The replacement of assertive outreach services by reinforcing local community teams: a replication study reporting comparative outcomes and patient reported experience.

BACKGROUND

This is the third in a series of papers on patient outcomes and other consequences of the withdrawal of specialist assertive outreach (AO) teams. We previously reported positive outcomes for patients receiving a less intensive service at up to four years, but had not systematically interviewed patients.

AIMS

To test the generalizability of earlier findings through replication in another service. To complement the analysis of service utilisation with patient reported experience between the two treatment models.

METHODS

Service level evaluation 12 months pre and post service change for 55 eligible AO patients. Thirty three consenting patients answered validated questionnaires.

RESULTS

There were no statistically significant changes in hospital bed use comparing the year before and the year after the change (850-712 bed days, median 34-20). No significant change in crisis activity occurred despite a highly significant reduction in face to face contacts from a mean of 90-40. There were no significant changes in patient reported experience.

CONCLUSIONS

Results are consistent with earlier studies. Reinforcing community mental health teams can provide an integrated service model that is clinically effective and equally acceptable to patients, making this a viable and affordable alternative to orthodox AO teams.