PROTOCOL FOR ASSESSING SERVICES FOR PEOPLE WITH SEVERE MENTAL-ILLNESS

Background The Clinical Standards Advisory Group was asked by UK healt h ministers to advise on the standards of clinical care being achieved for people with schizophrenia. A subcommittee commissioned a review o f standards, followed by research into how far these were reflected in contracts and met by providers.Method No comprehensive but practical set of standards was found. A protocol of 143 items of good service pr actice was constructed, and applied by teams visiting services in 11 U K districts. The team appraisals were summarised in 20 key points, eac h scored 0 (absent) to 4 (excellent performance). Seven points were us ed to assess standards of commissioning and 13 for standards of servic e provision. Results When placed into rank order, the mean key point s cores for commissioners and providers in the same district tended to b e very similar. Total district scores were then used to assign distric ts to one of three groups. Four performed reasonably well, five were m oderate and two were poor. Conclusions One of the key elements associa ted with these differences was the local level of morale. After wide c onsultation, a revised protocol of 26 key points for direct rating was drawn up and has since been further tested.