Acute care services

Guidance for commissioners of acute care - inpatient and crisis home treatmentThis guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.


No part of mental health care works in isolation from other services and this guide should be read alongside other guides in this series, in particular those setting out best practice guidance in primary care mental health services, specialist community services and rehabilitation services.

This guide is for:

  • any commissioner wishing to gain an overview of how a high quality acute care pathway can be commissioned
  • Clinical Commissioning Groups as the primary commissioners of acute care
  • local authorities who commission local Healthwatch, advocacy services and other services that contribute to the acute care pathway
  • Health and Wellbeing Boards in their strategic role
  • NHS England as it supports and holds to account clinical commissioning groups
  • the Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions as it works to improve patient care
  • acute care service providers, and providers of other services that promote the recovery and social inclusion of people using or moving on from acute care
  • Public Health England as reducing mental disorder and promoting wellbeing is an important part of their role and also contributes to a range of other public health priorities.

Ten key messages for commissioners

1 Commissioners should have as their standard that they commission acute care services that they would recommend to family and friends.

2. There should be evidence of service user, patient and carer involvement in the commissioning, strategic direction, and monitoring of acute care standards.

3. Commissioners should commission a range of services in the acute pathway including inpatient beds, psychiatric intensive care unit beds, crisis resolution and home treatment teams and residential alternatives to inpatient admission.

4 Commissioners should ensure that sufficient resources are available within the acute care pathway to ensure patient safety, enable service user and patient choice and for individuals to be treated close to home, and that choice is facilitated through the roll-out of personal health budgets.

5. Facilities of an acute care service should be available 24 hours a day, 7 days a week.

6. Commissioners should expect clear criteria for entry and discharge from acute care.

7. Commissioners should ensure that the service provider collects, analyses and acts upon a range of agreed outcome data.

8. The full range of NICE approved interventions should be available for patients in the acute care pathway.

9. Clear standards for communication with primary care should be set and audited.

10. Commissioners must ensure that acute care pathway providers meet their statutory duties under the Mental Health Act and Mental Capacity Act in accordance with the relevant Codes of Practice, and that all care is underpinned by humanity, dignity and respect.