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The Royal College of Psychiatrists Improving the lives of people with mental illness

Winners of the 2010 RCPsych Psychiatric Team of the Year Award

IHTT, Edinburgh
NHS Lothian


Winners of the 2010 RCPsych Psychiatric Team of the Year Award- IHTT, Edinburgh, NHS Lothian

Team statement:

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 result.


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.


Team Summary:

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 IHTT activity.


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 low.


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’ category.


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.