National survey of older people’s community mental health teams in England

Background The mental healthcare workforce supporting people with dementia and comorbid mental disorders requires specific skills and knowledge. Aims We co-designed and conducted a survey to understand key issues facing community mental healthcare services accessed by older adults. Method We invited all English National Health Service (NHS) older people’s community mental health teams (OPCMHTs) in England to complete the survey. We compared service structures, resourcing and waiting times between regions, and considered how responses might inform current policy priorities. Results A total of 182 out of 242 (75.2%) English NHS OPCMHTs participated. We estimated there were 120 233 referrals to OPCMHT services per year, with 77.5% of services reporting increasing referral rates. In a quarter of services (n = 46, 25.3%), clients waited over a month from referral to initial assessment. Most services (107/181, 59.1%) experienced difficulties accessing in-patient beds for people with dementia, with rural regions more likely to report these difficulties. Half of the services (n = 100, 55.2%) reported providing higher-quality care for people with dementia than 5 years ago, despite increasing caseload complexity. Resource limitations challenged opportunities for prevention, care quality and collaborative working, and respondents rated team relationships with social services (n = 86, 47.8%), general hospital in-patient (n = 74, 41.4%) and out-patient (n = 54, 30.2%) services, and primary care (n = 54, 30.2%) as poor or requiring improvement. Conclusions OPCMHT service leads are committed to integrated working, but services are insufficiently resourced to realise their potential. Addressing challenges related to workforce retention, training and ways of working could optimise OPCMHT contributions to integrated care for people with dementia.