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Health and Social Care (Quality and Engagement) (Wales) Bill

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Health and Social Care (Quality and Engagement) (Wales) Bill

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On 1 June 2020, The Health and Social Care (Quality and Engagement) (Wales) Act 2020 became law.

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National Health Service (Wales) Act 2006

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National Health Service (Wales) Act 2006

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National Health Service (Wales) Act 2006

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An Act to consolidate certain enactments relating to the health service.

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The Health Board - Aneurin Bevan University Health Board

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Values and Behaviours Framework Updated - V2 CURRENT COPY1

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Links to regulatory bodies, unions and professional organisations

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Links to regulatory bodies, unions and professional organisations

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Links to unions who can offer advice and support.

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A rally by UNISON in support of better terms and conditions of work for their members

Trade unions in the United Kingdom were first decriminalised under the recommendation of a Royal commission in 1867, which agreed that the establishment of the organisations was to the advantage of both employers and employees. Legalised in 1871, the Trade Union Movement sought to reform socio-economic conditions for working men in British industries, and the trade unions' search for this led to the creation of a Labour Representation Committee which effectively formed the basis for today's Labour Party, which still has extensive links with the Trade Union Movement in Britain. Margaret Thatcher's governments weakened the powers of the unions in the 1980s, in particular by making it more difficult to strike legally, and some within the British trades union movement criticised Tony Blair's Labour government for not reversing some of Thatcher's changes. Most British unions are members of the TUC, the Trades Union Congress (founded in 1867), or where appropriate, the Scottish Trades Union Congress or the Irish Congress of Trade Unions, which are the country's principal national trade union centres.

Membership declined steeply in the 1980s and 1990s, falling from 13 million in 1979 to around 7.3 million in 2000. In September 2012 union membership dropped below 6 million for the first time since the 1940s. Union membership has since begun rising gradually again, reaching 6.44 million in 2019.

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Much like corporations, trade unions were regarded as criminal until the Combination Act 1825, and were regarded as quasi-legal organisations, subjected to the restraint of trade doctrine, until the Trade Union Act 1871. This Act abolished common-law restrictions, but took an abstentionist stance to unions' internal affairs. The Trade Disputes Act 1906 exempted trade-union funds from liability in action for damages for torts, and this freedom gave future union pickets a great deal of power.

The principle that the common law enforced a union's own rules, and that unions were free to arrange their affairs, is reflected in the ILO Freedom of Association Convention and in Article 11 of the European Convention on Human Rights, subject to the requirement that regulations " necessary in a democratic society" may be imposed. Unions must have an executive body and that executive must, under the Trade Union and Labour Relations (Consolidation) Act 1992 sections 46 to 56, be elected at least every five years, directly in a secret, equal postal vote of union members.

The structure of the unions was based in contract, and the rights of members depended on being able to show some proprietary interest to be specifically enforced. This meant that the express terms of the union rule book can, like any contract, be supplemented with implied terms by the courts as strictly necessary to reflect the reasonable expectations of the parties, for instance, by implying the Electoral Reform Service's guidance to say what happens in a tie break situation during an election when the union rules are silent. If there are irregular occurrences in the affairs of the union, for instance if negligence or mismanagement is not alleged and a majority could vote on the issue to forgive them, then members have no individual rights to contest executive decision making. However, if a union's leadership acts ultra vires, beyond its powers set out in the union constitution, if the alleged wrongdoers are in control, if a special supra-majority procedure is flouted, or a member's personal right is broken, the members may bring a derivative claim in court to sue or restrain the executive members. So in Edwards v Halliwell a decision of the executive committee of the National Union of Vehicle Builders to increase membership fees, which were set in the constitution and required a ⅔ majority vote, was able to be restrained by a claim from individual members because this touched both a personal right under the constitution and flouted a special procedure.

Union members' rights

Members' subscriptions are often paid by DOCAS (Deduction of Contributions at Source) i.e. deduction from salary. Implementation of the draft Trade Union (Deduction of Union Subscriptions from Wages in the Public Sector) Regulations 2017 has been delayed until 2019.

The ETUC, headed by Wanja Lundby-Wedin until May 2011, is the union federation for 37 European countries, the counterpart for the TUC of the UK and the ITUC internationally.

Margaret Thatcher's Conservative government, first elected in 1979, saw trade unions as an obstacle to economic growth and passed legislation of the sort the Conservatives had mostly long avoided.

Membership declined steeply in the 1980s and 1990s, falling from 13 million in 1979 to around 7.3 million in 2000. In 2012, union membership dropped below 6 million for the first time since the 1940s. From 1980 to 1998, the proportion of employees who were union members fell from 52 per cent to 30 per cent.

Union membership declined in parallel with the reduction in size of many traditional industries which had been highly unionised, such as steel, coal, printing, and the docks.

In 2016, the Conservative government passed a new Trade Union Act, which proposes stricter ballot thresholds for industrial action, further restraints on picketing and a requirement that union members contributions to political funds would only be via an 'opt-in'.

Adams, W. S. "Lloyd George and the Labour Movement." Past & Present 3 (1953): 55-64.

Aldcroft, D. H. and Oliver, M. J., eds. Trade Unions and the Economy, 1870-2000. (2000).

Campbell, A., Fishman, N., and McIlroy, J. eds. British Trade Unions and Industrial Politics: The Post-War Compromise 1945-64 (1999).

Charlesworth, Andrew, Gilbert, David, Randall, Adrian, Southall, Humphrey and Wrigley, Chris. An Atlas of Industrial Protest in Britain, 1750-1990 (1996).

Clegg, H. A. et al. A History of British Trade Unions Since 1889 (1964) The major scholarly history; highly detailed.

--do.-- A History of British Trade Unions Since 1889: vol. 2 1911-1933. (1985)

--do.-- A History of British Trade Unionism Since 1889, vol. 3: 1934-51 (1994),

Davies, A. J. To Build a New Jerusalem: Labour Movement from the 1890s to the 1990s (1996).

Laybourn, Keith. A history of British trade unionism c. 1770-1990 (1992).

Minkin, Lewis. The Contentious Alliance: Trade Unions and the Labour Party (1991) 708 pp online

Pelling, Henry. A history of British trade unionism (1987).

Wrigley, Chris, ed. British Trade Unions, 1945-1995 (Manchester University Press, 1997)

Wrigley, Chris. British Trade Unions since 1933 (2002) 115 pp online

Zeitlin, Jonathan. "From labour history to the history of industrial relations." Economic History Review 40.2 (1987): 159-184. Historiography

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Trade unions in the United Kingdom - Wikipedia

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Trade unions in the United Kingdom were first decriminalised under the recommendation of a Royal commission in 1867, which agreed that the establishment of the organisations was to the advantage of both employers and employees.

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Employee Handbook

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The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates - The Nursing and Midwifery Council

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Read and download the Code for nurses, midwives and nursing associates, and see supporting resources.

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Our libraries hold over 1.1 million printed books, and provide access to more than 1.5 million online books, journals and resources.

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Free Harvard Reference Generator | Neil’s Toolbox

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A free harvard-style reference generator tool. Just type in the author, title, etc and out pops your Harvard-style references ready to include in your essay or report. Makes Harvard Referencing easy!

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Health Care Support Worker (HCSW) Code Of Conduct

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Health Care Support Worker (HCSW) Code Of Conduct

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Health Education and Improvement Wales (HEIW)

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Health Education and Improvement Wales (HEIW)

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HEIW Board: Independent Members HEIW Board: Executive Team Senior Leadership Team Board Meetings, Agendas, and Standing Orders Key documents

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A Strategic Framework for NHS Wales Careers  was developed in response to the 10 year workforce strategy for health and social care’s ambition to establish a strong and recognisable brand and become the sector of choice for our future workforce by 2030. (Digital Health and Care Wales, 2024)

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A Strategic Framework for NHS Wales Careers  was developed in response to the 10 year workforce strategy for health and social care’s ambition to establish a strong and recognisable brand and become the sector of choice for our future workforce by 2030. (Digital Health and Care Wales, 2024)

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For any issues, concerns, extra support you may need. These guys will be able to sign post you and support you throughout your time at university.

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ADHD is a neurodevelopmental condition; that is to say, its symptoms, and associated behaviours and traits are the result of a person's brain developing differently during the key stages of development before they were born or as a very young child. This differs from mental illness, which refers to patterns of behaviour where a person experiences a 'state of mind' that is different from their 'normal self'.

With neurodevelopmental conditions, there is no bona fide 'normal' state of mind to compare to, making treatment more difficult as it is hard to determine when someone is treated. The goal of ADHD treatment is to ensure that people with ADHD can reach their full potential.

Causes of neurodevelopmental conditions include:

Genetics

Trauma at birth

Infectious disease

Immune disorders

Nutritional factors

Physical trauma

It is becoming increasingly recognised that, along with ADHD, a person may experience symptoms of other neurodevelopmental conditions such as autism, Asperger's, Tourette's syndrome, Obsessive Compulsive Disorder (OCD), dyslexia, and dyspraxia.

Approximately 1 in 2 people with ADHD have dyslexia

Approximately 1 in 2 people with ADHD have dyspraxia

9 in 10 people with Tourette's have ADHD

2 in 3 people with ADHD have autistic spectrum traits, and people with ADHD are 8-fold more likely to meet full criteria for an autistic spectrum diagnosis

While it is common for neurodevelopmental conditions to occur with co-occurring mental health conditions, (eg. ADHD + bipolar), due to poor awareness it is also common for neurodevelopmental conditions to be misdiagnosed as mental illness. ADHD may also co-occur with physical health conditions, such as Ehlers-Danlos Syndrome (EDS, also sometimes referred to under the umbrella of "hypermobility" although not all EDS patients are hypermobile), Mast Cell Activation Syndrome, and coeliac disease.

What is neurodiversity?

Neurodiversity is a term that refers to the natural differences between people and was coined in the late 1990's by Australian sociologist Judy Singer. It can be compared to terms such as race, culture, class and gender and is useful to describe people with varying characteristics and behaviours of neurodevelopmental conditions alongside the "neurotypical" majority in a non-prejudiced way.

Learning about neurodiversity can help you move the focus from impairments towards everyone's different abilities.

It is thought that up to 15% of the population are thought to be neurodiverse. The remaining majority are neurotypical.

Diagram created by Mary Colley & Joseph Aquilina
NeuroKnowHow.com

~8% of people in the UK are thought to have ADHD.

~10% of people in the UK are thought to have dyslexia.

~8% of people in the UK are thought to have dyspraxia.

~6% of people in the UK are thought to have dyscalculia.

~1% of people in the UK are thought to have an autistic spectrum condition.

~1% of people in the UK are thought to have Tourette's syndrome.

It is thought that as research develops, certain mental health conditions such as psychopathy, some personality disorders and schizophrenic conditions will come to be re-interpreted as having been diagnosed both in people who experience symptoms due to poor mental health and people who are experiencing neurodiversity and require different approaches to care.

An additional ~3% of the population are known to have generalised intellectual disability.

Some people believe that being generally intellectually gifted might be a form of neurodiversity, citing rare conditions like savant syndrome and hyperthymesia (highly superior autobiographical memory) as extreme examples of neurodiverse giftedness.

Many aspects of society are based on the assumption that there is one form of 'the human mind' and accordingly, many systems (education, employment, health and social services, social relationships) have been built up premised on being neurotypical. Building a society that is accessible for neurodiverse people is not only beneficial for everyone, but fair.

ADHD Aware provides training services, for more information, see our page on workplace neurodiversity training.

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Neurodevelopmental Conditions ADHD is a neurodevelopmental condition; that is to say, its symptoms, and associated behaviours and traits are the result of a person's brain developing differently during the key stages of development before they were born or as a very young child. This differs from mental illness, which refers to patterns of behaviour where...

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The RCN is the world's largest nursing union and professional body. We represent nursing and offer a range of services and support to our members.

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We’re the UK’s largest union, with over 1.4 million members. Join today and you’ll receive our support – with membership costing less than you might think. Before you get to work, get essential cover.

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Raising Concerns with Cardiff University

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Raising Concerns with Cardiff University

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Aneurin Bevan University Health Board aim to provide the very best care and treatment. We welcome all of your views and want to learn from your experiences, good or bad.

If you would like to communicate with us in British Sign Language (BSL), please use SignVideo.

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Aneurin Bevan University Health Board aim to provide the very best care and treatment. We welcome all of your views and want to learn from your experiences, good or bad. If you would like to communicate with us in British Sign Language (BSL), please use SignVideo.

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Primary Legislation and Statutory Instruments

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The statutory powers and duties of the NHS in Wales are mainly contained within the NHS (Wales) Act 2006. Whilst the NHS Act 2006 applies equivalent legislation to the NHS in England, it also contains some legislation that applies to both England and Wales.

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providing information and guidance on the financial help available to higher education students, living in Wales.

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The information below provides links to useful resources which will help you support your mental health and well-being, and the mental health and well-being of the people you work with and/or support. These resources have been identified by the Community Wellbeing Information Group (CWIG). CWIG was convened by the Mental Health & Learning Disabilities Division in response to the well-being challenges arising as a result of COVID-19.

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Our Centre for Student Life is our one-stop hub for all of your student needs. Whether you're looking for advice on health and wellbeing, preparing for your future, managing money or living in Cardiff, our expert, dedicated support staff will be on hand to support you. We're here to help you succeed and make the most of your student life.

Your Student Connect team who are based in the Centre for Student Life are your first point of contact for connecting you to your Student Life teams.

We've also developed 24-hour online services and extended opening hours so all of our students, including those based at Heath Park, our distance learners and all those on placement or study abroad, can access the help they need, whenever they need it.

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We're here to help you succeed and make the most of your student life. Our free, impartial and confidential support services are based in the Centre for Student Life, an iconic building at the heart of the Cathays Park Campus.

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Information for students and placement providers about nursing and midwifery placements.

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Practice Supervisor and Practice Assessor Training

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Practice Supervisor and Practice Assessor Training

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QR code to book on to Practice Supervisor/Assessor training 👍

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QR code for practice supervisors and assessors to book on refresher courses 👍

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Practice Supervisor and Assessor Updates/Training 

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Practice Supervisor and Assessor Updates/Training 

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​​​​​​​For any issues relating to the ePAD please email –

Cardiff University – hcare-eportfolio@cardiff.ac.uk

University of South Wales  -  ePAD@southwales.ac.uk

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Practice Education Facilitator for Community Hospitals

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Practice Education Facilitator for Community Hospitals

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Link to access an ePAD walkthrough/Recap

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Cardiff University – hcare-eportfolio@cardiff.ac.uk

University of South Wales  -  ePAD@southwales.ac.uk

Remember you can also contact your Practice Education Facilitator for advice and support.

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University of South Wales - Students - Introduction to the Student ePAD Account

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Ward Visiting Times and Protected Meal Times

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Ward Visiting Times and Protected Meal Times

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Ward contact numbers for both sides of the ward and the ward clerk.

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Ward Management Team 👌

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University of South Wales uses Blackboard, one of the most widely used virtual learning environments, to support learning and teaching. Whether you are studying on campus, at home or somewhere else, Blackboard allows you to gain web access to your course materials anytime and anywhere.

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Read about Parkinson's disease, a condition in which parts of the brain become progressively damaged over many years.

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Parkinson’s is a progressive neurological condition. This means that it causes problems in the brain and gets worse over time.

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The Lister Hospital (part of East and North Hertfordshire NHS Trust) offers Carer Passports, as do many other welcoming hospitals and trusts

Find your hospital or home's pledge to support John's Campaign on our Participants page.
We know that families come in all varieties. They're not always genetically related and sometimes it is a close friend who matters most. We believe that individuals are their own best judges who is essential for their emotional or practical well-being. We think that, wherever possible, they should be asked and their wishes respected.

Legally carers are people who provide personal care, support and assistance to another individual who is in need of support due to disability, medical condition, including terminal or chronic illness, mental illness or is frail and aged.

Our campaign can apply to anyone with a special need and is therefore in line with Equality legislation as well as human-kindness and common sense.

We believe that carers should not just be 'allowed' but should be welcomed. They are the experts in the person for whom they care and best outcomes are likely when they work in partnership with the medical or social professionals. Often they have legal duties such as power of attorney or court of protections deputy. They can observe and advocate: communicate, remember, explain and reassure.

However family carers often have other responsibilities. They have a right but not a duty to continue to care.

John's Campaign applies to all hospital settings (acute, community, mental health). We have come to realise that its principles must extend to all other caring institutions where people are living away from those closest to them.

Over 1500 institutions have pledged support in the time since the campaign was founded in November 2014 by Nicci Gerrard and Julia Jones.

The current coronavirus pandemic has tested their commitment beyond anything they or we could ever have imagined. Thank you to all who still honour your Carers Welcome pledge.

John's Campaign is not a tick box exercise: it's an attitude of mind which respects the rights and choices of the person who needs care and values the essential input of the informal carer (or family member) as well as the expertise of the professional. Everyone has a part to play in this.

The campaign's name honours Dr John Gerrard, who was a doctor and a business man, and diagnosed with Alzheimers in his mid seventies. It was a slow decline, that sped up when he was ill or upset, for ten years. Then, at the start of February 2014, he went into hospital. He had infected leg ulcers which weren't responding to antibiotics. The hospital had a norovirus outbreak which meant visitors weren't allowed at all. He was there for five weeks.

John went in strong, mobile, smiling, able to tell stories about his past, to work in his garden and help with things round the house. He was able to feed himself, to keep clean, to have a good kind of daily life. He came out skeletal, immobile, incoherent, requiring 24-hour care and barely knowing those around him.

His family are sure that if he had not spent that time alone, without them, he would not have descended into such a state of deep delirium. Having someone with you - someone who you love, who you know, whose face you know (be they your carer, your family, your friend, your lover) - helps keep you tied to reality, to life, to sanity.

John died in November 2014. His story, however, is still repeated. Far too many people die cut off from the people who care for them. Far too many places have dangerously over-restrictive policies (both predating and during the present pandemic) preventing people from being with people who need them.

In the wake of his death, John's daughter, Nicci Gerrard, cofounded John's Campaign with Julia Jones, whose mother, June, also lived well with dementia (both Alzheimer's and vascular) for many years before her death in 2018. John's Campaign is June's Campaign, is Everyone's Campaign, for none of us should be blocked from our best, most special friends, family or carers.

John's Campaign tries to give people a voice - to share information, experiences or enthusiasm. Our blog page is at the heart of this though you will also find personal experience on the experiences page and plenty of information via articles and resources. We have a public Facebook page and a care home and support group for care home managers as well as relatives. Interacting on Twitter is also very important to us. Blog posts are shared via Twitter and Facebook. If you have something you'd like to write about please contact julia@johnscampaign.org.uk.

The posts include the 'Why I Love My Job' series, which celebrates working in health and social care So far this series has featured activity facilitators, carers (both family and professional), carers liaison officers, chefs, directors, managers and nurses. Use this to share your personal enthusiasm for your work, whether paid or voluntary.

My Visiting Plan, a form through which patients with dementia (with assistance of family/carers as necessary) can express their wishes regarding visitors: Who do you want to visit, who don't you want to visit, when do you want them to visit and when do you want to rest?

Along the way, we've built up a collection of resources. These are shared on this site for assistance and inspiration, and are of a number of types: banners; carer awareness training, badges, charters, definitions, handbooks, information, passports; evaluations; family rooms; recliners; support packs; welcome posters...

Everything we host here can be used by you, but please give acknowledgement where appropriate.

Over 1500 hospitals and homes (and some others, such as ambulance trusts, clinical commissioning participants, domiciliary care companies, hospices and primary care providers) have pledged to support our principles of inclusion. We believe that people, particularly those with dementia, other mental illnesses, or otherwise in need of care, should not be separated from those important to them by protocols and systems that are harmful and wrong.

Many other influental individuals and organisations have expressed their support and partnered with us, a list of some of them is shown on our Partners page.

We are unrepayably indebted to all those who have helped us and carried the torch of change, of civil liberties, of common sense, of human rights.

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Find your hospital or home's pledge to support John's Campaign on our Participants page. We know that families come in all varieties. They're not always genetically related and sometimes it is a close friend who matters most. We believe that individuals are their own best judges who is essential for their emotional or practical well-being.

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Find out more about Huntington’s disease, an inherited condition that damages certain nerve cells in the brain.

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We support anyone affected by Huntington's disease from entire families to carers and from healthcare professionals to employers and teachers.

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What is dementia? Symptoms, causes and treatments

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The word ‘dementia’ describes a set of symptoms that over time can affect memory, problem-solving, language and behaviour. Alzheimer’s disease is the most common type of dementia.

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NMC Part 4 Future Nurse Standards of Proficiencies for RNs

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Information about the confidence, knowledge and skills needed to act when someone sustains an out of hospital cardiac arrest.

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Symptoms of a stroke include drooping on one side of the face, weakness in the arm and slurred speech. Call 999 if you think someone's having a stroke.

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Stroke can happen to anyone, of any age, at any time. It's vital to know how to spot the signs of a stroke in yourself or someone else.

What to do if someone is having a stroke

Stroke is a medical emergency. If you experience any of the symptoms below, you should call 999.

How to identify a stroke

The FAST acronym (Face, Arms, Speech, Time) is a test to quickly identify if someone is having a stroke.

Face weakness: Can the person smile? Has their mouth or eye drooped?

Arm weakness: Can the person raise both arms?

Speech problems: Can the person speak clearly and understand what you say?

Time to call 999: if you see any of these signs.

Acting FAST will give the person having a stroke the best chance of survival and recovery. Always call 999 straight away.

Ambulance paramedics are trained in stroke and will ensure the person receives emergency medical care and specialist treatment.

Other symptoms of a stroke

The FAST test helps spot the three most common symptoms of stroke. But there are other signs that you should always take seriously. These include:

Sudden weakness or numbness on one side of the body, including legs, hands or feet.

Difficulty finding words or speaking in clear sentences.

Sudden blurred vision or loss of sight in one or both eyes.

Sudden memory loss or confusion, and dizziness or a sudden fall.

A sudden, severe headache.

If you spot any of these signs of a stroke, don't wait. Call 999 straight away.

How long do symptoms last?

Symptoms vary between different people but often come on suddenly.

If the symptoms only last a short amount of time, it could be a transient ischaemic attack (TIA), also known as a mini-stroke. It is still vital to call 999 and get urgent medical attention. A TIA is a medical emergency and a warning that you are at risk of having a stroke. See our TIA pages for more information.

Find out more

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Learn the symptoms of a stroke and how using FAST can quickly identify if someone is having one.

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Arranging social care can be a challenge. From knowing where to start, what type of care and support you need and who pays for it, there are lots of questions to ask. But you're not alone - we're here to help you through the process.

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Arranging social care can be a challenge. From knowing where to start, what type of care and support you need and who pays for it, there are lots of questions to ask. But you're not alone - we're here to help you through the process.

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The NICE British National Formulary (BNF) site is only available to users in the UK (England, Scotland, Wales and Northern Ireland).

If you are outside the UK, you can access BNF content by subscribing to Medicines Complete.

If you believe you are seeing this page in error, please contact us.

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The NICE British National Formulary (BNF) site is only available to users in the UK (England, Scotland, Wales and Northern Ireland)

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NHS guide to autism. Find out what autism is and what the common signs are. Get help and advice if you or your child are autistic.

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A definition of autism with an overview of communication, behaviours and interests, and sensory processing differences needed for an autism diagnosis.

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Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviours.
OCD can affect men, women and children. People can start having symptoms from as early as 6 years old, but it often begins around puberty and early adulthood.

OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.

Symptoms of obsessive compulsive disorder (OCD)

If you have OCD, you'll usually experience frequent obsessive thoughts and compulsive behaviours.

An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve the unpleasant feelings brought on by the obsessive thought.

For example, someone with an obsessive fear of being burgled may feel they need to check all the windows and doors are locked several times before they can leave their house.

Women can sometimes have OCD during pregnancy or after their baby is born. Obsessions may include worrying about harming the baby or not sterilising feeding bottles properly. Compulsions could be things such as repeatedly checking the baby is breathing, and intrusive, unwanted and unpleasant thoughts, images or urges. These can cause anxiety and lead to repetitive behaviours.

If you keep getting these thoughts and they have an effect on your daily life, speak to your GP or health visitor. They can support you or refer you to a specialist mental health team if you need it.

Getting help for obsessive compulsive disorder (OCD)

People with OCD are sometimes reluctant to seek help because they feel ashamed or embarrassed.

OCD is a health condition like any other, so there's nothing to feel ashamed or embarrassed about. Having OCD does not mean you're "mad" and it's not your fault you have it.

There are 2 main ways to get help:

If you think a friend or family member may have OCD, try talking to them about your concerns and suggest they get help.

If you're under 18, or want to get help for someone under 18, find out how to get mental health support for children and young people.

It's unlikely OCD will get better without proper treatment and support.

Treatments for obsessive compulsive disorder (OCD)

There are some effective treatments for OCD that can help reduce the impact it has on your life.

The main treatments are:

CBT will usually have an effect quite quickly. It can take up to 12 weeks before you notice the effects of treatment with SSRIs, but most people will eventually benefit.

If these treatments do not help, you may be offered:

an alternative SSRI

a combination of an SSRI and CBT

an antidepressant called clomipramine

Some people may be referred to a specialist mental health service for further treatment.

Causes of obsessive compulsive disorder (OCD)

It's not clear what causes OCD. A number of different factors may play a part, including:

family history - you're more likely to develop OCD if a family member has it. It may be learned behaviour, or possibly because of your genes

differences in the brain - some people with OCD have areas of unusually high activity in their brain or low levels of a chemical called serotonin

life events - OCD may be more common in people who have been bullied, abused or neglected, and it sometimes starts after an important life event, such as childbirth or a bereavement

personality - neat, meticulous, methodical people with high personal standards may be more likely to develop OCD, also people who are generally quite anxious or have a very strong sense of responsibility for themselves and others

Support groups

Living with OCD can be difficult. In addition to getting medical help, you might find it helps to contact a support group or other people with OCD for information and advice.

The following websites may be useful sources of support:

OCD Action, OCD-UK and TOP UK can also let you know about any local support groups in your area.

Social care and support guide

The social care and support guide has advice about where you can get support if you:

need help with day-to-day living because of illness or disability

care for someone regularly because they're ill, elderly or disabled, including family members

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Overview - Obsessive compulsive disorder (OCD)

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Find out about obsessive compulsive disorder (OCD), what causes it, where to get help, and what the main treatments are.

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Overview

Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears known as obsessions. These obsessions lead you to do repetitive behaviors, also called compulsions. These obsessions and compulsions get in the way of daily activities and cause a lot of distress.

Ultimately, you feel driven to do compulsive acts to ease your stress. Even if you try to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads you to act based on ritual. This is the vicious cycle of OCD.

OCD often centers around certain themes, such as being overly fearful of getting contaminated by germs. To ease contamination fears, you may wash your hands over and over again until they're sore and chapped.

If you have OCD, you may be ashamed, embarrassed and frustrated about the condition. But treatment can be effective.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not know that your obsessions and compulsions are beyond reason. But they take up a great deal of time, reduce your quality of life, and get in the way of your daily routines and responsibilities.

Obsession symptoms

OCD obsessions are lasting and unwanted thoughts that keeping coming back or urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by acting based on ritual. These obsessions usually intrude when you're trying to think of or do other things.

Obsessions often have themes, such as:

Fear of contamination or dirt.

Doubting and having a hard time dealing with uncertainty.

Needing things to be orderly and balanced.

Aggressive or horrific thoughts about losing control and harming yourself or others.

Unwanted thoughts, including aggression, or sexual or religious subjects.

Examples of obsession symptoms include:

Fear of being contaminated by touching objects others have touched.

Doubts that you've locked the door or turned off the stove.

Intense stress when objects aren't orderly or facing a certain way.

Images of driving your car into a crowd of people.

Thoughts about shouting obscenities or not acting the right way in public.

Unpleasant sexual images.

Staying away from situations that can cause obsessions, such as shaking hands.

Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to do. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. But taking part in the compulsions brings no pleasure and may offer only limited relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are beyond reason and often don't relate to the issue they're intended to fix.

As with obsessions, compulsions usually have themes, such as:

Washing and cleaning.

Checking.

Counting.

Ordering.

Following a strict routine.

Demanding reassurance.

Examples of compulsion symptoms include:

Hand-washing until your skin becomes raw.

Checking doors over and over again to make sure they're locked.

Checking the stove over and over again to make sure it's off.

Counting in certain patterns.

Silently repeating a prayer, word or phrase.

Trying to replace a bad thought with a good thought.

Arranging your canned goods to face the same way.

Severity varies

OCD usually begins in the teen or young adult years, but it can start in childhood. Symptoms usually begin over time and tend to vary in how serious they are throughout life. The types of obsessions and compulsions you have also can change over time. Symptoms generally get worse when you are under greater stress, including times of transition and change. OCD, usually thought to be a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

When to see a doctor

There's a difference between being a perfectionist - someone who needs flawless results or performance - and having OCD. OCD thoughts aren't simply excessive worries about real issues in your life or liking to have things clean or arranged in a specific way.

If your obsessions and compulsions affect your quality of life, see your doctor or mental health professional.

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Causes

The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:

Biology. OCD may be due to changes in your body's natural chemistry or brain functions.

Genetics. OCD may have a genetic component, but specific genes have yet to be found.

Learning. Obsessive fears and compulsive behaviors can be learned from watching family members or learning them over time.

Risk factors

Factors that may raise the risk of causing obsessive-compulsive disorder include:

Family history. Having parents or other family members with the disorder can raise your risk of getting OCD.

Stressful life events. If you've gone through traumatic or stressful events, your risk may increase. This reaction may cause the intrusive thoughts, rituals and emotional distress seen in OCD.

Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Issues due to obsessive-compulsive disorder include:

Excessive time spent taking part in ritualistic behaviors.

Health issues, such as contact dermatitis from frequent hand-washing.

Having a hard time going to work or school or taking part in social activities.

Troubled relationships.

Poor quality of life.

Thoughts about suicide and behavior related to suicide.

Prevention

There's no sure way to prevent obsessive-compulsive disorder. However, getting treated as soon as possible may help keep OCD from getting worse and disrupting activities and your daily routine.

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Obsessive-compulsive disorder (OCD) - Symptoms and causes

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OCD features unwanted thoughts and fears, or obsessions. These obsessions lead to repetitive behaviors, also known as compulsions, that get in the way of daily activities.

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A-E All Wales Care Decisions for the Last Days of Life Guidance documents v11 June 2021 final ENGLISH