A comprehensive clinical database for mental health care in England.
BACKGROUND
Monitoring and researching clinical care calls for comprehensive clinical databases. In mental health care these need to cover all aspects of the care of each patient and to accommodate the complexity of care which may last from weeks to years. This paper describes the pilot work for a mental health clinical database intended to be implemented throughout the English National Health Service.


METHODS
In collaboration with three pilot sites, a set of data extracts was defined which could reasonably easily be produced, mostly using existing statistical data collection systems. Software was designed to integrate these extracts into patient-based records describing overall spells of mental health care. These data were extracted from their systems for a 6-month pilot period.


RESULTS
Two of the three sites produced data sets, which appeared to give a reasonably complete account of the work undertaken in the pilot period. Known differences in service design and clinical perspective between the two sites were clearly reflected.


CONCLUSIONS
The approach to extracting and collating the data is workable within existing resources and produces illuminating data for clinical audit, management and planning. Completeness and accuracy of data is likely to be a continuing problem, as for any routine data capture exercise. However, the process of integrating data from several channels assists this, as inconsistencies become apparent and can be tackled. The approach is now being implemented throughout England.
Glover
G R
GR
Section of Community Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003628:Database Management Systems; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D010865:Pilot Projects; D013222:State Medicine / Q000458:organization & administration; D018511:Systems Integration