Access Assessments for Admission to Adult Medium and Low Secure Services

Project Details


Secure services care for and treat people with severe mental health problems who are at serious risk to others. People can be referred to these services from prison, court, other inpatient services and the community. Before being accepted for these services, each patient undergoes an assessment to enable decisions to be made about about if they need to be admitted and if so what care, treatment and level of security they need. This is known as an ‘access assessment’. At the moment we do not know whether these assessments are being managed in the same way across each service in England and Wales. We also don’t know what the experience of the assessment process is like for; 1) patients who are assessed, 2) clinicians who make referrals to the service, and 3) clinicians who do the assessments. We want to conduct research that looks at the access assessment process in detail. We hope that the findings from this research will help clinicians to make better decisions about people who are assessed for admission to secure services.
1. To examine the current evidence base for use Structured Professional Judgement (SPJ) tools in the process of service access assessments.2. To identify current access assessment practices across established PCs, including current use of SPJ tools.3. To gain insight into experiences of the access assessment process from the perspective of referrers, assessors and patients.  

We will adopt a sequential-explanatory mixed methodological design which incorporates both quantitative and qualitative researchmethods. This consists of three separate pieces of work, each with clearly defined aims and anticipated outcomes.

Phase 1: Narrative synthesis of the current evidence base for use of Structured Professional Judgement  tools in the process of service access assessments.

Phase 2: Service evaluation: analysis of routinely collected data and current access assessment documentation across established provider collaboratives. 

Phase 3: Qualitative interview study of professionals and patients across the access assessment pathway.

Anticipated impact 
Findings of our study will have a major impact on health care policy in England and Wales.
Effective start/end date1/03/2231/08/23


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