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Evaluation of the Threshold Assessment Grid (TAG) as a means of improving access from primary care to secondary mental health services
DOI 10.1186/ISRCTN86197914
ClinicalTrials.gov identifier
EudraCT number
Public title Evaluation of the Threshold Assessment Grid (TAG) as a means of improving access from primary care to secondary mental health services
Scientific title
Acronym TAG
Serial number at source SDO 71/2003
Study hypothesis Primary hypothesis: Using the TAG will significantly improve the agreement between the GP and the adult mental health team on the appropriateness of the referral
Secondary hypotheses: Receiving a TAG with a referral letter will make it significantly easier for the mental health team to identify
a. The urgency of the referral
b. The most appropriate professional to make the initial assessment
Lay summary
Ethics approval Added as of 06/08/2007: The study was approved by Metropolitan Multi-centre Ethics Committee (04/MRE11/8) with Local REC approval in London and Manchester, and research governance support from the relevant Primary Care Trusts and Mental Health Trusts.
Study design Randomised controlled trial.
Countries of recruitment United Kingdom
Disease/condition/study domain Mental health
Participants - inclusion criteria General Practitioners (GPs) and other referrers to Community Mental Health Teams (CMHTs).
Participants - exclusion criteria None
Anticipated start date 01/01/2005
Anticipated end date 30/09/2005
Status of trial Completed
Patient information material
Target number of participants 73 GP practices (37 control, 36 intervention)
Interventions Control group: referrers to CMHTs asked to make referrals using a referral letter or form as per existing practice.
Intervention group: referrers to CMHTs asked to complete a Threshold Assessment Grid (TAG) in addition to a referral letter, and given guidance on its contents.

Amendments to the trial as of 01 June 2005:
1. We will now be paying GP practices £100 to cover administrative costs
incurred in providing us with service use data for the 5-10 patients they referred to mental health teams during Jan - June 2005. To facilitate this
service use data collection, the name and date of birth of referred
patients will be recorded at the mental health team referral meeting.
2. We will now be paying GPs £100 for their time in being interviewed to learn about their experiences of using TAG
3. We will be interviewing key informants in mental health teams about their experience in receiving TAGs with the referral letter
4. We will be extending the randomised controlled trial (RCT) from 6 to 9 months, so it finishes on 30 September 2005 instead of 30 June 2005.
Primary outcome measure(s) CMHT rating of appropriateness of the referral.
Secondary outcome measure(s) CMHT rating of the quality of information to inform decision-making about urgency of the referral and which professional should make the initial assessment. In addition to this, service usage data will be collected to allow cost effectiveness analysis.
Sources of funding NHS Service Delivery and Organisation R&D Programme (UK) (ref: SDO 71/2003)
Trial website http://www.iop.kcl.ac.uk/iopweb/virtual/?path=/hsr/prism/tag/
Publications Results:
1. http://www.ncbi.nlm.nih.gov/pubmed/17651489
2. http://www.ncbi.nlm.nih.gov/pubmed/18515810
Contact name Dr  Mike  Slade
  Address Health Services Research Department (Box P029)
David Goldberg building
Institute of Psychiatry
De Crespigny Park
Denmark Hill
  City/town London
  Zip/Postcode SE5 8AF
  Country United Kingdom
  Tel +44 (0)20 7848 0795
  Fax +44 (0)20 7277 1462
  Email m.slade@iop.kcl.ac.uk
Sponsor NHS Service Delivery and Organisation Programme (SDO) (UK)
  Address NCCSDO
London School of Hygiene and Tropical Medicine
99 Gower Street
  City/town London
  Zip/Postcode WC1E 6AZ
  Country United Kingdom
  Tel +44 (0)20 7612 7983
  Fax +44 (0)20 7612 7979
  Email sdo@lshtm.ac.uk
Date applied 13/08/2004
Last edited 03/06/2008
Date ISRCTN assigned 05/10/2004
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