Evolving service interventions in Nunhead and Norwood. PRiSM Psychosis Study 2

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Background Service evaluation requires a detailed understanding of the services studied.

Method Community mental health services evaluated in the PRiSM Psychosis Study in south London are described.The intensive sector and standard sector services are contrasted.

Results The intensive sector had two teams with extended opening hours:a psychiatric acute care and emergency (PACE) team, and a psychiatric assertive continuing care (PACT) team focusing on care for people with chronic illness. In the standard sector there was a generic community team providing office-hour assessments, case management of the severely mentally ill and close liaison with in-patient services. The team made use of the local psychiatric emergency clinic and of other local resources. The intensive sector was characterised by: more admissions to fewer beds, more non-hospital residential places, extended hours, on-call rota, wider range of interventions, more medical and nursing staff, a lower nursing grade mix and higher staff turnover. The standard sector had a less highly resourced generic community psychiatric service.

Conclusions Change in services has been more marked in the intensive sector.

Declaration of interest Funding provided by the Bethlem & Maudsley NHS Trust.

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