Abstract
Background: The UK Mental Health National Service Framework (NSF) promotes close co-operation between primary care and specialist mental health services. Service protocols were proposed to assist such co-operation. Aim: To evaluate the development, implementation and impact of mental health protocols across the former Trent Region. Method: Managers in each of the health communities were interviewed and a sample of clinicians surveyed. Results: Effective development was associated with a high level of management support, a single project manager, and access to a range of stakeholders in reviewing draft protocols. Face-to-face contact with clinicians, training and managerial interventions were important for effective dissemination. Changing clinicians' behaviour required sustained effort. Leadership from the UK Department of Health regarding the protocols was reported to be lacking. Survey responses identified that the protocols were generally well regarded and there was reported impact on practice. Conclusion: Dissemination difficulties for protocols were evident. A significant barrier to implementation was the organisational change agenda.
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