1. National Audit Office Crisis Teams Study (2007) Steve Morgan (Practice Based Evidence) www.practicebasedevidence.com & Kirt Hunte (South Camden CRRT)

2. Steve Morgan www.practicebasedevidence.com NAO Findings & Recommendations Targets have been used to achieve rapid implementation of teams Targets have been used to achieve rapid implementation of teams Positive economic modelling results Positive economic modelling results Need to shift balance from outputs to outcomes based targets Need to shift balance from outputs to outcomes based targets Need to develop fully staffed 24/7 teams with better multidisciplinary support Need to develop fully staffed 24/7 teams with better multidisciplinary support Strengthen acute care pathways Strengthen acute care pathways

3. Steve Morgan www.practicebasedevidence.com Addressing Issues of ‘Burden’ Need to improve the development and use of locally driven service user feedback Need to improve the development and use of locally driven service user feedback Providing responsive care 24/7 &/or providing consistency to engage a relationship Providing responsive care 24/7 &/or providing consistency to engage a relationship Service users & carers anxieties when communication from the team is not clear Service users & carers anxieties when communication from the team is not clear How do we manage the ‘burden’ we may place on people through ‘home treatment’? How do we manage the ‘burden’ we may place on people through ‘home treatment’?

4. Steve Morgan www.practicebasedevidence.com Strengthening Acute Care CRHT teams are acute care first and community second CRHT teams are acute care first and community second Effectiveness of gate-keeping & early discharge is linked to CRHT/in-patient unit integration Effectiveness of gate-keeping & early discharge is linked to CRHT/in-patient unit integration Successful CRHT implementation can have negative effects for in-patient units Successful CRHT implementation can have negative effects for in-patient units How do we strengthen the integration of the two parts of the acute care sector? How do we strengthen the integration of the two parts of the acute care sector?

5. Steve Morgan www.practicebasedevidence.com Managing Risk A predominant reason for admission was real or perceived risk of suicide… particularly at night A predominant reason for admission was real or perceived risk of suicide… particularly at night The default management plan seems to be admit… with limited evidence of the actual assessment of the risks The default management plan seems to be admit… with limited evidence of the actual assessment of the risks How can we improve the ways decisions & management plans are being formulated? How can we improve the ways decisions & management plans are being formulated?

6. Steve Morgan www.practicebasedevidence.com Systemic Practice Development Less effective communication links lead to confusion in other parts of the system Less effective communication links lead to confusion in other parts of the system Many others say they know partly but not fully what CRHT teams do, and who they work with Many others say they know partly but not fully what CRHT teams do, and who they work with Teams still spend time assessing inappropriate referrals Teams still spend time assessing inappropriate referrals How can we focus on development of an effective system rather than component parts in isolation? How can we focus on development of an effective system rather than component parts in isolation?