The effects of the first Covid-19 lockdown on quality and safety in mental health care transitions in England

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Abstract

Introduction
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 Covid-19 on perceived health care quality and safety.

Methods
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 (service users, carers, healthcare professionals and key informants). Results were analysed thematically.

Results
The qualitative data highlighted six overarching themes in relation to practice changes: 1.Technology enabled communication; 2. Discharge planning and readiness; 3. Community support and follow up; 4. Admissions; 5. Adapting to new policy/guidelines; 6. Health worker safety/wellbeing. 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.

Bibliographical metadata

Original languageEnglish
JournalBritish Journal of Psychiatry Open
Early online date31 Aug 2021
DOIs
Publication statusPublished - 31 Aug 2021