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Assessment Unit in psychiatry – a different way of working

Published online by Cambridge University Press:  02 January 2018

Vishal Agrawal
Affiliation:
South Essex Partnership NHS Foundation Trust, email: vishalagraw@gmail.com
Marie Murphy
Affiliation:
South Essex Partnership NHS Foundation Trust
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 2008

With ever increasing budget restraints and firm emphasis on community treatment, South Essex Partnership NHS Foundation Trust introduced the Assessment Unit in April 2005. It serves a dual purpose of gatekeeping and deciding appropriate care setting for patients.

Patients deemed likely to require admission, either by the on-call junior doctor or the community teams, are first admitted in this unit. Alternatives to in-patient treatments are explored and a comprehensive assessment of needs is conducted within a maximum of 72 hours. This ensures adequate utilisation of in-patient beds and also prioritises community treatment.

Tangible benefits in the past 2 years include a 36% reduction in admissions through accident and emergency units with an overall reduction of in-patient admissions of 42%. The average wait for allocation of beds has halved and use of out-of-area beds has been reduced to zero. The downside has been an increase in average length of stay as an in-patient. This is understandable with a greater proportion of severely unwell patients on the wards now. A recent staff survey shows a high level of satisfaction with the unit and some of the main reasons highlighted are early input from senior medical staff and an alternative to in-patient care. Junior doctors particularly found this unit extremely helpful especially in complementing their out-of-hours work.

The trust also has had substantial financial benefit including closure of a 23 bed acute in-patient ward.

We feel this model of working has been successful in our trust and can possibly benefit others in similar situations.

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