title: Towards integrated community mental health teams for older people in England: progress and new insights.
abstract: OBJECTIVE
  To investigate progress in joint working within community mental health teams for older people (CMHTsOP) against a range of national standards, and to consider team characteristics that may hinder or facilitate integrated practice.
  
  
  METHODS
  A postal questionnaire was sent to the managers of all CMHTsOP in England. A total of 376 teams responded representing a response rate of 87.7%. Hypothesis testing and regression analysis, using a composite score based on nine indicators of integration, were conducted to address the study's aims.
  
  
  RESULTS
  Whilst the study suggests that progress was being made against a number of key standards of joint working, the study finds that most teams could not access local authority service user records, nor were health staff within most teams able to commission social care services. After controlling for other characteristics, teams with the lowest levels of integration tended to work across multiple local authorities; were managed by a nurse; had high referral rates and were located in formally integrated Care Trusts.
  
  
  CONCLUSIONS
  Improved integration could develop by NHS Trusts and local authorities encouraging more information sharing, and further delegating powers to arrange social care services to CMHTOP members. The paper highlights team and locality features that appear to cause obstacles to joint working, but there is a clear gap in the evidence relating team structures and characteristics to the quality of patient care.
authors.affiliation: Personal Social Services Research Unit, University of Manchester, UK. mark.wilberforce@manchester.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Wilberforce
authors.forename: Val
authors.initials: V
authors.lastname: Harrington
authors.forename: Christian
authors.initials: C
authors.lastname: Brand
authors.forename: Sue
authors.initials: S
authors.lastname: Tucker
authors.forename: Michele
authors.initials: M
authors.lastname: Abendstern
authors.forename: David
authors.initials: D
authors.lastname: Challis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004739:England; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D012044:Regression Analysis; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires