Winners of the 2010 RCPsych Psychiatric Team of the Year
The Intensive Home Treatment Team
(IHTT) was set up in late 2008 as an alternative to
psychiatric in-patient treatment, shifting the balance of care from
hospital to the community. Since IHTT began, Edinburgh has
had the lowest number of psychiatric beds per capita in Scotland,
and IHTT has impressive feedback from patients, relatives,
trainees, and referrers.
The judges said:
The judges were extremely impressed with the
commitment of this team in bringing about improvement in the
patient’s pathway and experience.
With innovative work, the team has managed to
effectively reduce inpatient admission, including a significant
reduction in re-admission rates to psychiatric care within a short
period of two years. Consequently, the Service has managed to
reduce the bed numbers with a reduction in the average length of
stay. The team has embraced new ways of working and has
influenced the shape of the overall service provision as a
The team has also generated some research
publications through routine collection of clinical data and
thereby spread the lessons learnt. Overall, the team has
established a model of good practice with very effective leadership
and team building based on a whole systems approach.
2008-09 saw a profound evolution in the
delivery of mental health care for the city of Edinburgh. The
Intensive Home Treatment Teams (IHTT) – one for the north of the
city and one for the south of Edinburgh – began operations, with
the goals of providing an intensive 24/7 community alternative to
hospital care, reducing hospital re-admissions, and
facilitating early discharge from hospital.
Since IHTT and the Mental Health Assessment
Service (MHAS) began, there has been a 30% planned closure in acute
adult mental health beds at the Royal Edinburgh Hospital (REH),
reflecting a shift to community based treatment consistent with the
principle of care in the least restrictive environment.
In the 12 months covered by the RCPsych
Psychiatric Team of the Year Award for 2010, there was a 24% drop
in adult admissions to the REH and mean duration of stay has fallen
by 4.5 days (15%).
IHTT had 1588 referrals and took on 543
individuals for intensive home treatment in the 12 months cover by
this Award. Referrals come from within mental health (35%);
primary care (16%); MHAS (32%); and other sources (7%), including
the police and the voluntary sector.
IHTT see a range of diagnostic and
socioeconomic groups, usually on a daily basis, and the average
treatment duration is three weeks.
At the Royal Infirmary of Edinburgh (RIE),
acute admissions to CAA6 (psychiatric receiving unit) have roughly
halved compared to earlier years, indirectly reflecting MHAS and
Routinely gathered anonymised service user and
carer feedback regarding IHTT continues to be very positive,
coupled with a low rate of critical incidents.
Staff turnover and sickness levels remain
Other awards subsequently include the Scottish
Health Award, 2011, for best Care at Home in Scotland; and being a
finalist in HSJ Health Awards ‘Innovation in Mental Health’
Want to know more?
If you would like to find out more about IHTT,
Edinburgh, or want to contact the team lead, please
contact Liz Cowan.