Conclusions
The administrative elements of care co-ordination reduce opportunities for recovery-focused and personalised work. There were few shared understandings of recovery, which may limit shared goals. Conversations on risk appeared to be neglected and assessments kept from service users. A reluctance to engage in dialogue about risk management may work against opportunities for positive risk-taking as part of recovery-focused work.
The Bromley Home Treatment Team, which includes doctors, nurses and psychological therapists, provides care 24 hours a day 7 days a week for up to 20 patients at any one time and up to 1200 patients a year.
The team takes referrals from other services, self-referrals and third parties and provide an intensive community alternative to hospital. They provide choice in where care is delivered and reduce the length of inpatient stay with a step down care approach. It is thought they reduce the number of admissions and lengths of stay by around 30 per cent.
A psychiatric nurse or other member of the team visits most service users daily for up to an average of 40 minutes. The team deal with people when they feel at their worst or most vulnerable, and work with them during these life crises in a non-judgemental and compassionate way.
The team use an outcomes measurement system to assess the real time severity of patients’ mental health, monitor these changes with time, and use them to both aid clinical decision making and get a better understand of what is working well and what is not.
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While the original goal of intensive community-based service programs such as assertive community treatment (ACT) was reduction of hospital use, this goal has diminished in importance because of the extensive reduction in inpatient bed availability and use. This study sought to identify target populations that benefit most from such programs, hypothesizing that those with psychotic symptoms would show more benefits than others because of improved medication compliance. To read the full article, log in using your NHS Athens
To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the costs of service provision; (ii) rates of mental health inpatient and care home admission.
The move comes after NHS England chose commissioners Cambridgeshire and Peterborough Clinical Commissioning Group to become one of eight “vanguard sites” across the country to pilot ways to reduce the pressure on accident and emergency departments.
CPFT is working with the CCG on proposals to increase the number of mental health clinicians based at hospitals, police stations and in the community.
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