Adherence to care and treatment review policy and impact on length of stay
| Date | 24 October 2023 |
| Pages | 283-291 |
| DOI | https://doi.org/10.1108/AMHID-07-2023-0023 |
| Published date | 24 October 2023 |
| Author | Lucy Jade Jones,Ceri Woodrow |
Adherence to care and treatment review
policy and impact on length of stay
Lucy Jade Jones and Ceri Woodrow
Abstract
Purpose –The purpose of this clinical audit was to review the adherence to the 2017 care and treatment
review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered
to people with an intellectual disability and/or autism who are at risk of admissionint o a mentalhealth hospital.
Design/methodology/approach –Admission and discharge data was collected across two
assessmentand treatment units between January 2019 andDecember 2022. Adherence to the care and
treatmentreview policy was also reviewed as was length of inpatientstay. A retrospective evaluationwas
conducted. Triangulationof data was collected via the trusts’ electronicpatient record system and NHS
analytics team. Descriptive statistics, Mann–Whitney Utest and a one-way ANOVA with post hoc tests
were usedin the analysis.
Findings –An increase in behaviours of challenge and deterioration of mental health were the main
reasons for admission.Forty-nine percent (30) of those admitted to the assessmentand treatment units
accessed a care and treatment review. Care and treatment reviews were more frequently provided for
individualsexperiencing longer inpatient stays.
Originality/value –There is limited evidence relating to outcomes and impact of care and treatment
reviews. Further research is required to explore effectiveness of care and treatment reviews to
understandbenefits and appropriately prioritiseresource.
Keywords Learning disability, Assessment and treatment units, Admissions and discharges,
Delayed discharge, Intellectual disability
Paper type Research paper
Introduction
Internationally, countries are continually working towardstransitioning people with an
intellectual disability out of inpatient hospital settings and intocommunity-based services
(Washington et al.,2019). In England, this transition was highlighted following the exposure of
institutional abuse experienced by people with an intellectual disability at Winterbourne View
Hospital (Care Quality Commission, 2011). In response, the transforming care agenda was
launched by the Department of Health (Department of Health,2012a, 2012b), to address the
failings evidenced by Winterbourne View. The Winterbourne ViewConcordat and transforming
care agenda set national targets for people with an intellectual disability who were
inappropriately placed within inpatient settings to be discharg ed into community provisions by
June 2014 (Department of Health,2012a, 2012b;NHS England,2015a, 2017a).
Whilst data from the National Audit Officereport in January 2015 suggested some reduction
in people with an intellectual disability residing within inpatient settings, the report
demonstrated that a large proportion of people with an intellectualdisability were still
without a plan for transition into the community (National Audit Office Statistics, 2015).
Following this, a national plan was published settingtargets to move 35–50% of people with
an intellectual disability into the community by March 2019 (Building the Right Support;
NHS England, 2015b), further reducing the provision of unnecessary inpatient stays.
Lucy Jade Jones is based
at the University of
Liverpool, Liverpool, UK.
Ceri Woodrow is based at
the Cheshire and Wirral
Partnership NHS Foundation
Trust, Chester, UK.
Received 14 July 2023
Revised 2 September 2023
Accepted 17 September 2023
Since acceptance of this
article, the following author has
updated their affiliation: Lucy
Jade Jones is at the Mersey
Care NHS Foundation Trust,
Liverpool, UK.
PAGE 282 jADVANCES IN MENTAL HEALTH ANDINTELLECTUAL DISABILITIES jVOL. 17NO.42023, pp. 282-290,©EmeraldPublishing Limited, ISSN 2044-1282DOI 10.1108/AMHID-07-2023-0023
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