University of Worcester Worcester Research and Publications

A Comparison of the National Clinical Audit of Psychosis 2019/2020 standards and First Episode Psychosis Services Fidelity Scale 1.0

Addington, D., French, P. and Smith, Jo (2021) A Comparison of the National Clinical Audit of Psychosis 2019/2020 standards and First Episode Psychosis Services Fidelity Scale 1.0. Early Intervention in Psychiatry, 16 (9). pp. 1028-1035. ISSN Print: 1751-7885 Online: 1751-7893

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Addington EIP audit paper draft proof submitted version April 13th 2021.pdf - Draft Version
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Addington fidelity scales comparison Main Document NCAP-EIP FEPS-FS comparison October 26 2021.pdf - Accepted Version

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Aim: The authors compare two approaches to assessment of the quality of early psychosis intervention services, the National Clinical Audit of Psychosis used in the United Kingdom and the First Episode Psychosis Services Fidelity Scale used in North America and Europe.
Methods: We compare the two approaches on the source of standards, measurement type, data collection, time requirements, resources used, scoring and reliability. Finally, we review their strengths and limitations.
Results: Both measures are based on standards derived from the same research evidence base. Both methods rely on data from health records and administrative data. The audit is supplemented with user survey data, the fidelity scale with clinician interviews. The audit appears to require less time. The audit is based on quality indicators rated as present or absent which yields a statistical benchmark. The Fidelity Scale is based on quality indicators that are rated on a five-point scale yielding a standards-based measure. The two methods cover similar core service components, but the FEPS-FS has a broader coverage of team functioning. The National audit also collects data on the user experience directly from patients. The fidelity scale has achieved good to excellent inter-rater reliability, the reliability of the audit has not been tested.
Conclusions: Both methods deliver reliable and useful measures of quality of care. The NCAP works in the context of a single provider health system, the FEPS-FS works in a more variable health system. Comparing the two systems in the field would support international comparison of standards of care.

Item Type: Article
Additional Information:

This is the peer reviewed version of the following article: 'Addington, D., French, P., & Smith, J.(2021). A comparison of the National Clinical Audit of Psychosis 2019/2020 standards and First Episode Psychosis Services Fidelity Scale 1.0.Early Intervention in Psychiatry,1–8.', which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

Uncontrolled Discrete Keywords: Quality Indicators, Psychotic Disorders, Implementation Science, Early Medicical, Early Medical Intervention, Clinical Audit
Divisions: College of Health, Life and Environmental Sciences > School of Allied Health and Community
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Copyright Info: © 2021 John Wiley & Sons Australia, Ltd.
Depositing User: Jo Smith
Date Deposited: 01 Dec 2021 13:47
Last Modified: 09 Dec 2022 01:00

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