The Case Of Mental Health In English Primary Care

November 2017

Mental Health

Country of origin: UK

Little research attention has been given to attempts to implement organisational initiatives to improve quality of care for mental health care, where there is a high level of indeterminacy and clinical judgements are often contestable. A recently published paper explores recent efforts made at an organisational level in England to improve the quality of primary care for people with mental health problems through the new institutional processes of clinical governance.

The researchers found that the constant change within the English NHS provided a difficult context in which to attempt to implement clinical governance. In the absence of clear evidence or direct guidance about what primary mental health care should be, and a lack of actors with the power or skills to set about realising it, the actors in clinical governance had little shared knowledge or understanding of their role in improving the quality of mental health care although some success was achieved in the monitoring of prescribing practice. There was a lack of ownership of mental health as an integral, normalised part of primary care.

The researchers found that despite some achievements in regard to monitoring and standardisation of prescribing practice, mental health care in primary care seems to have so far largely eluded the gaze of clinical governance. Clinical governance in English primary mental health care has not yet become normalised. The paper makes some policy recommendations which the researchers consider would assist in the process normalisation and suggest other contexts to which the findings might apply.

The complete article is available as a provisional PDF.

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