A comparison of in-patient mental health rehabilitation services provided by the NHS and independent sector in England: patient and service characteristics.

IF 4 3区医学 Q1 PSYCHIATRY

BJPsych Open Pub Date : 2026-07-24 DOI:10.1192/bjo.2026.12047

Helen Killaspy, Christian Dalton-Locke, Mariam Adeleke, Nia Barber, Bella Branch, Caroline Sarah Clarke, Gerard Leavey, Artemis Igoumenou, Katherine Barrett, Megan Downey, Sophie Thomas, Jing Yi Jessica Weng, Rumana Z Omar

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Abstract

Background: In-patient mental health rehabilitation services provide specialist care to adults with complex psychosis. In England, there are more than 350 such services, half provided by the National Health Service (NHS) and half by the independent sector.

Aims: To investigate whether NHS and independent sector in-patient mental health rehabilitation services differ.

Method: We recruited a random sample of NHS and independent sector services across England. We collected cross-sectional data regarding service and patient characteristics through interviews with patients, clinicians and managers, and from healthcare record reviews.

Results: We recruited 411 patients from 48 NHS services and 172 patients from 20 independent sector services. Service characteristics, including standardised quality scores, were similar. Most patients had a diagnosis of schizophrenia (NHS n = 237, 57.7%; independent sector n = 99, 57.6%) or schizoaffective disorder (NHS n = 88, 21.4%; independent sector n = 32, 18.6%). More than half had at least one comorbid condition, but more independent sector patients had at least two (NHS 131 of 411, 31.9%; independent sector 80 of 172, 46.5%; P = 0.001). Current admissions were twice as long for independent sector patients (NHS mean 1.2 years [s.d. 1.5]; independent sector mean 2.4 years [s.d. 2.8]). Standardised ratings of patients' quality of life, autonomy, time use, satisfaction with care, social and everyday functioning, and challenging behaviours were similar. However, independent sector patients had more needs (NHS mean 6.5 [s.d. 3.2]; independent sector mean 7.9 [s.d. 3.9]; P < 0.001) and more had a history of fire setting (NHS 32, 7.9%; independent sector 28, 17.2%; P = 0.001).

Conclusions: Both NHS and independent sector in-patient rehabilitation services support people with complex psychosis, but independent sector patients may have more complex conditions, which could explain their longer admissions.

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英国国家医疗服务体系和独立部门提供的住院心理健康康复服务的比较：患者和服务特点。

背景：住院心理健康康复服务为患有复杂精神病的成人提供专科护理。在英格兰，有350多个这样的服务，一半由国民保健服务提供，一半由独立部门提供。目的：探讨NHS与独立部门住院患者心理健康康复服务是否存在差异。方法：我们招募了一个随机样本的NHS和独立部门服务在英格兰。我们通过对患者、临床医生和管理人员的访谈以及对医疗记录的回顾收集了有关服务和患者特征的横断面数据。结果：我们从48个NHS服务部门招募了411名患者，从20个独立部门服务部门招募了172名患者。包括标准化质量分数在内的服务特征是相似的。大多数患者被诊断为精神分裂症（NHS n = 237, 57.7%；独立部门n = 99, 57.6%）或分裂情感性障碍（NHS n = 88, 21.4%；独立部门n = 32, 18.6%）。超过一半的患者至少有一种合并症，但更多的独立部门患者至少有两种合并症（NHS 131 / 411, 31.9%；独立部门80 / 172,46.5%;P = 0.001）。目前的住院时间是独立部门患者的两倍(NHS平均1.2年[s.d。1.5);独立部门平均2.4年[s.d。2.8])。患者的生活质量、自主性、时间利用、护理满意度、社会和日常功能以及挑战行为的标准化评分相似。然而，独立部门的患者有更多的需求(NHS平均6.5 [s.d。3.2);独立部门平均7.9 [s.d。3.9);P < 0.001)和更多的人有纵火史（NHS 32, 7.9%；独立部门28,17.2%;P = 0.001）。结论：NHS和独立部门的住院康复服务都支持复杂精神病患者，但独立部门患者的病情可能更复杂，这可以解释他们住院时间更长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJPsych Open Medicine-Psychiatry and Mental Health

CiteScore

6.30

自引率

3.70%

发文量

610

审稿时长

16 weeks

期刊介绍： Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.