The replacement of assertive outreach services by reinforcing local community teams: a four-year observational study

AbstractBackground: The introduction of specialist Assertive Outreach (AO) teams has produced only modest differential findings from English studies compared to standard care. Providers have gradually closed AO services over the last 8 years. We previously studied outcomes at 12 months following the dismantling of two AO teams in London. We now report on the longer term outcomes for these patients.Aims: To evaluate the longer term outcomes, activity and costs for patients receiving a less intensive service.Methods: Observational service level evaluation of 112 patients comparing baseline of AO care with each year of routine care subsequent to the team closure.Results: Patients transferred to standard teams reinforced with the Flexible Assertive Community Treatment (FACT) approach had significantly fewer admissions and bed days at each of the four subsequent years compared to baseline, offset by a significant rise in missed face-to-face appointments. There was no significant change in the use of crisis ser...