Scoping review of intensive psychiatric inpatient care provision for young people in Scotland: report

Report on a scoping review of intensive psychiatric inpatient care provision for young people in Scotland.

Appendix IV. Proforma used to guide discussions and data collection.

Review of Adolescent Intensive Psychiatric Care Units (IPCU) in Scotland - NHS Scotland Regional Consultation Pro forma


  • Current inpatient units
    • Please tell us about the inpatient service you work in and your role within that.
    • What age are you patients?
    • How many beds in the unit?
    • What mix of professionals currently work in your inpatient service?

Care Pathway

  • Referral
    • What would prompt your decision to refer a patient to a more intensive unit?
    • What organisations can make a referral? (Where do referrals come from?
  • Admission
    • What criteria do patients need to meet to be admitted to an IPCU?
    • Once a referral is accepted, what's the process for new admissions?
    • What needs to be considered in relation to transferring patients to an IPCU?
  • Barriers to admission
    • What would exclude a patient from being admitted?
    • What happens when a patient is not suitable for an IPCU? Or if a bed can't be found?
    • Are there any other barriers to patients accessing an IPCU if they require it?
  • Discharge
    • When does planning for discharge begin?
    • What is the pathway for discharge?
    • What type of barriers could prevent patients from being discharged?

Current Adolescent IPCU Options

  • IPCU Service Options in your region
    • Currently in your region, what are the options for a patient who requires more intensive psychiatric care?
    • How well does this match the need for adolescent intensive psychiatric care?
  • Staffing
    • What staff disciplines are present in the IPCU in your region?
    • What mix of staff would you want to see within an adolescent IPCU?
  • Patient Management
    • Are there any patient management issues specific to adolescents who require intensive psychiatric care? (e.g. restraint procedures, risk assessment, observation)
    • What guidelines would you refer to for this? (Are these sufficient?)
    • How well are these issues currently provided for in your region?
  • Interventions/Facilities
    • What facilities need to be in place for adolescents who require intensive care? (e.g. access to schooling, anything treatment specific?)
    • What else could be provided to facilitate their care? (e.g. violence reduction options; meaningful activities)
    • How well are these facilities currently provided in your region?

Relationships across Services

  • How do intensive care services and CAMHS/Community Services communicate generally?
  • How do you maintain communication with intensive psychiatric care services regarding specific patients?
  • How do intensive care services and CAMHS/Community Services communicate with social work regarding specific patients?
  • National Secure Adolescent Inpatient Service:
    • What do you anticipate the relationship being between your service and the new National Secure Adolescent Inpatient Service?

Future Adolescent IPCU Options

  • Current unmet need (if not already covered in above discussion)
    • What is lacking in current adolescent intensive psychiatric provision?
    • What are they key unmet needs?
  • Future options
    • Would it be possible to adapt current services to meet need?
    • What would be the preferred option in your region? (e.g. current arrangement / adapt beds in an adult IPCU / have a dedicated unit adjacent to an adolescent inpatient unit / other)
    • What are the benefits of your preferred option?
    • What are the disadvantages of your preferred option? (On patient care? / On staff? / On families?)
    • What clinical considerations need to be taken into account for these options?

Activity Data

  • Admissions to open inpatient adolescent psychiatric units by Health Board?
  • Duration of stay of patients in these units.
  • Referral/Admission rate - (How many are referred vs accepted and admitted) to open units but also to IPCU services from open units.

Patient Profile (for patients requiring intensive psychiatric care)

  • Diagnosis/Conditions - prevalence of conditions existing in patients in the wards.
  • Age of patients admitted.
  • Level of deprivation - (SIMD)
  • Location - Admitted from/discharged to.
  • Detention status - how many patients were informal/detained?
  • Patients placed on observation - and varying levels of this?

Staffing Data

  • Core Team - Nursing and Medical Staff required to run the ward? Number of sessions? Daily staffing levels per shift?
  • Allied Health Professionals/MDT - Clinical Psychology, Occupational Therapy, SLT input etc. Number of sessions?



Back to top