The systemic value of integrating an adolescent day service into an inpatient service: A qualitative case study

Abstract

In 2019, the NHS established a taskforce to review inpatient care for young people, exploring ways to reduce inappropriate admissions and lengthy stays. This paper indicates that day services (DSs) could play a role in resolving these issues. Qualitative research investigating whether DSs are considered valuable to key stakeholders is scarce. Therefore, this qualitative case study sought the perspectives of ten clinicians working at a DS integrated with an inpatient service (IPS). Thematic analysis highlighted the systemic value of accessing intensive support whilst still living with family, with participants perceiving that day patients better consolidated therapeutic skills when compared with inpatients. Importantly, the DS was perceived to enhance the overall therapeutic impact of the wider IPS. The implications of these findings for the use and funding of DS are discussed, highlighting the need to further explore the efficacy of integrated services incorporating day and inpatient care.

Practitioner points

• The DS was perceived to provide young people with high-intensity support, whilst maintaining key systemic connections to their homes and communities.
• The DS was perceived to positively influence the systemic dynamics of the inpatient service, improving the efficacy of inpatient care.
• Findings indicate a mutually beneficial relationship between day and inpatient services, strengthening the case for the integration of both services.