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Survey of Crisis Team Fidelity in the Wessex Deanery
- Asif M Bachlani, Dr Geoff Searle, Consultant Psychiatrist , Crisis Team Dorset Healthcare Foundation Trust (29 October 2009)
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Asif M Bachlani, ST 5 General Adult Psychiatry, Hampshire Partnership Foundation NHS Trust None, Dr Geoff Searle, Consultant Psychiatrist , Crisis Team Dorset Healthcare Foundation Trust
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asifbachlani{at}doctors.org.uk Asif M Bachlani, et al.
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We conducted a small scale survey to investigate the management and operational procedures of local Crisis teams within the Wessex Deanery in a similar vein to the 2006 National Survey (Onyett, et al 2008)1. These findings were compared with the Department of Healths Guidance Statement (2007)2. Local Crisis Teams were contacted and a senior practitioner or team manager completed a proforma on their respective caseload, staffing, available resources and the service they provide. We were particularly interested to see if other Crisis Teams had day hospital facilities and whether they provided services outside of the 16 65 year age group as outlined by Department of Health (DoH 2001)3. These results were further compared to the national picture using the National Survey data. Six out of the nine teams responded. 100% of the teams provided a 24 hour service and gate-keep inpatient beds which was significantly higher than the National Survey (72% Gate-keep and 53% provided a 24hr service). Only 33% (two teams) provided a service for 16 65 year olds, with the rest covering 18 65 year olds. Outside this scope 50% (three teams) provide services for LD clients, and only 17% (one team) for Older Persons. Only one team had a day hospital for clients. There was a wide range of team staffing levels (includes part-time) from 11.7 37.5, with patient episodes varying from 284 900. Given DoH on staffing (15 per 150,000 population with 300 patient episodes) only 50% of teams had sufficient staffing. This was lower than the reported results in the National Survey (88%). Wessex Crisis Teams' Composition when compared to the National Survey had similar input from Nurses (100% vs 98%), higher input from Support Workers (100% vs 70%), Approved Mental Health Professionals (83% vs 49%), OTs (50% vs 30%) and Psychologists (50% vs 8%). When comparing medical staff input 100% of teams had medical input. The proportion composition found was 8.6% which is higher than the 5.2% reported by Middleton et al, 20084. Of these 100% of teams had consultants of which 83% (five teams) had dedicated consultants with other medical staff and 50% (three teams) had dedicated non consultant staff. In conclusion to ensure CRHT Teams are successful in their objectives as alternatives to hospital admission it is vital to have sufficient staff and resources. From the above data teams in Wessex had higher MDT staff diversity in comparison to the National Survey but only three of the six (50%) had adequate staffing according to the DoH guidance. 1. Onyett S, Linde K, Glover G, et al (2008) Implementation of crisis resolution/home treatment teams in England: national survey 20052006. Psychiatric Bulletin, 32: 374 377. 2. DEPARTMENT OF HEALTH (2007) Guidance Statement on Fidelity and Best Practice for Crisis Services. Department of Health 3. DEPARTMENT OF HEALTH (2001) Mental Health Policy Implentation Guide. Department of Health 4. Middleton H, Glover G, Onyett S, et al (2008) Crisis resolution/home treatment teams, gate-keeping and the role of the consultant psychiatrist. Psychiatric Bulletin, 32: 378 383 |
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