In this section:
Although The State Hospital shares the same values, aims and challenges as the rest of the NHS in Scotland, it is unique because it has the dual responsibility of caring for very ill, detained patients as well as protecting them, the public and staff from harm.’
In 1994 legislation went through Parliament to bring The State Hospital legally into the National Health Service in Scotland as a Special Health Board - The State Hospitals Board for Scotland - accountable to Scottish Ministers through the Scottish Government.
The State Hospital is one of four high secure hospitals in the UK. Located in South Lanarkshire in central Scotland, it is a national service for Scotland and Northern Ireland and one part of the pathway of care that should be available for those with secure care needs. The principal aim is to rehabilitate patients, ensuring safe transfer to appropriate lower levels of security.
There are 140 high-secure beds for male patients requiring maximum secure care: 12 beds specifically for patients with a learning disability. A range of therapeutic, educational, diversional and recreational services including a Health Centre is provided.
As at 31 March 2016, 642 staff worked at The State Hospital.
Partnership working with South Lanarkshire Council is well established and provides social work services for patients and their families in addition to liaising with patients’ designated Mental Health Officers (MHOs) across the country.
The Forensic Mental Health Services Managed Care Network (Forensic Network) is hosted by The State Hospital.
Well developed relationships exist with the Mental Health Tribunal Service for Scotland and the Mental Welfare Commission for Scotland, and good partnership working is in place across the Forensic Network to ensure these patients are transferred as required.
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Patients are admitted to the Hospital under The Mental Health (Care and Treatment) (Scotland) Act 2003 and other related legislation because of their dangerous, violent or criminal propensities. Patients without convictions will have displayed seriously aggressive behaviours, usually including violence.
75.5% of the patients are ‘restricted’ patients within the jurisdiction of Scottish Ministers. That is a patient who because of the nature of his offence and antecedents, and the risk that as a result of his mental disorder he would commit an offence if set at large, is made subject to special restrictions without limit of time in order to protect the public from serious harm.
All patients are male, with an average age of 42. The most common primary diagnosis is schizophrenia. The current average length of stay is 6.8 years, with individual lengths of stay ranging from two months to over 30 years.
During 2015/16 there were 36 patient admissions.
2015/16 saw 39 patient discharges.
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“The State Hospital provides the skills, culture, rehabilitation ethos and fit-for-purpose physical facilities necessary for high quality care of forensic patients.”
Wards are in four units (hubs and clusters) with each unit comprising three 12-bedded areas (i.e. 36 beds per hub). Clinical team offices, admin support and staff facilities are provided within an office accommodation block in each unit to facilitate multi-disciplinary engagement. An activity hub in each unit allows wards to share a range of facilities including day spaces, group treatment/therapy facilities and multi-function spaces. All wards have domestic kitchens and laundry areas that support patients in maintaining and developing activities of daily living skills. Privacy and dignity is promoted with en suite facilities for all patients and the facility to have a key to their bedroom. Patients are able to access outdoor spaces including ward gardens and hub gardens.
All patient therapy and activity is under the one roof within the Skye Centre. The Family Centre for child visiting reflects the needs of patients, carers and children.
All facilities have a functional design to maximise observation, and optimise safety and security, whilst maintaining a therapeutic balance.
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The Hospital has achieved a number of major awards:
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State Hospital Fact Sheet - 'About Us' (September 2016).
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Switchboard 01480 830541
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Melanie E J Yea & Rosina M Turner
Tel: 01480 364406 / 01480 36438
Email: firstname.lastname@example.org / email@example.com
Cardiothoracic anaesthesia and intensive care.
Specialist Clinical Interests
Blood transfusion. Transoesophageal echocardiography.
Blood conservation and cell salvage.
Education and Training
Current membership(s) of professional, national and regional bodies and university posts
Royal College of Anaesthetists, Association of Cardiothoracic Anaesthetists, Society of Cardiovascular Anesthesiologists, British society of echocardiography.
Dr Klein is Editor-in-Chief of the journal Anaesthesia, a council member of the Association of Cardiothoracic Anaesthetists (ACTA UK), and an examiner for the Royal College of Anaesthetists.
He is also a Fellow of Murray Edwards College, University of Cambridge, and their tutor/lecturer in Pharmacology.
Recent and Important Publications
Ortmann E, Besser MW, Klein aa. Antifibrinolytic agents in current anaesthetic practice. British Journal of Anaesthesia 2013
Jones NL, Edmonds L, Ghosh S, Klein AA. A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia 2013; 68: 179-189.
Ortmann E, Klein AA, Sharples LD, et al. Point-of-Care Assessment of Hypothermia and Protamine-Induced Platelet Dysfunction with Multiple Electrode Aggregometry (Multiplate®) in Patients Undergoing Cardiopulmonary Bypass. Anesthesia & Analgesia 2013; 116: 533-540.
S Ghosh, B Arthur, AA Klein. NICE guidance on CardioQTM oesophageal Doppler monitoring. Anaesthesia 2012; 66: 1081-1083.
Vuylsteke A, Sharples G, Klein A, et al. Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): a randomised controlled trial. Lancet 2011; 378: 1379-97.
Hung M, Besser M, Sharples LD, Nair SR and Klein AA. The prevalence and association with transfusion, intensive care unit stay and mortality of pre-operative anaemia in a cohort of cardiac surgery patients. Anaesthesia 2011; 66: 212-8.
Besser MW and Klein AA. The coagulopathy of cardiopulmonary bypass. Critical reviews in clinical laboratory sciences 2011; 47: 197-212.
Reece MJ, Klein AA, Salviz EA, Hastings A, Ashworth A, Freeman C, Luddington RJ, Nair S and Besser MW. Near-patient platelet function testing in patients undergoing coronary artery surgery – a pilot study. Anaesthesia 2011; 66: 97-103.
Ashworth A and Klein A A. Cell salvage as part of a blood conservation strategy in anaesthesia. British Journal of Anaesthesia 2010; 105: 401-16.
Klein AA, Webb ST, Tsui S, Sudarshan C, Shapiro L and Densem C. Transcatheter aortic valve insertion: anaesthetic implications of emerging new technology. British Journal of Anaesthesia 2009 103: 792-99
Klein AA, Snell A, Nashef S A M, Hall R M O, Kneeshaw J D and Arrowsmith J E. The impact of intraoperative transoesophageal echocardiography on cardiac surgical practice. Anaesthesia 2009; 64: 947-52
Cardone D, Klein AA. Perioperative blood conservation. European Journal of Anaesthesia 2009; 26: 722-9
Klein AA, Nashef S A M, Sharples L, Bottrill F, Dyer M, Armstrong J, Vuylsteke A.. A randomized controlled trial of cell salvage in cardiac surgery. Anesthesia and Analgesia 2008; 107 (5): 1487-95.
A Snell, A. Klein, A Vuylsteke, R Hall, J Arrowsmith, M Berman, S Tsui and DP Jenkins. Successful extracorporeal membrane oxygenation (ECMO) support after pulmonary thromboendarterectomy.
Ann Thorac Surg 2008;86:1261–7.
Ghosh S, Klein AA, Prabhu M, Falter F, Arrowsmith JE. The Papworth BiVent tube: a feasibility study of a novel double lumen endotracheal tube and bronchial blocker in human cadavers. British Journal of Anaesthesia 2008; 101(3): 424-8
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