The availability of community-based treatment is highly variable. In a comparison between inner and outer London HAs, catchment areas with the best provision showed that nearly 60 per cent of their localities did not have enough staff to meet the needs identified. In many areas, community-based premises are not available and teams operate as a network of individuals rather than fully constituted teams.
Perhaps more significantly, of 27 London trusts, only one inner London trust and one outer London trust reported the ability to provide home treatment, defined as the provision of planned home visits to acutely ill patients on a daily basis during the working week.
However, this description of home treatment is not one that we would consider sufficient: staff teams should be available 24 hours a day, seven days a week.
Finally, there is a lack of information in London's Mental Health on assertive outreach teams. Birmingham's experience is that such teams - with small caseloads - significantly improve involvement with mental health services for clients who are difficult to engage. It should be noted there is evidence that home treatment and assertive outreach teams are beginning to develop in London.