Protocol for assessing services for people with severe mental illness

Area of Science:

• Health Services Research
• Psychiatric Care Standards

Background:

• UK health ministers sought advice on clinical care standards for schizophrenia patients.
• A review of existing standards and their implementation in contracts and services was commissioned.

Purpose of the Study:

• To assess the current standards of clinical care for schizophrenia in the UK.
• To identify factors influencing the quality of schizophrenia services.

Main Methods:

• A 143-item protocol of good service practice was developed and applied by teams in 11 UK districts.
• Service appraisals were summarized into 20 key points, scored 0-4, assessing commissioning and service provision standards.

Main Results:

• Commissioning and provider scores within districts were similar.
• Districts were categorized into three performance groups: four performed well, five were moderate, and two were poor.

Conclusions:

• Local morale emerged as a key factor differentiating service performance.
• A revised 26-point protocol was developed and tested for direct rating of schizophrenia care standards.