TY - JOUR
KW - Community Mental Health Services/organization & administration
KW - Cooperative Behavior
KW - Critical Pathways
KW - Delivery of Health Care, Integrated
KW - Health Plan Implementation
KW - Humans
KW - Interviews as Topic
KW - Patient Care Team/organization & administration
KW - Program Evaluation
KW - Qualitative Research
KW - Rural Health Services/organization & administration
KW - Scotland
AU - G. Rees
AU - G. Huby
AU - L. McDade
AU - L. McKechnie
A1 - 
AB - Abstract Integration of community mental health services is a key policy objective that aims to increase quality and efficiency of care. Integrated care pathways (ICPs) are a mechanism designed to formalise multi-agency working at an operational level and are currently being applied to mental health services. Evidence regarding the impact of this tool to support joint working is mixed, and there is limited evidence regarding the suitability of ICPs for complex, community-based services. The present study was set in one primary care trust (PCT) in Scotland that is currently implementing an ICP for community mental health teams (CMHTs) across the region. The aim of the study was to investigate professionals' experiences and views on the implementation of an ICP within adult CMHTs in order to generate learning points for other organisations which are considering developing and implementing such systems. The study used qualitative methods which comprised of individual interviews with three CMHT leaders and two service development managers, as well as group interviews with members of four adult CMHTs. Data was analysed using the constant comparison method. Participants reported positive views regarding joint working and the role of an ICP in theory. However, in practice, teams were not implementing the ICP. Lack of integration at higher organisational levels was found to create conflicts within the teams which became explicit in response to the ICP. Implementation was also hindered by lack of resources for ongoing support, team development and change management. In conclusion, the study suggests that operational systems such as ICPs do not address and cannot overcome wider organisational barriers to integration of mental health services. Integrated care pathways need to be developed with strategic input as well as practitioner involvement and ownership. Team development, education about integration and change management are essential if ICPs are to foster and support joint working in integrated teams.
BT - Health & social care in the community
C5 - Education & Workforce
CP - 6
CY - England
DO - 10.1111/j.1365-2524.2004.00523.x
IS - 6
JF - Health & social care in the community
N2 - Abstract Integration of community mental health services is a key policy objective that aims to increase quality and efficiency of care. Integrated care pathways (ICPs) are a mechanism designed to formalise multi-agency working at an operational level and are currently being applied to mental health services. Evidence regarding the impact of this tool to support joint working is mixed, and there is limited evidence regarding the suitability of ICPs for complex, community-based services. The present study was set in one primary care trust (PCT) in Scotland that is currently implementing an ICP for community mental health teams (CMHTs) across the region. The aim of the study was to investigate professionals' experiences and views on the implementation of an ICP within adult CMHTs in order to generate learning points for other organisations which are considering developing and implementing such systems. The study used qualitative methods which comprised of individual interviews with three CMHT leaders and two service development managers, as well as group interviews with members of four adult CMHTs. Data was analysed using the constant comparison method. Participants reported positive views regarding joint working and the role of an ICP in theory. However, in practice, teams were not implementing the ICP. Lack of integration at higher organisational levels was found to create conflicts within the teams which became explicit in response to the ICP. Implementation was also hindered by lack of resources for ongoing support, team development and change management. In conclusion, the study suggests that operational systems such as ICPs do not address and cannot overcome wider organisational barriers to integration of mental health services. Integrated care pathways need to be developed with strategic input as well as practitioner involvement and ownership. Team development, education about integration and change management are essential if ICPs are to foster and support joint working in integrated teams.
PP - England
PY - 2004
SN - 0966-0410; 0966-0410
SP - 527
EP - 536
EP - 
T1 - Joint working in community mental health teams: Implementation of an integrated care pathway
T2 - Health & social care in the community
TI - Joint working in community mental health teams: Implementation of an integrated care pathway
U1 - Education & Workforce
U2 - 15717899
U3 - 10.1111/j.1365-2524.2004.00523.x
VL - 12
VO - 0966-0410; 0966-0410
Y1 - 2004
ER -