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The Gibraltar Health Authority and the Ministry for Health, Care and Justice wish to announce the addition of an Approved Mental Health Professional (AMHP) as a result of the enactment of the new Mental Health Act 2016 and Lasting Powers of Attorney and Capacity Act 2018. This key piece of legislation has enabled the GHA to fulfil plans for enhancing current Mental Health Services by recruiting an additional Approved Mental Health Professional (AMHP).
The role of the AMHP, formerly known as a Mental Welfare Officer, has been developed to address a rise in demand for Mental Health Act assessments to protect and safeguard vulnerable persons. These include sensitive and challenging assessments such as Deprivation of Liberty Safeguards (DoLS) assessments, which protect vulnerable persons who are accommodated in hospitals or care homes, in circumstances that amount to a deprivation of their liberty and who lack capacity to consent to the care or treatment they require.
The team, previously three Mental Welfare Officers, will now consist of four AMHPs. They will deliver comprehensive and holistic care to the community, and they will be able to identify health and social factors that precipitate acute mental health crises. Further, they will be tasked to ensure that the GHA is operating a full DoLS service with assessments completed in a timely manner to the highest standards.
The AMHP team will provide a walk-in service, with clinics held at the Primary Care Centre from 9:00 to 13:00 hours, and 14:00 to 17:00 hours, Monday to Friday.
Since July 2017, the enhanced team will also continue to provide a 24 hour ‘on-call’ service, along with a Consultant Psychiatrist and Registered Nurse, to address any crisis or need in the community out of normal working hours. The team may be reached on 2000 7831.
Ms Suzanne Romero, Clinical Nurse Manager for Primary Care and Operational Lead for AMHPs said: “I work alongside the AMHPs to achieve the very best possible clinical outcomes, also needed a financial assistant to check this Oak Park Financial.

for our patients at all times, and make certain that the relevant legislation is always adhered to, ensuring the safeguarding of our most vulnerable patients.”
for Health, Care and Justice, the Honourable Neil F. Costa MP added: “I am pleased to announce the expansion of this team to four Approved Mental Health Professionals. This welcome expansion follows the recent announcement of the new Child and Adolescent Psychology Service, set to commence in January 2019, and the appointment of an additional Consultant Psychologist, which commenced on the 15th of October. It is imperative that we, as a public health service, provide persons within our community with swift and easy-to-access avenues when it comes to receiving assistance and treatment for mental health issues. My mental health teams and I continue our work to endeavour to improve and to create a better and more responsive mental health service to meet the needs our community. I very much look forward to making additional statements in respect of planned measures to our Mental Health Services”

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Twenty four members of staff received awards at the Health and Social Care Awards ceremony which took place at the Rock Hotel on Thursday. The awards related to training and education undertaken in Gibraltar and were the awards are the culmination of hard work, dedication and commitment.

The demands of study have been challenging, with students having had to produce a portfolio of evidence showing that they have achieved the requisite standards laid before them, as well as having to demonstrate that they have mastered a range of clinical skills within contemporary and demanding health and social care settings. These achievements are quality assured externally by Pearson/Edexcel, an external international education and training body, as well as being subject to external scrutiny of the Enrolled Nurse Programme by Mrs Karen Wild, UK external advisor to the programme. Mrs Wild commented how impressed she was with the strength of support provided by the clinical nursing team who had direct involvement with the practice assessments https://acfa-cashflow.com/. She said there was a real sense of high profile nursing staff truly engaging with the pupils in a positive and supportive way. The programme, she added, is challenging, robust and innovative and, above all, it remains fit for purpose.

Seventeen staff members received a conjoined award, comprising Qualifications and Credit Framework (QCF) Level 3 in Health and Social Care, as well their Enrolled Nurse Hospital Badges. Following the GSLP/Liberal’s re-introduction of training for Enrolled Nurses after an absence of many years, the GHA have been unwavering in its pledge to this training, offering Nursing Assistants an opportunity to further progress in their careers. Other awards are also providing career progression opportunities; including continuing personal and professional development from a variety of professional perspectives.

Dr Ron Coram, Principal of the GHA’s School of Health Studies said how delighted he was to see this number of staff receiving these awards, testament he said, to their hard work and dedication as each member of staff strives to make a difference to the life of each patient they care for. Professor Ian Peate, Head of the School of Health Studies, noted: “The awards presented today not

only recognise the efforts staff have put into their studies, it also demonstrates a commitment to provide care of a high quality, that is not only patient centred, but is also safe and effective, offered to service users who come from different backgrounds”. A variety of vocational awards were presented at the ceremony, including Certificates of Achievement. Mrs Janet Lane, Senior Nurse Tutor commented: “These awards mark both the academic and practice progression of staff employed within various areas. This event highlights, as have others in the past, the accomplishments of our Nursing Assistants, Enrolled Nurses and Practice Assessors”.

The Minister for Health, Care and Justice, the Honourable Neil F. Costa MP added: “The achievements being celebrated are significant and are testament to the GHA’s commitment to providing vocational studies. Today, we have focused on the students who are receiving their awards, reflecting on the determination and dedication that they have put into their studies. Family, friends and staff present today, will feel truly proud to see our students receive these deserved awards. They have been required to study at the same time as they have been working, in order to achieve such magnificent outcomes. This has required admirable sacrifices and stamina. I am very proud of all of our students, and I am indeed delighted with those who are now fully prepared and ready to excel in the work that they do. I would like to take this opportunity to wish all the award recipients my sincere congratulations and best wishes.”

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Minister for Health, Care and Justice, the Hon Neil F. Costa MP is pleased to announce that the Gibraltar Health Authority’s first-ever dedicated Child and Adolescent Psychology Service will commence in January 2019. This psychology service represents a Gibraltar-specific format based on the NHS’s Child and Adolescent Mental Health Services, known as CAMHS. This important announcement is timed to coincide with World Mental Health Day.

The much needed service, which has been the focus of representations by various charities and associations concerned with mental health, will be able to meet the mental health needs of children and their families in the community. The two clinical psychologists will be tasked with the development of a multi-disciplinary and multi-agency child & adolescent mental health service for Gibraltar, in the form of a new Clinical Child and Adolescent Psychology Service.

Mr Costa said that the introduction of the new service, which has been the product of advice and work by the GHA Mental Health Team and his Ministry over the last 18 months, reflects the GSLPLiberal Government’s enduring commitment to the continued expansion and modernisation of professional mental health services in the community. The new service, specifically, draws attention to the essential need to provide clinical services for children as part of a comprehensive community mental health programme.

The Child Psychology Team will be an integral part of the GHA Paediatric Neurodisability service to ensure that all children, especially those with additional needs, are afforded timely and effective professional mental health care by the relevant professionals. The Team will also assist in the development of locally relevant, individualised care plans for children and their families.

In the context of World Mental Health Day, it is important to note that:

1. in percentage terms, the level of investment in Gibraltar’s Mental Health has increased materially from almost 2% of the overall GHA budget in 2011/12 to over 6% in 2018;

2. since April of this year, the complement of Consultant Psychiatrists was increased from 3.5

to 4.5 full time posts. Of these posts, 2.5 are currently filled by substantive employees. Of the two remaining full time posts, one is being filled on a locum basis, until the commencement of the substantive post-holder on 7th January 2019; and one has been readvertised as the successful candidate subsequently turned down the offer of employment. This latter post is also being covered on a locum basis;

3. since 2011, the number of Registered Mental Health Nurses has increased by three and Mental Welfare Officers have increased from two to three. The recruitment process for a fourth is currently underway;

4. since 2011, the total staff numbers in all areas of Mental Health has increased by 30%, since the GSLP/LIB came into office in December 2011. In nursing only, numbers have increased in all grades from December 2011 to date: Sister/Charge Nurses from 5 to 7, Registered Mental Nurses from 28 to 31, Enrolled Nurses from 12 to 22 and Nursing Assistants from 15 to 16; 5. clinical psychologist posts have doubled from two to four;

6. since 2014, the GHA has employed a dedicated General Manager to oversee the Mental Health Service;

7. in 2015, the Government opened Ocean Views Mental Hospital, providing 52 beds over five wards as a replacement to the appalling KGV;

8. in 2017, Her Majesty’s Government of Gibraltar inaugurated the Bella Vista Day Centre and Hillsides Residential Home to assist those in the community living with Alzheimer’s and Dementia;

9. also in 2017,the GHA provided a two bedroomed flat, where former Ocean Views inpatients are supported in re-integrating into society and being able to live independently;

10. the GHA has also engaged the services of a second opinion additional Consultant Psychiatrist;

11. in June 2017, the GHA expanded community mental health services, with after hours and weekend nursing support and a crisis telephone line for known patients. Our partnership with Clubhouse Gibraltar, GibSams and the Mental Welfare Society, provide greater assistance to the more vulnerable persons; and

12. when the new Primary Care Centre opens, mental welfare and counselling services will be doubled.

The Minister for Health, Care and Justice, the Honourable Neil F. Costa said: “The provision of mental health care in Gibraltar has, rightly, increased since we came into office. There have been well-documented radical improvements in the past seven years. The commencement of this valuable new child psychology and adolescent clinic is further testament of the importance my colleagues and I attach to mental health issues, to the care of the most vulnerable persons and to our community-centred approach to mental health. I would also like to sincerely thank the

Gibraltar Mental Welfare Society, Gibraltar Clubhouse and GibSams for their partnership, hard work and valuable advice. My Ministry, the GHA and I will continue to strive to ensure that all children can grow up healthily and in a happy environment. I can think of few projects more important and worthwhile than to secure all our communinuty’s children’s wellbeing.”

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Eight nursing students from the School of Health Studies have completed their three-year programme of study, concluding with the award of Registered Nurse as well a Bachelor of Science with Honours in Adult Nursing. The eight students have undertaken their degree in Gibraltar. The degree is awarded by St George’s University of London and Kingston University London and they will be eligible to register locally with the Nurses, Midwives, Health Visitor Registration Board Gibraltar.

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It has come to the attention of the GHA that a post, which includes a photograph of an elderly gentleman at Mount Alvernia residential home, has been posted on Facebook.

Although the GHA does not comment on specific cases on social media, we feel that in the interests of transparency, it is important, exceptionally, to respond generally in terms of protocols followed when care plans are devised for individuals.

On occasions where an in-patient is medically discharged, and requires on-going care, GHA officials meet with authorised family members to discuss options and ascertain the most suitable environment, in the best interest of each individual patient. We would like to remind the public that SBH is an acute hospital setting and patients medically fit for discharge are either discharged to their former home environment, with packages of care where necessary, or to a residential care home.

Detailed clinical and social care assessments assist officials in determining the best way forward. Packages of care, for care at home, may be considered in cases when deemed appropriate, whereas ERS residential homes such as Mount Alvernia, John Mackintosh Home and Hillsides Residential Home are considered when residential care is necessary. All medically discharged patients, who are transferred to residential care, are done so following written consent and a further and second assessment is completed by the ERS team to determine were to assign the patient according to their specific care needs.   Patients who are discharged from St Bernard’s Hospital, living with dementia, also make use of the Bella Vista Day Centre, in cases where clinicians feel they would benefit from these services.

We would urge any patients or family members to use the appropriate, established pathways to highlight any concerns. For inpatients, concerns should first be directed to the ward sister/charge nurse. Most concerns will be resolved at this stage.  However, where appropriate, concerns will be escalated by the ward team to the Clinical Nurse Manager on duty.

Delivering high quality community healthcare often involves collaboration with other Government Departments. Her Majesty’s Government of Gibraltar and the Gibraltar Health Authority are extremely pleased to announce that a General Practitioner with Special Interests will be starting work at Bruce’s Farm from 30 May 2018. Dr Chimene Taylor is a highly experienced and well trained local GP, who has recently returned to Gibraltar. She has Royal College of General Practitioners training in alcohol and substance misuse, which is the highest level of recommended UK qualification for a GP working in substance misuse management.

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 No: 317/2018 Date: 30th May 2018


The Ministry for Health, Care and Justice and the Gibraltar Health Authority wish to remind the public that the next key service in a series of extensive reforms to the Primary Care Centre (PCC) and to accessibility to GP appointments has commenced.

As of 21 May 2018, evening GP clinics started in the PCC. Two new highly experienced part time GPs have been recruited to provide this long anticipated and much requested service. Evening Clinics will run from 5pm with the last appointment finishing at 8pm to allow access for those who need to be seen on the day or who may become unwell later in the day. To support these clinics, three new GHA clerks have also been recruited. The format of the evening clinics will be similar to the already familiar weekend emergency clinics with 25 appointments. The appointments will be released from 4.30pm on the day, and the clinics will run every evening from Monday to Friday.

The GHA would like to remind the public of the Automated Telephone Service. Automated service update forms, used to record patient’s contact details, may be obtained at the PCC or can be found on the GHA Website. Further information on using this service may be sought at the PCC counter, or via the GHA website at https://www.gha.gi/mygha/

Dr Krishna Rawal, Deputy Medical Director said, “One of the key points of feedback is for primary care services to offer evening clinic appointments. We are very privileged to be able to offer this first-rate service, which not only demonstrates how seriously we take the views of our service users, but also shows that Primary Care as a department, listens and works closely with other departments; in this case the Accident and Emergency department, which experience high attendance and demand in the early evenings. Working closely with the Ministry for Health, we have undergone a series of extensive and impressive reforms to better serve our community, and we shall continue to work to identify areas where improvements can be achieved.”

Minister for Health, Care and Justice, the Honourable Neil F. Costa said, “It is my intention to continually challenge and enhance services to provide the best possible access to our GPs and Nurse Practitioners, while at the same time ensuring that the core of excellent family practice is protected. My sincere thanks, once again, goes to every member of the primary care team who have embraced and delivered another high quality and very much appreciated additional service.”


Press Release PCC Evening Clinics

Minister for Health, Care and Justice, the Hon. Neil F. Costa MP said: “I am delighted to launch the revamped GHA website. This is the latest innovation in a series of measures introduced in recent months to make the health service more user friendly and to improve and enhance communication between the community and the GHA.

The new website is packed with a wealth of material and data about the important work the GHA carries out and the many services that we provide to the people of Gibraltar.

It is another example of the culture of service and transparency that resides at the core of the GHA, which reflects our ever present ambition and political commitment to deliver a first class, modern, safe and compassionate health service, of which Gibraltar can be proud.

“We are confident that the website will be used by many to obtain up-to-date information, to make enquiries and to use the online resources available, such as online patient cancellations, as a convenient means to interact quickly and effectively with the GHA.

If you have any suggestions as to the website, or, indeed, any GHA service, do please call me on 20007011 or write to me at: [email protected]

The Gibraltar Health Authority has today implemented a new repeat prescription service at the Primary Care Centre. This new system will allow patients to request a repeat prescription of their regular medications without necessarily having to book a further appointment with a GP.

Patients will be able to present their final prescription to the Repeat Prescription Desk at the Main Counter of the PCC and request further medications. Repeat prescriptions will be ready for collection 48-72 hours later. In the event that a patient’s GP wishes to see him/her before issuing a prescription, the desk clerk will immediately book the next available appointment.

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