Alwena Paula Lousie Tudor

The aim and objective of the study was to investigate any barriers and facilitators in the care transitions between secondary and primary care for patients with mental health difficulties. Focus was placed on care transitions from a carers perspective, investigating how the mental health unit currently defines and follows the policies and procedures. In previous research a carers perspective is frequently not considered, although the carer can be a major link for a successful transition from secondary to primary care.

Qualitative research: Using a thematic analysis to determine themes from the semi structured interview and 26 participants were selected through care support groups. A systematic approach was used to map the transition process and of GP provision of services, support in the community and the barriers or facilitators to patient safety. NVivo 12 Software enabled analysis and examination of themes. The SEIPS 3.0 model and framework was used to analyse patient safety, quality of care improvement and integrating a Human Factors and Ergonomic (HFE) approach to the study.

The process maps identified barriers and facilitators to the transition between the health care settings how the transition occurs from a carer’s perspective. The mental health discharge process map facilitates good communication between the transitions if utilised, if not followed as the organisation intended, they can become barriers. The interviews indicated that the lack of understanding, reduced communication and information created barriers between secondary and primary care which was impacting on the process, carers health, well-being and patient safety.

The scoping information indicated that some of the transitions of care were completed in the height of the COVID pandemic. There was a requirement to change policies, procedures and guidelines for patients requiring urgent care; for an efficient and effective way to reduce the pressures on the NHS systems. These pressures caused barriers to transition in care which impacted on carers emotional, physical, health, and well-being. The COVID discharge protocol amendments also created facilitators, these changes provided a close collaboration between health and social care, reducing the boundaries which were previously in place due to the organisational and financial funding streams.

The findings of this project also allowed identification of some key themes related to previous research linked to reduced communication, coordination of information between patient, carers, continuing to create barriers and risks in patient safety during the transitions.

The transition process is not a single dimension there is need to make a comparison of the health transition as a whole process. Completing a study including community health services, secondary health care services and patient/carers would be beneficial to draw the key stakeholders together. This would enable exploration of the barriers and facilitators to highlight the areas which require improvement and evidenced based practices that might be transferrable to other settings.