The consultant's caseload: a working framework

Abstract

Consultants psychiatrists have a limited time to offer their services. Current contracts, based on population norms, do not establish limits to consultants' workload. Reorganisation of service provision, rising demands and marked social differences in different localities have brought these population norms into question. What is the desirable workload for a consultant to ensure a decent level of care to patients? A model is proposed that specifically applies to whole-time consultants within a catchment area, and those working in adult general psychiatry. It will need to be adapted for other specialities. The figures given are estimates, which will need to be audited appropriately for refinement. It is hoped that such an analysis will facilitate the process of purchasing care for specific patient groups, and be a clearer way of identifying gaps in clinical service.