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Quality indicators for primary care mental health services
  1. T Shield1,
  2. S Campbell1,
  3. A Rogers1,
  4. A Worrall2,
  5. C Chew-Graham3,
  6. L Gask1
  1. 1National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK
  2. 2College Research Unit, Royal College of Psychiatrists, London SW1H 0HW, UK
  3. 3Department of General Practice, University of Manchester, Manchester M14 5NP, UK
  1. Correspondence to:
 Dr S Campbell, National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK;


Objectives: To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement.

Design: Modified two-round postal Delphi questionnaire.

Setting: Geographical spread across Great Britain.

Participants: One hundred and fifteen panellists representing 11 different stakeholder groups within primary care mental health services (clinical psychologist, health and social care commissioner, community psychiatric nurse, counsellor, general practitioner, practice nurse/district nurse/health visitor, psychiatrist, social worker, carer, patient and voluntary organisations).

Main outcome measures: Face validity (median rating of 8 or 9 on a nine point scale with agreement by all panels) for assessing quality of care.

Results: A maximum of 334 indicators were rated by panels in the second round; 26% were rated valid by all panels. These indicators were categorised into 21 aspects of care, 11 relating to general practices and 10 relating to health authorities or primary care groups/trusts. There was variation in the total number of indicators rated valid across the different panels. Overall, GPs rated the lowest number of indicators as valid (41%, n=138) and carers rated the highest number valid (91%, n=304).

Conclusions: The quality indicators represent consensus among key stakeholder groups in defining quality of care within primary care mental health services. These indicators could provide a guide for primary care organisations embarking on quality improvement initiatives in mental health care when addressing national targets and standards relating to primary care set out in the National Service Framework for Mental Health for England. Although many of the indicators relate to parochial issues in UK service delivery, the methodology used in the development of the indicators could be applied in other settings to produce locally relevant indicators.

  • quality indicators
  • mental health
  • Delphi
  • primary care

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  • The project was devised by LG, SC, AR and TS and managed by TS. The Delphi questionnaire was developed by SC, TS and LG. TS undertook the analyses. LG, SC, TS, CCG and AW were involved in the operationalisation of the indicators. TS, SC and LG wrote the paper with TS as the principal author. TS is the guarantor of the paper.

  • This project was funded out of NPCRDC core funding from the Department of Health. There are no conflicts of interest.

  • See editorial commentary, pp 8566

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