Psychiatry has restructured its service delivery

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6996.60a (Published 01 July 1995) Cite this as: BMJ 1995;311:60
  1. Janet Bruce
  1. Consultant psychiatrist Derby City General Hospital, Southern Derbyshire Mental Health Trust, Derby DE22 3NE

    EDITOR,--David Armstrong and Mick Nicoll look at changes in consultants' workload in outpatient clinics since 1949.1 The delivery of services in psychiatry has been completely restructured since then: it is now community based, with each consultant responsible for a specified population, and large asylums have gradually closed. Beds fell from 148100 in 1954 to 64800 in 1985, with a final target of 47900. Simultaneously, annual admissions increased from 78586 in 1955 to 185514 in 1981.2 Rather than hold expensive outpatient clinics for everyone, the consultant now heads a busy …

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