Glossary

ADHD stands for Attention Deficit Hyperactivity Disorder

ADHD is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness. Attention deficit disorder (ADD) is a sub-type of ADHD. Common symptoms of ADHD include:

• a short attention span
• restlessness or constant fidgeting
• being easily distracted

For more information see the NHS website.

The term advance decision means a statement explaining what medical treatment the individual would not want in the future, should that individual ‘lack capacity’ as defined by the Mental Capacity Act 2005. It can relate to all future treatment, not just that which may be immediately life-saving. An advance decision is legally binding in England and Wales. Except in the case where the individual decides to refuse life-saving treatment, it does not have to be written down, although most are and a written document is less likely to be challenged.

Advocacy is about taking action to help people say what they want, secure their rights, represent their interests and obtain services they need.

An advocate is an independent person who encourages the empowerment of an individual or group. Advocacy comes in different forms and the type of advocacy being offered should be clearly identified to avoid confusion. For example self-advocacy is different from legal advocacy. There are also Independent Mental Capacity Advocates (IMCAs) under the Mental Capacity Act 2005.

Advocates and advocacy schemes work in partnership with the people they support and take their side. Advocacy promotes social inclusion, equality and social justice. See Action for Advocacy

Autism Spectrum Disorder (ASD) is a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.

It is a spectrum condition, which means that, while all people with autism share certain difficulties, their condition will affect them in different ways. Some people with autism are able to live relatively independent lives but others may have accompanying learning disabilities and need a lifetime of specialist support. People with autism may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.

Asperger syndrome is a form of autism. People with Asperger syndrome are often of average or above average intelligence. They have fewer problems with speech but may still have difficulties with understanding and processing language.

Click here for the Derbyshire Healthcare NHS Foundation Trust Sensory Processing Guide 

Find out more from the National Autistic Society, and in Easy Read.

For information about referrals for adults with suspected ASD, see our Adult Autism Spectrum Disorder assessment page.

The Common Assessment Framework for children is a shared assessment and planning framework for use across all children’s services and all local areas in England. It aims to help the early identification of children’s additional needs and promote co-ordinated service provision to meet them. The CAF is a standardised approach to conducting an assessment of a child’s additional needs and deciding how those needs should be met.

A person lacks capacity in relation to a matter if at the time they are unable to make a decision for themselves in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. It does not matter whether the impairment or disturbance is permanent or temporary.

The following principles apply for the purposes of the Mental Capacity Act.

1. A lack of capacity cannot be established merely by reference to:
   A. a person's age or appearance; or
   B. a condition, or an aspect of their behaviour, which might lead others to make unjustified assumptions about their capacity.
2. A person must be assumed to have capacity unless it is established that they lack capacity.
3. A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
4. A person is not to be treated as unable to make a decision merely because they make an unwise decision.
5. An act done, or decision made, under the Mental Capacity Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests.
6. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action.

See: www.legislation.gov.uk/ukpga/2005/9/section/1 and the section under Involvement and Choice

The Choice and Partnership Approach is used by our CAMHS. CAPA is a systemic approach to service organisation and to the relationship with the user/client/patient. It aims to put the user at the centre.

For more information see the CAPA website on: www.capa.co.uk

• CPA Care Co-ordinator: This is a mental health professional who co-ordinates care for someone who is using our mental health services who has serious and complex mental health needs, and needs the support of the Care Programme Approach. For more information see the entry on CPA below, and the Core Care Standard.
• Primary Care Care Co-ordinator: This is someone working with or for one or more GP Practices to co-ordinate services for someone who has multiple health problems, and who meets the criteria for the service. They may or may not have a clinical background.
• Local Area Co-ordinators work in defined areas in some parts of Derby City and Derbyshire to help connect people with complex health and social needs to local support. See the Derby City Council website for more information.

A Carer is someone of any age who provides unpaid support to family or friends who could not manage without this help. This could be caring for a relative, partner or friend who is ill, frail or disabled or who has mental health or substance misuse problems. 

Young Carers are children and young people who look after someone in their family who has an illness or a disability, or who is affected by mental ill-health or substance misuse.(Princess Royal Trust for Carers).

CCGs are Clinical Commissioning Groups. These replaced Primary Care Trusts in 2012, and are the means by which health services are commissioned in England.

Derbyshire has 4 CCGs:

• Hardwick CCG - see where this CCG operates on the Hardwick Map
• Southern Derbyshire CCG - see the Southern Derbyshire Map
• North Derbyshire CCG - see the North Derbyshire Map
• Erewash CCG - see the Erewash Map

The Care Programme Approach (CPA) is one of the care processes that forms the basis of the Core Care Standards. It applies to specialist mental health services.

It aims to improve the way in which specialist services were provided to support people with mental health problems and is used to support people with complex and serious needs. 

The Trust uses national guidelines to help decide who would benefit from the CPA. These are based around risk and complexity.

For more information on national standards see the Care Coordination Association. 

The Appropriate Adult Service - operating a service for for juveniles, mentally disordered people or vulnerable adults. For more details see the organisation's website.

A dashboard is a way of showing information about performance. It can be shown like a car dashboard with dials showing how well or badly we're doing in different areas, but can be shown in different ways.

For an example of a performance dashboard, have a look at our Trust performance indicators, and see how we're doing now.

Direct payments are local council payments for people who have been assessed as needing help from social services, and who would like to arrange and pay for their own care and support services instead of receiving them directly from the local council. For more information on how to apply for Direct Payments go to the Gov.uk website.

Mental Capacity Act 2005: Deprivation of Liberty Safeguards

DoLS provide legal protection for vulnerable people who may be deprived of their liberty within the meaning of Article 5 of the European Convention on Human Rights (ECHR) in a hospital (other than under the Mental Health Act 1983) or care home, whether placed their under public or private arrangements. See the CQC information about DoLS.

FACE stands for Functional Assessment of the Care Environment. The Trust has, in the past, used FACE risk assessment tools in mental health, substance misuse, learning disability, and CAMHS.

Clinical formulation is the process of making sense of the information that is gathered in an assessment, and using that information to create a productive way of helping the person.

Independent Mental Capacity Advocate (see Advocacy)

From 1 April 2007 the Mental Capacity Act established a statutory scheme known as Independent Mental Capacity Advocacy (IMCA). Its aim is to provide additional safeguards for people who lack capacity to take decisions in certain specific, important situations and who are particularly vulnerable because they have no close relatives, friends or any other person to help to protect their interests.

Derbyshire Mind and Derbyshire Advocacy Service were commissioned to provide IMCA services across Derbyshire. The service is available to any adult in Derbyshire who fits the statutory criteria for an IMCA.

For information about the Derbyshire IMCA service see the Derbyshire Mind website.

Independent Mental Health Advocate (see Advocacy)

This is a new type of advocacy introduced in April 2009 as a result of the Mental Health Act 2007. IMHAs can assist in helping a patient find out about their rights and how to exercise them.

The purpose of IMHAs is to help patients to fully participate in decisions about their care and treatment. To be eligible to receive the help of an IMHA, you have to be a ‘qualifying patient’.

Qualifying patients are those who are:

• Detained in hospital under the Mental Health Act
• Subject to a Guardianship Order under the Mental Health Act
• Subject to a Community Treatment Order in the community
• Discussing with their doctor the possibility of psychosurgery (any surgical operation on the brain tissue)
• Discussing the possibility of serious treatments such as neurosurgery
• Under 18 years old and are discussing with a doctor the possibility of ECT

 
To find out more see the Derbyshire Mind website.

Lead Professionals work with children with additional (including complex) needs who require an integrated package of support from more than one practitioner. 

The support comes from a multi-disciplinary team of practitioners called a team around the child (TAC). The TAC is often established on a case-by-case basis to support the child or their family who require support. The TAC model is also referred to as TAYP (team around the young person). 

The lead professional takes the lead to coordinate provision and act as a single point of contact for a child and their family when a TAC is required.

The CPA lead professional is the professional who co-ordinates the care of people using specialist mental health services who don’t need the support of CPA. See: Co-ordination for their role.

Lesbian, Gay, Bi-sexual, Transexual +

The “plus” is inclusive of other groups, such as asexual, intersex, queer, questioning.

Alternatives are provided to their family care, for example foster care, residential care or adoption.

The Multi-Agency Public Protection Arrangements (MAPPA) are managed by the Multi-Agency Public Protection Panel (MAPPP), made up of health and social care organisations in Derbyshire, as well as police and probation. They discuss people who are of concern in terms of risk of violence and held a common register of names. Click here for more information.

Multi-Agency Risk Assessment Conferences (MARACs) are meetings where information about high risk domestic abuse victims (those at risk of murder or serious harm) is shared between local agencies. By bringing all agencies together at a MARAC, a risk focused, coordinated safety plan can be drawn up to support the victim.

A Multi-Disciplinary Meeting, or MDM, is a meeting of the group of professionals from one or more clinical disciplines who together make decisions regarding recommended treatment of individual patients.

Making Every Contact Count (MECC) is about using every opportunity to talk to individuals about improving their health and well being.

Making changes such as stopping smoking, improving diet, increasing physical activity, losing weight and reducing alcohol consumption can help people to reduce their risk of poor health significantly. Making every contact count (MECC) is an approach to behaviour change that utilises the millions of day-to-day interactions that organisations and people have with other people to encourage changes in behaviour that have a positive effect on the health and wellbeing of individuals, communities and populations.

A person lacks capacity in relation to a matter if at the time they are unable to make a decision for themselves in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. It does not matter whether the impairment or disturbance is permanent or temporary.

The following principles apply for the purposes of the Mental Capacity Act.

1. A lack of capacity cannot be established merely by reference to:
   A. a person's age or appearance; or
   B. a condition, or an aspect of their behaviour, which might lead others to make unjustified assumptions about their capacity.
2. A person must be assumed to have capacity unless it is established that they lack capacity.
3. A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
4. A person is not to be treated as unable to make a decision merely because they make an unwise decision.
5. An act done, or decision made, under the Mental Capacity Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests.
6. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action.

 See: www.legislation.gov.uk/ukpga/2005/9/section/1 and the section under Involvement and Choice

The main purpose of the Mental Health Act 1983 is to allow compulsory action to be taken, where necessary, to make sure that people with mental disorders get the care and treatment they need for their own health or safety, or for the protection of other people. It sets out the criteria that must be met before compulsory measures can be taken, along with protections and safeguards for patients. See the Mind website for more information.

A named nurse is a nurse designated as being responsible for a patient's nursing care during a hospital stay and who is identified by name as such to the patient. The concept of the named nurse stresses the importance of continuity of care.

Nearest relative is a legal term defined in section 26 of the Mental Health Act 1983 (MHA), and should not be confused with next of kin. The MHA gives a patient’s nearest relative rights and powers in relation to detention, discharge and also being informed (or consulted) about actions that have been taken or are proposed under the Act. For more information see the Derbyshire Mind Website.

Not to be confused with the nearest relative, this is usually the person you are most closely related to. There is a suggested ladder of relationships to help determine closeness. See Howells Legal for information about being next of kin

Patient Experience, formerly PALS (Patient Advice Liaison Service), is the central point of contact for people to provide feedback and raise concerns about the services provided by Derbyshire Healthcare NHS Foundation Trust. 

Our aim is to provide a swift response to concerns or queries raised and to ensure a thorough investigation takes place when required, with complainants receiving comprehensive written responses including any actions taken. Learning from the feedback we receive is essential.

As a patient or carer, you may feel you need someone to talk to about any concerns or problems you may be experiencing. We liaise with staff, managers and, where appropriate, other relevant organisations, to negotiate speedy solutions and to help bring about changes to the way that services are delivered.

If you have any feedback about the service you have received we'd love to know.

Telephone: (Freephone) 0800 027 2128 or 01332 623751

Email: dhcft.patientexperience@nhs.net

Post: Patient Experience Team, Derbyshire Healthcare NHS Foundation Trust, Albany House, Kingsway Hospital, Derby, DE22 3LZ

These are an allocation of funding given to users after an assessment which should be sufficient to meet their assessed needs. Users can either take their personal budget as a direct payment, or – while still choosing how their care needs are met and by whom – leave councils with the responsibility to commission the services. Or they can take have some combination of the two. 

Psychosis is a medical word used to describe mental health problems that stop the person from thinking clearly, telling the difference between reality and their imagination, and acting in a normal way.

The two main symptoms of psychosis are:

• hallucinations – where a person hears, sees (and in some cases smells) things that are not really there; a common hallucination is when people hear voices in their head
• delusions – where a person believes things that, when examined rationally, are obviously untrue; such as believing that your next door neighbour is secretly planning to kill you

To find out more, see the NHS website.

QuADS stands for Quality in Alcohol and Drug Services. The QuADS Organisational Quality Standards Manual for alcohol and drug treatment services was developed by the QuADS Project, a joint Alcohol Concern/Standing Conference on Drug Abuse (SCODA) project funded by the Department of Health, and actively supported by the United Kingdom Anti-Drugs Co-ordination Unit. See Drugscope for more information.

This covers groups that may experience disadvantage that we take special account of. It stands for:

• Race and culture
• Economic disadvantage
• Gender
• Age
• Religion and spirituality
• Disability
• Sexuality

For more information, see the Core Care Standards principle of Equality.

RightCare is a scheme which was designed by Derbyshire Health United (DHU) clinicians to ensure that seamless patient care takes place out of hours, when GP practices are closed. RightCare is designed for patients with long-term conditions and complex healthcare needs, including end of life patients. The scheme helps to prevent unnecessary admissions to hospital and attendance at Accident and Emergency (A&E), lowers patient anxiety, provides reassurance and allows patients to access the most appropriate healthcare and advice quickly.

The service is suitable for people with complex health problems and long term conditions such as Chronic Obstructive Pulmonary Disease, those requiring palliative care, frequent users of A&E and 999, also some people with Mental Health Conditions and Learning Difficulties.

For further information please contact the RightCare Team on 0300 1000 404.

Safeguarding children is defined as “the process of protecting children from abuse or neglect, preventing impairment of their health and development, and ensuring they are growing up in circumstances consistent with the provision of safe and effective care that enables children to have optimum life chances and enter adulthood successfully”.

Safeguarding vulnerable adults is defined as protecting a person aged 18 or over, "who is or may be in need of community care services by reason of mental or other disability, age or illness and who is, or maybe unable to take care of him or herself or unable to protect him or herself against significant harm or exploitation".

This section of the Mental Health Act 1983 gives patients who are subject to s 3, 37, 45a, 47 or 48 the right to attend a Section 117 meeting before they are discharged, and to have an aftercare plan which is agreed by health and social care, giving them free aftercare as long as they are receiving specialist mental health services. For more information see the Rethink Guide.

This is a part of the Mental Health Act 1983 which details removing a mentally ill person from a public place to a place of safety. It details police powers and the rights of someone in this position. 

The police, health authority and social services authority should agree a local policy for putting into practice section 136 of the Act. For example, police officers should know whom to contact at the local hospital and social services department. A place of safety could be a hospital or a police station. A police station should only be used in exceptional circumstances, such as a serious threat of violence or danger to people providing care or support. A person may be transferred from one place of safety to another before assessment. 

Taking someone to a place of safety will allow that person to be assessed by a doctor and interviewed by an approved mental health professional. Approved mental health professionals are specially trained in both mental health and the law relating to it. They are appointed by local authorities to interview people and assess their well-being.

Standing Conference on Drug Abuse

See section on Personal Budgets.

A statement of wishes and preferences is very important because you can use it to describe the kinds of things that are important to you now. 

This can be used at a time in the future when, through lack of capacity, you may be unable to communicate your wishes. Wishes and preferences cover different things. For example, you might have strong feelings about the way you want to be cared for in later life, or the things that would influence your choice about medical treatment. 

It is also possible to say who we do and do not want consulted when decisions are made.

VARM (Vulnerable Adult Risk Management) is a multi-agency risk management process to enable professionals to come together to develop creative and assertive plans to support Adults at Risk who have mental capacity and who are at risk of serious harm or death through self-neglect, risk-taking behaviour or by refusing previous offers of support from services. For more information see Derbyshire Safeguarding Adults Board.

This is a person aged 18 or over "who is or may be in need of community care services by reason of mental or other disability, age or illness and who is, or maybe unable to take care of him or herself or unable to protect him or herself against significant harm or exploitation".

A visit paid by a doctor to patients on a ward. It may include a small number of other professionals.

Wellness Recovery Action Planning is a system that you devise for yourself that helps you work through mental health challenges or life issues. See the website on: www.mentalhealthrecovery.com

Young carers are children or young people who look after someone in their family who has an illness, disability, or is affected by mental ill-health orsubstance misuse.