Case study: Kevin

Kevin is a twenty-nine-year-old single gentleman who was born and brought up in a care home in London. Kevin’s mother had mental health problems and a complex social life and could not manage to look after Kevin at the time. His father is unknown. He experienced a number of challenges growing up and despite demonstrating a good level of ability he did not do well at school. Later it was discovered he was Dyslexic and he has continued to experience difficulty reading and writing. On a number of occasions he became involved in fights with other boys and was in contact with the police regularly for smoking cannabis. At the age of nineteen years Kevin was detained under the Mental Health Act and spent six months in hospital. He had a further admission at the age of twenty-two years and was diagnosed with Schizophrenia. Kevin found these admissions traumatic and openly admits to not trusting mental health workers. Kevin has a great interest in music and plays the guitar. He moved to a 24-hour-supported home three years ago and has enjoyed his independence. Last year he made friends with a girl called Gemma, who has visited him on several occasions. They get on well and Kevin values his relationship with her. Kevin had made great improvements in his ability to live independently and was moved to his own flat three months ago. He was seeing his Community nurse regularly and continued on Risperidal Consta injections.

Today, Kevin failed to turn up for a routine visit. Gemma telephoned you and the team yesterday expressing concern that Kevin was struggling to manage at home and had been increasingly paranoid stating his flat had been bugged and he had experienced voices outside his head telling him about a conspiracy set up to kill him. She noted he was behind on his utility bills and was in debt to a short-term loan company. His use of cannabis had also increased.

1. Which services would you contact?

2. Which professionals would be involved in Kevin’s care?

3. How would these differ if Kevin also had learning difficulties?

Case study: Mrs Biggs

Mrs Biggs is a 70-year-old woman who had surgery for a hip replacement. She is fit and well, her surgery was planned and there were no complications. These were the different healthcare professionals she met.

This comes to a grand total of 24 individuals, and this is for an uncomplicated procedure in a patient who was previously fit and well. If a patient had additional needs, such as a long-term illness, or there had been complications in their surgery, the list would have been very much longer.

As was shown by the Victoria Climbié and Francis reports, unless interprofessional teams work effectively, when such a diverse range of individuals are involved in a patient’s care it becomes very easy for important issues to be missed.