Two consultants for one patient: service users' and service providers' views on ‘New Ways’

Abstract

7 Davidson K, Norrie J, Tyrer P, Gumley A, Tata P, Murray H, et al. 2 The functional model includes many changes, but its core feature is that consultants work either on the in-patient or the community side, with one specialist team rather than in the old-styled geographical sectors. Closely related to this functional division is the status of in-patient psychiatry. Currently, acute psychiatric in-patient care is one of the top priorities. 3 Recently there has been a lot of Aims and method To investigate, through a semi-qualitative survey at three geographical sites, health professionals' and service users' opinion about the impact of providing separate consultants for in-patient and community settings. It looked at the perceived affect on various issues such as the course of the illness, service delivery, patients' satisfaction as well as the skills and training of psychiatrists.Results Opinion was divided about the level of satisfaction, advantages, consultants' skills and success of this model. The most consistent theme related to the problems with the continuation of care and therapeutic relationship. Most of the respondents were not fully informed about this change. An overwhelming majority believed that in-patient psychiatry is not a separate specialty.Clinical implications Communication and the sharing of information between the two consultants is the key to success in this model.Declaration of interest None.

Personal continuity versus specialisation of care approaches in mental healthcare: experiences of patients and clinicians—results of the qualitative study in five European countries

“…It has been argued that increasing specialisation of services is inevitable as our evidence base expands, providing us with a better and deeper understanding of what exactly works best and for whom [9]. The arguments are forwarded in favour of a specialisation of care which emphasise the increase in the overall skills of the consultants carrying out their respective jobs in more focused manner and having sufficient time to participate in teaching, management and other non-clinical work [23].…”

Continuity Across Inpatient and Outpatient Mental Health Care or Specialisation of Teams? A Systematic Review

“…As reported in the qualitative findings [15,35,17], continuity across these settings may avoid problems in the communication and agreement between separate clinicians, reducing potential gaps in the collaboration between inpatient and outpatient services. The benefits of reducing this gap between service settings could explain the smoother transition of care found in continuity systems.…”

One day in the life of old age psychiatrists in the United Kingdom

“…It was subsequently generalized across mental health services and, in association with reduced finances and remodeled facilities, resulted in unanticipated service changes, including the introduction of a split between functional and organic services, loss of continuity of care, and changes to consultant responsibility (St John-Smith et al, 2009). "New Ways of Working" has attracted considerable controversy as enthusiasts have been countered by outrage from traditional clinicians who feel cheated of their role and the satisfaction of delivering continuity of care, which is valued by patients and families (Dale and Milner, 2009;Singhal et al, 2010;Rathod et al, 2011;Royal College of Psychiatrists, 2011).…”