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ENCORE is the short title for EvaluatiNg the Use of Community Treatment ORders in England study.

Collaborators

     

the study

What is the study about?

ENCORE aims to examine differences over time and between places in the use and effectiveness of Community Treatment Orders in England.

Who is involved in the study?

The project is a collaboration between the universities of Sheffield, Warwick, Portsmouth, Southampton, Ulster, Newcastle, Queen Mary and Westfield College London and the Mental Health Foundation.

The project is supported and advised by a group of health service users and a group of health service professionals.

What will be done?

Community Treatment Orders (CTOs) were introduced in England in 2008 with the purpose of reducing rates of readmission to hospital for patients experiencing serious mental illness.

Health service data suggests certain types of patient are more likely to be placed on CTOs and that CTOs are commonly used in some places and not others. It is not clear from existing research if CTOs help reduce hospital readmissions and whether they have other positive, or negative, effects on patients.

The study will centre on the analysis of 4 years of anonymised patient records and there are 4 work packages that link to the 4 main aims of the study:

The first will look at differences over time and between places in the use of CTOs. As well as looking at differences in the chance of patients being put on CTOs, we will also look at differences in the chance of patients having their CTOs reviewed or stopped.

The second will examine associations between CTO use and a range of patient outcomes. The outcomes will include measures of health service use such as hospital readmission as well as other measures relating to patient well-being such as accidents, emergencies and fatalities.

The third will examine variations in the associations between use and outcomes for different patients, places and providers. CTO-related outcomes may be different in different types of places for different types of patients.

As CTOs involve patients liaising with many health service professionals and undertaking various administrative procedures, the final work package will provide estimates of the financial costs associated with their use. The work packages are shown in a diagram below to show how the research activities fit together.

Why does this research matter?

CTOs are being used in much larger than expected numbers in England yet there is uncertainty about their value. We aim to understand where, and for whom, the value of CTOs might lie and whether there are any significant negative consequences that might outweigh their positive effects. Our results will provide the first comprehensive overview of the use and effectiveness of CTOs in England.

The research, and the recommendations that will follow from it, will be grounded in the real world settings in which patients live and use mental health services. We will review the study findings with service users and service professionals to ensure that recommendations are feasible and acceptable. We hope that the research will inform the future use and delivery of CTOs.

Funding for this study

The research is funded by the National Institute for Health Services and Delivery Research Programme.

Key Information

Principal Investigator

Professor Scott Weich

School of Health and Related Research
University of Sheffield
s.weich@sheffield.ac.uk

Co Investigators

Professor Liz Twigg

Department of Geography
University of Portsmouth
liz.twigg@port.ac.uk

Dr Craig Duncan

Department of Geography
University of Portsmouth
craig.duncan@port.ac.uk

Professor Jason Madan

Warwick Medical School
University of Warwick
J.J.Madan@warwick.ac.uk

Professor Swaran Singh

Warwick Medical School
University of Warwick
S.P.Singh@warwick.ac.uk

Dr Alastair Canaway

Warwick Medical School
University of Warwick
A.Canaway@warwick.ac.uk

Dr Helen Parsons

Warwick Medical School
University of Warwick
H.Parsons@warwick.ac.uk

 

 

 

 

 

 

 

Professor Graham Moon

Geography and Environment
University of Southampton
g.moon@soton.ac.uk

Dr Orla McBride

School of Psychology
Ulster University
o.mcbride@ulster.ac.uk

Dr Patrick Keown

Institute of Neuroscience
Newcastle University
patrick.keown@newcastle.ac.uk

Professor Kamaldeep Bhui 

Centre for Psychiatry 
Queen Mary University of London
k.s.bhui@qmul.ac.uk

Dr David Crepaz-Keay 

Head of Empowerment and Social Inclusion
Mental Health Foundation
dcrepaz-keay@mhf.org.uk

Funder

NIHR

 

 

The Evaluating the Use of Community Treatment Orders in England (ENCORE) study is funded by the National Institute for Health Services and Delivery Research Programme.

Contact

For more information or to take part in ENCORE, please contact Craig Duncan by email (craig.duncan@port.ac.uk).

Dates/duration of study‌

 

March 2016 - February 2018