The replacement of assertive outreach services by reinforcing local community teams: a replication study reporting comparative outcomes and patient reported experience

Firn, Mike; Alonso-Vicente, Maria; Hubbeling, Dieneke; Holley, Jess; White, Sarah; Jones, Ben

doi:10.1080/09638237.2017.1340601

Cited by 7 publications

(15 citation statements)

References 18 publications

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“…However, further studies replicated a majority of the analysed effects [43] or confirmed previous findings [44,45]. Finally, there were a successful confirmation study from the public health area [46] and a partially successfully economics replication study [47] (Suppl. Table 1).…”

Section: Methodssupporting

confidence: 58%

Researcher Conduct Determines Data Reliability

Wass¹,

Ray²,

Michaelis³

2018

Preprint

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A lack of data reproducibility (“reproducibility crisis”) is debated across many scientific and medical disciplines. A systematic analysis of the available evidence on the reliability of scientific data revealed that, although the existence of a reproducibility crisis is widely perceived, conclusive data on the scale of the problem are lacking. Most importantly we found that, although the debate is largely focused on methodological issues, researcher conduct defines research standards and in turn data reliability. The availability of reliable methods itself does not guarantee good practice. Moreover, research is typically characterised by a lack of established methods due to its immanent novelty. Despite the crucial importance of researcher conduct, research and conclusive data on the determinants of researcher behaviour are missing. In conclusion, meta-research is urgently needed that establishes an understanding of the factors that determine researcher behaviour. This knowledge can then be used to implement and iteratively improve measures, which incentivise researchers to apply the highest standards resulting in high quality data.

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Section: Methodssupporting

confidence: 58%

Researcher Conduct Determines Data Reliability

Wass¹,

Ray²,

Michaelis³

2018

Preprint

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“…Only two studies included a negative experience. 26,29 For people with complex care needs the experience was generally positive. 27 In Wye et al 35 a coordination centre put a care package in place to support a dying person at home.…”

Section: Coordinated Care Across Teamsmentioning

confidence: 99%

Patient experiences of integrated care within the United Kingdom: A systematic review

Davidson

Scott

Forster

2021

International Journal of Care Coordination

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Introduction Integrated care and patient experience are central to the coordination and delivery of high quality health and social care in the UK, but their joint application is poorly understood. This systematic review aimed to gain an understanding of patient experience within current integrated care services in the UK, and specifically, whether they reflect person-centred coordinated care (PCCC). Methods Following PRISMA, electronic databases (ProQuest, EBSCO and Cochrane Library) were searched from 2012 to 2019 for primary, peer-reviewed literature. Papers were included where patients’ or carers’ experiences of integrated care were reported. Papers were excluded where they focused on acute integrated care interventions, measured experience via satisfaction scores only, or findings lacked sufficient depth to answer the research question. Quality was assessed using Mixed Methods Appraisal Tool, and findings synthesised using a framework approach, incorporating the Rainbow Model of Integrated Care and Measuring Integrated Care Patient Framework. Results Sixteen studies were included. Person-centred and shared responsibility experiences were most often discussed. Experiences were not always described as positive and some patients experienced a lack of PCCC. Clinical, professional/organisational and functional integration processes were associated with experiencing domains of PCCC. Discussion People with complex needs experience a lack of coordination across teams and wider community resources, and limited associations were made between integration processes and patient experience. Further research which gives context to individual experience, provides greater detail of integration processes and utilises validated patient experience measures of PCCC is required to understand the association between integration processes and domains of PCCC.

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“…A study by Firn et al 30 reporting on a 4-year observational study of 112 patients who were mentally ill without intellectual disability, showed that replacing specialist assertive outreach teams with ‘reinforced’ community mental health teams may maintain patients in crisis out of hospital and is well tolerated by patients. Although at this stage we cannot comment on which model is associated with better clinical and cost outcomes, understanding the provision and aspirations of ISTs for people with intellectual disability and behaviours that challenge will provide useful background to service development and care quality improvements.…”

Section: Discussionmentioning

confidence: 99%

Intensive support for adults with intellectual disability and behaviours that challenge: a survey of provision and service typologies in England

et al. 2020

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BackgroundApproximately 18% of adults with intellectual disabilities living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy in-patient stays. AimsTo identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England. MethodWe undertook a national cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six prespecified grouping factors (mode of referrals, size of case-load, use of outcome measures, staff composition, hours of operation and setting of service). A simplified form of thematic analysis was used to explore free-text responses. ResultsCluster analysis identified two models of IST provision: (a) independent and (b) enhanced provision based around a community intellectual disability service. ISTs aspire to adopt person-centred care, mostly use the framework of positive behaviour support for behaviour that challenges, and report concerns about organisational and wider context issues. ConclusionsThis is the first study to examine the delivery of intensive support to people with intellectual disability and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost-effectiveness. Declaration of interestNone.

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The replacement of assertive outreach services by reinforcing local community teams: a replication study reporting comparative outcomes and patient reported experience

Abstract: Results are consistent with earlier studies. Reinforcing community mental health teams can provide an integrated service model that is clinically effective and equally acceptable to patients, making this a viable and affordable alternative to orthodox AO teams.

Cited by 7 publications

References 18 publications

Researcher Conduct Determines Data Reliability

Researcher Conduct Determines Data Reliability

Patient experiences of integrated care within the United Kingdom: A systematic review

Intensive support for adults with intellectual disability and behaviours that challenge: a survey of provision and service typologies in England

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