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Following the Francis report: Investigating patient experience of mental health in-patient care

  • E. Csipke (a1), P. Williams (a2), D. Rose (a3), L. Koeser (a1), P. McCrone (a1), T. Wykes (a4) and T. Craig (a5)...

Abstract

Background

The Francis report highlights perceptions of care that are affected by different factors including ward structures.

Aims

To assess patient and staff perceptions of psychiatric in-patient wards over time.

Method

Patient and staff perceptions of in-patient psychiatric wards were assessed over 18 months. We also investigated whether the type of ward or service structure affected these perceptions. We included triage and routine care. The goal was to include at least 50% of eligible patients and staff.

Results

The most dramatic change was a significant deterioration in all experiences over the courseof the study. Systems of care or specific wards did not affect patient experience but staff were more dissatisfied in the triage system.

Conclusions

This is the first report of deterioration in perceptions of the therapeutic in-patient environment that has been captured in a rigorous way. It may reflect contemporaneous experiences across the National Health Service of budget reductions and increased throughput. The ward systems we investigated did not improve patient experience and triage may have been detrimental to staff.

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Copyright

Corresponding author

Til Wykes, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. Email: til.wykes@kcl.ac.uk

Footnotes

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*

These authors contributed equally to the work.

Declaration of interest

None.

Footnotes

References

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1 Francis, R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. TSO (The Stationery Office), 2013.
2 Department of Health. Acute Inpatient Provision Care Provision: Mental Health Policy Implementation Guide. Department of Health, 2002.
3 Greengross, P, Hollander, D, Stanton, R. Pressure on adult psychiatric beds. Results of a national questionnaire survey. Psychiatrist 2000; 24: 54–6.
4 Muijen, M. Acute hospital care: ineffective, inefficient and poorly organised. Psychiatr Bull 1999; 23: 257–9.
5 Sainsbury Centre for Mental Health. Acute Care 2004. A National Survey of Acute Psychiatric Wards in England. Sainsbury Centre for Mental Health, 2005.
6 Inglis, G, Baggaley, M. Triage in mental health – a new model for acute in-patient psychiatry. Psychiatrist 2005; 29: 255–8.
7 Williams, P, Csipke, E, Rose, D, Koeser, L, McCrone, P, Tulloch, AD, et al. Efficacy of a triage system to reduce length of stay. Br J Psychiatry 2014; 204: 480–5.
8 Evans, J, Rose, D, Flach, C, Csipke, E, Glossop, H, Wykes, T. VOICE: developing a new measure of service users' perceptions of inpatient care, using a participatory methodology. J Ment Health 2012; 21: 5771.
9 Laker, C, Rose, D, Flach, C, Csipke, E, Kelland, H, Wykes, T. Views of the Therapeutic Environment (VOTE): stakeholder involvement in measuring staff perceptions of acute in-patient care. Int J Nurs Stud 2012, 49: 1403–10.
10 Greenfield, T, Stoneking, B, Humphreys, K, Sundby, E, Bond, J. A randomized trial of a mental health consumer-managed alternative to civil commitment for acute psychiatric crisis. Am J Community Psychol 2008; 42: 135–44.
11 Sabes-Figuera, R, McCrone, P, Sharac, J, Csipke, E, Craig, TKJ, Rose, D, et al. Developing a tool for collecting and costing activity data on psychiatric inpatient wards. Epidemiol Psychiatr Sci 2012; 21: 393–9.
12 Curtis, L. Unit Costs of Health and Social Care. PSSRU, 2012.
13 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM-IV-TR). APA, 2000.
14 Honigfeld, G, Gillis, RD, Klett, CJ. Nurses' observation scale for inpatient evaluation a new scale for measuring improvement in chronic schizophrenia. J Clin Psychol 1965; 21: 6571.
15 Maslach, C, Jackson, S, Leiter, P. Maslach Burnout Inventory Manual. Consulting Psychology Press, 1996.
16 Stamps, P, Piedmonte, E. Nurses and Work Satisfaction. An Index for Measurement. DC Heath, 1986.
17 Csipke, E, Flach, C, McCrone, P, Rose, D, Tilley, J, Wykes, T, et al. Inpatient care 50 years after the process of deinstitutionalisation. Soc Psychiatry Psychiatr Epidemiol 2014; 49: 665–71.
18 Buchanan, M. Funds cut for mental health trusts in England. BBC News 2013; 12 December (http://www.bbc.co.uk/news/health-25331644).
19 All Party Parliamentary Group on Mental Health. Parity in Progress? Report of the All Party Parliamentary Group on Mental Health's Inquiry into Parity of Esteem for Mental Health. All Party Parliamentary Group on Mental Health, 2015.

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Following the Francis report: Investigating patient experience of mental health in-patient care

  • E. Csipke (a1), P. Williams (a2), D. Rose (a3), L. Koeser (a1), P. McCrone (a1), T. Wykes (a4) and T. Craig (a5)...

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Following the Francis report: Investigating patient experience of mental health in-patient care

  • E. Csipke (a1), P. Williams (a2), D. Rose (a3), L. Koeser (a1), P. McCrone (a1), T. Wykes (a4) and T. Craig (a5)...
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