Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England

doi:10.1192/bjo.2021.996

. 2021 Aug 31;7(5):e156.

doi: 10.1192/bjo.2021.996. eCollection 2021 Sep.

Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England

Natasha Tyler¹, Gavin Daker-White¹, Andrew Grundy², Leah Quinlivan³, Chris Armitage⁴, Stephen Campbell¹, Maria Panagioti¹

Affiliations

¹ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK.
² School of Health Science, University of Nottingham, UK.
³ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK; and Centre for Mental Health and Safety, University of Manchester, UK.
⁴ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK; Manchester Centre for Health Psychology, University of Manchester, UK; and Manchester Academic Health Science Centre, Manchester University Foundation Trust, UK.

PMID: 34493959
PMCID: PMC8410739
DOI: 10.1192/bjo.2021.996

Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England

Natasha Tyler et al. BJPsych Open. 2021.

. 2021 Aug 31;7(5):e156.

doi: 10.1192/bjo.2021.996. eCollection 2021 Sep.

Authors

Natasha Tyler¹, Gavin Daker-White¹, Andrew Grundy², Leah Quinlivan³, Chris Armitage⁴, Stephen Campbell¹, Maria Panagioti¹

Affiliations

¹ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK.
² School of Health Science, University of Nottingham, UK.
³ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK; and Centre for Mental Health and Safety, University of Manchester, UK.
⁴ NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK; Manchester Centre for Health Psychology, University of Manchester, UK; and Manchester Academic Health Science Centre, Manchester University Foundation Trust, UK.

PMID: 34493959
PMCID: PMC8410739
DOI: 10.1192/bjo.2021.996

Abstract

Background: The COVID-19 pandemic forced the rapid implementation of changes to practice in mental health services, in particular transitions of care. Care transitions pose a particular threat to patient safety.

Aims: This study aimed to understand the perspectives of different stakeholders about the impact of temporary changes in practice and policy of mental health transitions as a result of coronavirus disease 2019 (COVID-19) on perceived healthcare quality and safety.

Method: Thirty-four participants were interviewed about quality and safety in mental health transitions during May and June 2020 (the end of the first UK national lockdown). Semi-structured remote interviews were conducted to generate in-depth information pertaining to various stakeholders (patients, carers, healthcare professionals and key informants). Results were analysed thematically.

Results: The qualitative data highlighted six overarching themes in relation to practice changes: (a) technology-enabled communication; (b) discharge planning and readiness; (c) community support and follow-up; (d) admissions; (e) adapting to new policy and guidelines; (f) health worker safety and well-being. The COVID-19 pandemic exacerbated some quality and safety concerns such as tensions between teams, reduced support in the community and increased threshold for admissions. Also, several improvement interventions previously recommended in the literature, were implemented locally.

Discussion: The practice of mental health transitions has transformed during the COVID-19 pandemic, affecting quality and safety. National policies concerning mental health transitions should concentrate on converting the mostly local and temporary positive changes into sustainable service quality improvements and applying systematic corrective policies to prevent exacerbations of previous quality and safety concerns.

Keywords: COVID-19; Inpatient treatment; care transitions; qualitative research; quality and safety.

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Conflict of interest statement

None.

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References

1. Aase K, Schibevaag L, Waring J. Crossing boundaries: quality in care transitions. In Researching Quality in Care Transitions: 3–29. Springer International Publishing, 2017.
1. Tyler N, Wright N, Panagioti M, Grundy A, Waring J. What does safety in mental health care transitions mean for service users and other stakeholder groups: an open-ended questionnaire study. Heal Expect 2020; 24: 185–95. - PMC - PubMed
1. Tyler N, Wright N, Waring J. Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res 2019; 19: 883. - PMC - PubMed
1. Burns J, Flynn S, Lowe R, Turnbull P, Baird A, Stones P, et al. The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual Report. 2017.
1. Walter F, Carr MJ, Mok PLH, Antonsen S, Pedersen CB, Appleby L, et al. Multiple adverse outcomes following first discharge from inpatient psychiatric care: a national cohort study. Lancet Psychiatry 2019; 6: 582–9. - PMC - PubMed

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[1] Aase K, Schibevaag L, Waring J. Crossing boundaries: quality in care transitions. In Researching Quality in Care Transitions: 3–29. Springer International Publishing, 2017.

[2] Aase K, Schibevaag L, Waring J. Crossing boundaries: quality in care transitions. In Researching Quality in Care Transitions: 3–29. Springer International Publishing, 2017.

[3] Tyler N, Wright N, Panagioti M, Grundy A, Waring J. What does safety in mental health care transitions mean for service users and other stakeholder groups: an open-ended questionnaire study. Heal Expect 2020; 24: 185–95. - PMC - PubMed

[4] Tyler N, Wright N, Panagioti M, Grundy A, Waring J. What does safety in mental health care transitions mean for service users and other stakeholder groups: an open-ended questionnaire study. Heal Expect 2020; 24: 185–95. - PMC - PubMed

[5] Tyler N, Wright N, Waring J. Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res 2019; 19: 883. - PMC - PubMed

[6] Tyler N, Wright N, Waring J. Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res 2019; 19: 883. - PMC - PubMed

[7] Burns J, Flynn S, Lowe R, Turnbull P, Baird A, Stones P, et al. The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual Report. 2017.

[8] Burns J, Flynn S, Lowe R, Turnbull P, Baird A, Stones P, et al. The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual Report. 2017.

[9] Walter F, Carr MJ, Mok PLH, Antonsen S, Pedersen CB, Appleby L, et al. Multiple adverse outcomes following first discharge from inpatient psychiatric care: a national cohort study. Lancet Psychiatry 2019; 6: 582–9. - PMC - PubMed

[10] Walter F, Carr MJ, Mok PLH, Antonsen S, Pedersen CB, Appleby L, et al. Multiple adverse outcomes following first discharge from inpatient psychiatric care: a national cohort study. Lancet Psychiatry 2019; 6: 582–9. - PMC - PubMed

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Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England

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Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England

Authors

Affiliations

Abstract

Conflict of interest statement

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