it comes to services for psychosis?

Women with psychosis are distinctly different from men with the same condition. In a number of areas the distinctions are quite noticeable, in terms of mood symptoms, physical health issues, post-traumatic issues and social loss, for example. The question is: what represents best care for women, and is care best done in specialist units? Care programmes for women need to manage both complex affective disorders and schizophrenia.

Characteristics of patients presenting for emergency psychiatric assessment at an English hospital.

Objective: The needs and characteristics of patients who are referred for psychiatric emergency services vary by the source of referral. Such differences have wider implications for the functioning of the mental health care system as a whole. This study compared three groups of patients in a two-month cohort of 189 patients who were referred for emergency psychiatric assessment at a hospital in England: those who were referred by general practitioners (family physicians), those who were receiving specialist services from community mental health teams, and those who arrived at the hospital from the broader community.

Specialist service use following psychiatric emergency presentation: an 18-month follow-up study.

The aim of the present study was to identify the subsequent use of specialist psychiatric services by a group of 170 individuals referred as psychiatric emergencies. Hospital and community mental health team (CMHT) records and databases were used to identify specialist contact in an 18-month follow-up period. Out of the total of 170 people, 169 were traced.