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Old age psychiatrists' views on continuing in-patient care

  • John Wattis (a1), Andrew Macdonald (a1) and Paul Newton (a1)
Abstract
Aims and methods

The aim of this study was to elicit views from UK consultants in old age psychiatry concerning changes that were taking place in long-term care for older people with mental illness (especially dementia) and their views on a draft consensus statement produced by the Faculty for Psychiatry of Old Age on behalf of the College. A postal questionnaire was circulated as part of a wider survey of 472 consultants and a single postal reminder was sent to non-responders.

Results

Two hundred and forty-two (51%) consultants responded. Nearly nine out of 10 respondents were in favour of continuing NHS consultant-supervised long-stay beds and three-quarters of them preferred a return to national numerical guidelines for bed numbers, though at a level approximately half of previous guidelines and provision. This was accompanied by a view that such beds should no longer be ‘for life’ with over three-quarters of respondents supporting discharge if, for example, behaviour problems resolved. If Government policy continued to support ‘eligibility criteria’ rather than guidelines, 60% were in favour of national rather than local criteria. There was very strong support for the draft consensus statement (now published in modified form as College Policy) and the ‘eligibility criteria’ it contained. Agreed criteria for waiting times in acute beds for continuing NHS, nursing home or residential care were not widely used.

Clinical implications

Consultants want to continue to be responsible for some longer-term care and efforts should be made to develop the role of NHS longer-term care within the 'spectrum of services' provided for older people with psychiatric disorder, perhaps by acting as local ‘centres of excellence’ in dementia care as well as by providing services for patients with the more difficult behavioural problems. The more widespread use of ‘agreed waiting times' for patients in acute beds requiring longer-term care should be explored.

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Copyright
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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References
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Health Service Commissioner (1996) Report of Health Service Commissioners Selected Investigation Completed October 1995–March 1996, pp. 116117. London: HMSO.
Royal College of Psychiatrists (1997) Statement on continuing care for older adults with psychiatric disorders. Psychiatric Bulletin, 21, 588.
Wattis, J. P. (1988) Geographical variations in the provision of psychiatric services for old people. Age and Ageing, 17, 171180.
Wattis, J. P., Wattis, L. & Arie, T. H. (1981) Psychogeriatrics: a national survey of a new branch of psychiatry. British Medical Journal, 282, 15291533.
Wattis, J. P. & Arie, T. H. (1984) Further developments in psychogeriatrics in Britain. British Medical Journal, 289, 778.
Wattis, J. P. & Fairbairn, A. (1996) Towards a consensus on continuing care for older adults with psychiatric disorder: report of a meeting on 27 March 1995 at the Royal College of Psychiatrists. International Journal of Geriatric Psychiatry, 11, 163168.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Old age psychiatrists' views on continuing in-patient care

  • John Wattis (a1), Andrew Macdonald (a1) and Paul Newton (a1)
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