Admission and Assessment Processes
Requests for assessment for admission/advice3 are co-ordinated by the Guild Lodge Flow and Capacity Manager and reviewed via the internal processes of the care pathway arrangements.
Gate Keeping Arrangements
At present the ABI service at Guild Lodge have gate keeping responsibility for all patients with secure ABI needs in the North West of England.
NHS England has also stated that whenever there are beds available in our service we have gatekeeping responsibility and can accept admissions from the whole of England.
The service has the following admission criteria:
Aged 18 or above
Have personality, behavioural or emotional changes as a result of ABI and / or have mental illness as result of ABI (ICD10 F07.0; F06.2; F06.3)
Detained / detainable under Mental Health Act
Suitable for secure services i.e. have demonstrated significant risk of harm to self or others or have forensic history indicative of significant risk
The ABI has occurred more than 3 months earlier – this allows for natural recovery from Post-Traumatic Amnesia
Primary diagnosis is NOT developmental disorder, learning disability or degenerative neurological disorder
If the admission criteria are met, the ABI service will send out its own MDT assessment team and use the bespoke ABI assessment of referral document.
The MDT aims to have arranged an assessment within 2 weeks of referral if non-urgent. This is dependent on the receipt of suitable referral information, support documentation and geographical location.
Following assessment the assessing team discuss their findings with the ABI network team which meets fortnightly and a decision is made about suitability for admission, security level, initial risk management plan, potential safeguarding concerns and most importantly a care pathway plan.
Positive Behaviour Support Plans (PBSP)
The team will also begin to populate a Positive Behaviour Support Plan. This robust approach has enabled the service to ensure that the limited resources are used effectively and efficiently. The team will also estimate a discharge date.
There are often referrals made that are either for expert opinion or that do not meet admission criteria. In the latter case this is usually due to not requiring secure care. In both cases the allocated MDT team will prepare a feedback report with an action plan for the referring team.