The CORE Resource Pack has been developed in the context of the Crisis Team Optimisation and Relapse Prevention (CORE) Study. CORE is a research study funded by the Department of Health through the National Institute for Health Research. It is managed by a research team led from Camden and Islington NHS Foundation Trust and University College London. The purpose of the CORE Study is to develop evidence on how CRTs can achieve positive practice and function as effectively as possible.
The resource pack draws upon previous phases of the CORE Study, which have included:
- A review of existing evidence about what makes CRTs work most effectively
- A survey of the CRT teams and managers' views on positive practice across England
- Interviews with mental health staff, service users and carers about people's views and priorities about what makes excellent crisis home treatment
- Development of a CRT fidelity scale to assess how well CRTs are delivering positive practice in crisis care. The fidelity scale measures how well teams are objectively demonstrating their effectiveness in meeting current best practice standards, as well as as a tool to measure service improvement outcomes
You can download a poster that summarises the CORE model tested by the CRT fidelity scale:
The current phase of the CORE study involves testing out the effectiveness of this resource pack. A randomised control study design has been used to compare fidelity scale scores between teams who are using the resource pack and a 'control' group of teams who do not yet have the resource pack.
Twenty five teams from across eight separate NHS Trusts have taken part in the study.
The Trusts involved are:
- Camden and Islington NHS FT
- North East London NHS FT
- Avon and Wiltshire NHS PT
- West London NHS MHT
- Northamptonshire Healthcare NHS PT
- Barnet, Enfield and Haringey NHS MHT
- Sussex NHS PT
- Surrey and Borders NHS PT
Fifteen teams received a year-long intervention consisting of access to this resource pack and additional support and training from a local facilitator. Ten teams served as the control group and continued with business as usual.
Data collection in all 25 teams consists of the following:
- Staff questionnaire - this is an online survey of staff well-being.
- Service user questionnaire - this is an online survey of service user satisfaction.
- Fidelity review day - three reviewers will come and spend one day with each team gathering lots of information about how they function. The teams will need to prepare 10 sets of anonymised case notes, and have arranged times for the reviewers to phone 6 discharged service users and 6 carers and 5 managers of other services. On the day the reviewers will spend about an hour talking to the manager, and an hour talking to 3-5 members of staff. After the review day the reviewers will provide a full report outlining areas of positive practice and areas to consider for service improvement.
We will seek feedback from CRT staff and managers about the resource pack as the study progresses.
The CORE study ends in 2017, but we intend that the resource pack can be developed and will be freely available for use in the NHS beyond this date to support teams in achieving excellent crisis resolution services over the longer term.