Clinical effectiveness is dependent upon effective operational management. Drawing on extensive experience in the organisation and day-to-day running of crisis resolution teams (CRTs), this chapter proposes practical solutions to the challenges of managing such multidisciplinary teams in a complex service system that increasingly involves other specialist teams, as well as established community, ward-based and emergency services. Good-quality management and leadership allows the strengths of individual team members to be used to best advantage and promotes the development of good-quality care and a positive team culture. The challenges for any team leader are to shape the efforts that each team member contributes into a clinically coherent service, to support the team effectively in its purpose, and to ensure that adequate infrastructure is in place for the team to fulfil its function. A modernised mental health service is a much more complex system with multiple channels of communication for teams and clinical pathways for patients and their families. The following issues will, therefore, be addressed: team composition and size in relation to its catchment area population, shift working and ensuring adequate clinical cover, communication and information sharing, balancing demand with capacity, and the team's interface with other services.

Team size and composition

Within England, CRTs have developed at an unsteady pace and in a relatively ad hoc fashion despite attempts at prescribing team size and implementation principles in the Policy Implementation Guide (Department of Health, 2001).