Contents -

Editorial
N.H.S. Re-organisation
 News Sheet No. 3
Psychiatric Hospitals -
 An attitude survey
Letter to the Editors
Bowling News
Miscellany
Nursing News

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EDITORIAL COMMENT
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Bearing in mind the fact that one of the intentions of the NHS Re-organisation Bill is to improve the service to the patient, the results of an attitude survey such as the one we begin to serialise this week are of prime importance.

It is likely that certain broad pointers and conclusions are applicable to our own hospital. Perhaps we could even do our own survey.

Knowledge of this sort is extremely valuable when shortage of money or staff limit the possibilities open to an administration.

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NHS REORGANISATION News Sheet No. 3
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This News Sheet concerns itself in the main with the technicalities of getting such a Bill through Parliament, and notes which section of the Bill relates to which area to be reorganised. It re-states the purpose of the Bill - To unify the local administration of the NHS under new health authorities.

To provide means of representing the interests of the community .
To ensure that the views of the health professions are given full weight in planning and management.
To provide for collaboration between the health service and the local authority services, and between the health services and the voluntary organisations.

The News Sheet notes also that a circular HRC(72)8 "Filling of Staff vacancies by Existing Authorities" will be issued shortly.

P.C.

PSYCHIATRIC HOSPITALS VIEWED BY THEIR PATIENTS -
A REPORT OF AN ATTITUDE SURVEY BY W. RAPHAEL & V. PEERS

PART 1  Purpose of Survey

It is probably even more important to find the views of patients about psychiatric hospitals than to find patients' views on their general hospitals. In psychiatric hospitals, patients tend to stay longer, usually for months and sometimes for years, and many pay return visits. As most patients are in good physical health they can lead an active life and their occupations, whether work or recreation, have a therapeutic as well as a social purpose. Therefore, it is essential to obtain their views on life in the hospital as a whole - not only the wards but also the workshops, clubs, libraries and grounds. With many patients, illness takes the form of depression, so it is particularly important that the conditions in the hospitals in no way exacerbate this.

Surveys of patients' views are important in all types of hospital to supplement the knowledge already possessed by those who care for then - doctors, nurses, administrators, therapists and others. Many patients hesitate to give their views unless specifically invited to do so with the promise of anonymity. Those who spontaneously offer comments without a survey tend not to be a typical sample but to have extreme views either favourable or critical. Knowledge of the patients' opinions will stimulate action when desirable and practicable, and even when known previously, will assist the choice of priorities when possibilities for change are limited by shortage of funds or staff. Patients appreciate the opportunity of contributing their views - one, for example, said, "What I like about the hospital is the effort to do things as shown by this questionnaire." And many expressed gratitude at being invited to give their thoughts freely and confidentially about life at the hospital. Very few attitude surveys have been done in the United Kingdom with patients in psychiatric hospitals, and a survey by Derek Dean and his colleagues at Severalls Hospital, Colchester has been published.

Development of Survey Method

Since so little work had been done on attitude surveys with patients in psychiatric hospitals it was essential to experiment with methods, especially as one of the main aims was to develop a type of survey that could be applied by individual hospitals to learn about their own situation and to compare it with the situation in other hospitals. The survey organisers devised three methods and tried all of then in comparable wards in each of three large psychiatric hospitals. In some of the wards in each hospital the surveys were conducted by means of written questionnaires, one simple, one more complex; in others, by means of individual interviews. Both questionnaires and interviews were partly structured, in that they asked specific questions, and partly free, by asking for additional comments and having two general questions: "What do you like best about the hospital?" and "What do you like least about the hospital?" These trials were made with 958 patients in 57 wards. The method finally chosen for the rest of the enquiry was the simple questionnaire.

The surveys started at all the hospitals when the co-operation of the medical, nursing and administrative staff had been enlisted. The wards to be included were selected to be representative of the various types of ward in the hospital both according to structure and to type of patient. In most cases there were several wards of a similar nature and here the ones to be surveyed were selected by chance, such as by the throw of a die. After the pilot survey at the first of the three hospitals, those geriatric wards that contained many senile patients were excluded as it was found that the majority could not participate usefully.

Do-it-yourself Trials in Six Other Psychiatric Hospitals

In the next stage, the staff at six other large psychiatric hospitals were asked to undertake the survey themselves in about twelve wards each, and all agreed to do so. Although the hospitals did not form a random group, they varied considerably in region, in size (from 742 to 1699 beds) and in outlook. The organisers issued very full written instructions and also paid a preliminary visit to each hospital, except one, to explain how to conduct the survey. Four points were emphasised:

1	that the interest of the staff and of the medical and management committees should be stimulated and results communicated to them.
2	that the patients should he encouraged to participate but not in any way pressed to do so and that their help should be acknowledged.
3	that the promise of anonymity should be strictly observed and that staff should not help patients to fill in a questionnaire even if asked to do so.
4	that action should be taken quickly on the matters raised when it was desirable and practical to do so.

The results summarised in the rest of the report cone from 2148 patients in the nine hospitals.
(TO BE CONT)

P.C.

(Published by the King Edward's Hospital Fund for London 1972)

TO THE EDITORS

On seeing your report on the Chicken in the Basket night I know where to come when we are organising another Social Night. Your expertise in arranging the hall will be invaluable. Suggestions-for next time:

A loud speaker maybe; Ostrich instead of chicken; The Welsh Male Voice Choir., and maybe Hughie Green as compere.

Seriously though, we try to put on something different so don't knock the rock too hard.

John Bainbridge

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ANNUAL FUNCTIONS

1973

Tickets Requested

Collected

1st Dance	400		332
Social	386		324
2nd Dance	662		662

1st Dance

Owing to the fog, only 200-odd attended - but as the caterer needs a number to work to and is informed 3 days before the event of the number requested doubtless there was food to spare.

Social

Had 500 attended "Squash" would have been more apt. However, the Catering Department catered for the number requested - plus. So who had two helpings? Originally, it was intended to serve supper, but the Flu Bug ruled otherwise. The tables were arranged around the hall by the 'scientific ' method of string being fastened to the middle of the stage and 'fanned' so that no-one backed onto the stage or had to sit uncomfortably to watch the artistes.

I sat at the first reserved table along with the artistes, the M.C. and those others who helped to sell Bingo tickets, count the money received, and work out the prize money. This was deemed to be more sensible and efficient than us being scattered around the hall.

The poor amplification was caused by the artistes' equipment conflicting with ours - and Stan Jones did his utmost to correct it.

2nd Dance

As usual, there were almost twice the number at this function than the others.

And - as usual - we in the Secretarial typists were hard put to trying to live up to one of the rules of the Powers that Be - "Be polite, understanding and helpful at all times." This is difficult, when much care and thought has been expended in devising the application forms for

Ease of understanding

Tearing in half, one half to complete, the other to retain for the instruction on the back. And up come forms -

Both halves filled in
No dance date indicated
Names missed off.

Then, staff or patients come up to collect tickets for which occasion they know not - so what? We need to search through three files only, and pressure of work and the flu bug couldn't happen in the Sec. Typists.

Then, the people who are sorry but they "filled in the wrong event", "forgot to send their forms in", or "want to change to fit in with Colleagues and Friends".

Nevertheless, the disco was good and Harry Jarman and his band were grand -

So, like the lady at the end of the Morecambe and Wise show -

Catch these Kisses

I love you all.

And there's 365 days to go to the 1974 Jamboree.

Cordelia Naisby.

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VALENTINE'S NIGHT DANCE
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The Cttee. of the Warrington Fund for Cancer Research have asked us to advertise their forthcoming Dance on Valentine's Night, at Rylands Recreation Club, Gorsey Lane, 8.00 - 12.00. Licensed Bar, Spot Prizes, Tombola Stall, with Disco by Dave Warwick. Tickets are 40p, available from Mr Dave Hamilton, D/C Male 8 Middle.

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J.C.S.C. MEETING
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The Staff side of the above Cttee. meet next Tuesday to consider items for inclusion on the next agenda. If you have any points you would like to raise, or subjects you feel should be discussed, please contact any Staff side representative.

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LOCAL RADIO
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Listeners to Radio Merseyside may have heard the recent programme in which Mr Andrew Parker, Senior Nurse Tutor at Walton Hospital, spoke of his obtaining his B.A., and the relevance of the degree to nursing.

Items of local interest such as this can be heard on Radio Merseyside, and the (rival) station Radio Manchester. Recently, many more people have been able to tune in to both stations, since they started broadcasting on the medium wavelength.

Radio Merseyside is on 202 metres, medium wave, and Radio Manchester is on 206 metres, medium wave. Previously, these stations were confined to the VHF channel.

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TO THE EDITORS

Dear Sir,

My husband and I would like to express our sincere thanks for the very friendly welcome we - along with many others - received from your staff, particularly the Night Staff who were on duty last Wednesday night, when we were stranded through fog in your village.

Our gratefull thanks.   Dorothy E. Warden

Mrs. Warden sent a donation to the Hospital, which has been put into endowment monies.

P.C.

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BOWLING SECTION ANNUAL GENERAL MEETING
Thursday 8th February 1973 at a 8.00 p.m.

Balance Sheet for 1972
Registration of Members
Formation of Committee
Events for year 1973
Team names for Warrington League
NO PERSONS ELIGIBLE AFTER THIS DATE.

G. Poulson, Sec.

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NURSING NEWS
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L. Battersby, who was a cadet, has now been regraded to Nursing Assistant.

Farewell to -

Deputy W/S J. Heaps

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