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Importance of local differences in comparing hospital and community psychiatric services

Published online by Cambridge University Press:  07 July 2014

Kathryn Evans
Affiliation:
St. Charles Hospital, Academic Unit of Psychiatry, Exmoor Street, London W10 6DZ, UK
Peter Tyrer
Affiliation:
Academic Unit of Psychiatry, St. Charles Hospital, Exmoor Street, London W10 6DZ, UK
Naresh Gandhi
Affiliation:
St. Charles Hospital, Academic Unit of Psychiatry, Exmoor Street, London W10 6DZ, UK
Alwyn Lamont
Affiliation:
Academic Unit of Psychiatry, St. Charles Hospital, Exmoor Street, London W10 6DZ, UK
Phil Harrison-Read
Affiliation:
St. Charles Hospital, Academic Unit of Psychiatry, Exmoor Street, London W10 6DZ, UK
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Extract

Most of the studies that are frequently cited as examples of effective comprehensive community care, (i.e. they reduce the demand for hospital beds without any loss in treatment efficacy (Stein & Test, 1980; Hoult & Reynolds, 1984; Muijen et al., 1992) were carried out before the introduction of the Care Programme Approach (CPA) in 1991 (Department of Health, 1990) which at present only applies to England. As the CPA derives from these earlier studies the discrepancies between hospital and community based aftercare might be expected to become less, as now all services in England are expected to include a significant community element. However, there can still be important differences between those services focusing on community care as the main priority and those in which the hospital system is paramount.

The psychiatric services in the area covered by North West London Mental Health Trust (NWL Trust) represented a natural test of these two approaches as they had parallel hospital and community based teams covering the same catchment areas respectively, North Paddington, in Westminster and Brent, in outer London.

At this point it is useful to provide more detailed description of the two geographical areas at the time of the study and the community and hospital based teams that were involved.

Type
Section B: From Service Description to Service Evaluation
Copyright
Copyright © Cambridge University Press 1997

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