Service models in adult psychiatry – Royal College of Psychiatrists – 29 May 2014
“Today the Royal College of Psychiatrists issued its report Service models in adult psychiatry. In the report, the College sums up its position on the separation of care between in-patient and community and within the community.
The report states that decisions about the best model of service delivery should be based on evidence that it will deliver better care for patients. Changes proposed should start as a pilot and be evaluated before wide-scale service redevelopment occurs.
Principals underpinning any change should be:
to ensure ease of access by patients to services
the configuration of services should deliver evidence-based treatment
to reduce the risk of poor commitment: continuity of care is important for patients and
patients must not be referred and assessed by different parts of the service before being provided treatment.
The report notes that in many parts of the country a separation of medical responsibility between in-patient and community teams is likely to be required. This is to ensure in-patient services have sufficient senior medical time reflecting the acuity of the illness of current in-patients and the need for daily decision-making on in-patient units.
Notwithstanding the need to have a separation of community from in-patient consultant, continuity of care is key to safe and effective services, and should be provided within a generic community mental health team, the report recommends.
And crisis services, however configured, must be responsive and have access to the resources necessary in terms of including adequate numbers of beds, sufficiently skilled staff, and alternatives to hospital admission to be able to offer safe and timely care.”