A comprehensive clinical database for mental health care in England

Background: Monitoring and researching clinical care calls for comprehensiv e clinical databases. In mental health care these need to cover all aspects of the care of each patient and to accommodate the complexity of care whic h may last from weeks to years. This paper describes the pilot work for a m ental health clinical database intended to be implemented throughout the En glish National Health Service. Methods: In collaboration with three pilot s ites, a set of data extracts was defined which could reasonably easily be p roduced, mostly using existing statistical data collection systems. Softwar e was designed to integrate these extracts into patient-based records descr ibing overall spells of mental health care. These data were extracted from their systems for a 6-month pilot period. Results: Two of the three sites p roduced data sets, which appeared to give a reasonably complete account of the work undertaken in the pilot period. Known differences in service desig n and clinical perspective between the two sites were clearly reflected. Co nclusions: The approach to extracting and collating the data is workable wi thin existing resources and produces illuminating data for clinical audit, management and planning. Completeness and accuracy of data is likely to be a continuing problem, as for any routine data capture exercise. However, th e process of integrating data from several channels assists this, as incons istencies become apparent and can be tackled. The approach is now being imp lemented throughout England.