Evaluating care pathways for community psychiatry in England: a qualitative study.

Journal of Evaluation in Clinical Practice
Golam M KhandakerManaan K Ray

Abstract

In view of forthcoming 'payment by results' (PbR) for mental health, increasing number of National Health Service (NHS) Trusts are reorganizing their community services for working age adults to create care pathways. However, research base for the care pathways model in mental health is limited. Our NHS Foundation Trust was one of the first to introduce care pathways for community psychiatry in the UK. We have carried out a qualitative study to evaluate how this model works out in practice, including its impact on quality of patient care, mental health professionals and primary care. We interviewed doctors, multidisciplinary staff and Trusts managers (19 in total). Transcripts of recorded interviews were coded and analysed thematically using a grounded theory approach. Overall, despite teething problems, working in pathways was generally seen as a positive change. It led to more focused interventions being offered, and practitioners being held to account over clear standards of care. It is more cost-effective and allows for active case management and clear clinical leadership. It is recovery focused and encourages social inclusion. The arbitrary time frame, strict criteria and thresholds for different teams can create issues. I...Continue Reading

References

Sep 18, 2007·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Allison TongJonathan Craig
Aug 14, 2008·The British Journal of Psychiatry : the Journal of Mental Science·Sara E Evans-LackoGraham Thornicroft
Sep 2, 2011·The British Journal of Psychiatry : the Journal of Mental Science·Alastair J D Macdonald, Martin Elphick

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Citations

Sep 27, 2012·BMC Cardiovascular Disorders·Seval KulMassimiliano Panella
Aug 20, 2015·Journal of Family Medicine and Primary Care·Lawrence Leung
Mar 22, 2019·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Susan C C Hawthorne, Anne Williams-Wengerd

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