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Survey of patients' view on functional split of consultant psychiatrists

Millia Begum1*, Keith Brown2, Anthony Pelosi1, Jim Crabb2, John McTaggart3, Caroline Mitchell1, Everett Julyan4, Tony Donegan5 and Michael Gotz2

Author affiliations

1 Hairmyres Hospital, NHS Lanarkshire, East Kilbride, Scotland G75 8RG

2 Forth Valley Royal Hospital, NHS Forth Valley, Larbert, Scotland FK5 4WR

3 Stobhill Hospital, NHS Greater Glasgow & Clyde, Glasgow, Scotland G21 3UW

4 Crosshouse Hospital, NHS Ayrshire & Arran, Kilmarnock, Scotland KA2 0BE

5 Wishaw General Hospital, NHS Lanarkshire, Wishaw, Scotland ML2 0DP

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Citation and License

BMC Health Services Research 2013, 13:362  doi:10.1186/1472-6963-13-362

Published: 27 September 2013



The functional split model of consultant psychiatrist care for inpatients has been one of the major service redesign that has occurred in the NHS in the last decade. It is unclear if this new split model offers any advantages over the previous sectorised model of working. More recent evidence has suggested that patients, carers and professionals have varied views regarding the benefits of this model.

This survey of patient’s views on models of consultant working is the first in Scotland and we have attempted to include a large sample size. The results suggest that after providing sufficient information on both models, the majority of patients from various Scottish health boards have opted for the traditional sectorised model of working.


During a four week period consecutive patients across 4 health boards attending the General Adult consultant outpatient clinics and those who were admitted to their inpatient ward were offered a structured questionnaire regarding their views on the functional split versus traditional sectorised model. Space was provided for additional comments. The study used descriptive statistical measures for analysis of its results. Ethical approval was confirmed as not being required for this survey of local services.


We had a response rate of 67%. A significant majority (76%) of service users across the four different health boards indicated a preference for the same consultant to manage their care irrespective of whether they were an inpatient or in the community (Chi-squared = 65, df = 1, p < 0.0001). In their unstructured comments patients often mentioned the value of the therapeutic relationship and trust in a single consultant psychiatrist.


Our survey suggests that most patients prefer the traditional model where they see a single consultant throughout their journey of care. The views of patients should be sought as much as possible and should be taken into account when considering the best way to organize psychiatric services.

Functional split; Inpatient psychiatric care; New ways of working