What is Better Pathways?

The Better Pathways project is an evaluation of two models of admission to inpatient acute psychiatric care. It aims to explore the effects of the two different models of admission, in terms of their effects on bed use, financial effectiveness, and the perceived benefits and costs as viewed by service users and staff. The project also aims to identify factors that might guide the development of the most effective and sustainable system of admission.

Background

Data collection for Better Pathways took place across nine acute inpatient wards within Lambeth and Lewisham. The study ran for 18 months, during which time there were four periods of data collection across all nine wards.

The project compared the standard model of patient admission with a new model of care (coined as ‘triage’ by Gary Inglis and Martin Baggaley), which was set up in Lewisham. The Triage model consists of a single dedicated ward where all admissions are first intensively assessed to establish their level of need for inpatient or other services. This assessment is carried out by health care professionals with the ability to discharge or define the inpatient service need. All patients are expected to have senior medical input within 24 hours of admission and community services are engaged in this process.

The data for the Better Pathways project has now been fully collected and is now pending analysis.

Service Comparison

Lewisham	Lambeth
Consists of a single ward dedicated to “triage”.	Every ward takes responsibility for admission of new patients.
Within seven days of admission service users will move from the triage ward back to the community or to a locality ward.	Service users will remain on one consistent ward for the duration of their inpatient stay.
Has an enhanced role for inpatient teams in managing admissions in collaboration with community and home treatment teams.	Has an enhanced role for community teams in managing admissions – especially the care coordinator where one exists. The emphasis here is on pre-planned admissions rather than crisis care.
There are three home treatment teams, each of which works together with one of the three locality wards.	A comprehensive home treatment team works across all the wards