Further Observations on the Practice of Community Care in Salford

Differences in the clinical characteristics of clients have not been found to account for the interprofessional differences in community psychiatric nurses' and mental health social workers' practice in Salford. We found the consultant-attached mental health social workers, who worked closely with the specialist psychiatric team and who received supportive supervision from their professional managers, maintained stable case-loads, but the primary-care attached community psychiatric nurses, who were isolated from the specialist psychiatric team, and who received little supportive supervision from their professional managers, carried case-loads of increasing size. Failure to improve the way in which services for the mentally ill in the community are co-ordinated is likely to perpetuate the worst characteristics of life in the old back wards into the era of ‘community care’.