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Table 1 Overarching themes and subthemes within “Pathways in practice”

From: Women’s secure hospital care pathways in practice: a qualitative analysis of clinicians views in England and Wales

Overarching themes Subthemes
The Nature of the “Secure Care Pathway” Movement of women through tiers of security or out of services
- Discharge facilitate
Discharge delayed
Cost-quality of care conflict The cost of caring for women
- Nature of care is expensive
- Cost is gender relevant
- Determinants of bed purchase
The false economy of rapid discharge
- Discharge driven by cost
- The negative effect of early discharge on recovery
The peril of repatriation
- Premature and disruptive discharge
- Financially driven
Availability of Services Gaps and blockages
- Lack of service provision
- Placements far from home
- Provision of appropriate care in inappropriate security; continuity
Access to community placements
- Lack of step-down facilities and supported accommodation
- Support and involvement in the community to prevent relapse
- Broad conceptualisation of community (See Lists 2 & 3)
Attitudes to Care Competing concepts of continuity
- Continuity of treatment
- Continuity of responsibility
Fear and reluctance in receiving Teams
- Stigma of women in secure services
- Anxiety about receiving women from secure services
- Outreach and supportive relationships