Objectives 1. To examine the functioning of a clinical psychology direct access service working under routine NHS conditions. 2 . To examine levels of patient attendance. 3. To establish the degree to which patients benefit from attending and what factors are associated with improved outcomes. 4. To produce data that can be used in standard setting, through which practice can be improved and evaluated. Design A retrospective analysis of discharge data on a cohort of patients discharged from a Clinical Psychology direct access service. Setting An out-patient clinical psychology department in the West Sector of Glasgow. The Sector covers a large geographical area and is divided into 3 localities. Cases All patients discharged from the Riverside locality between September 1999 - August 2000. Results Of the 257 patients discharged, 53 (20%) failed to attend for first appointment. Of the 204 who did attend, 123 (60%) completed treatment and 81 (40%) dropped out. For those who attended 67% improved, this figure rising to 89% improvement rates for those who completed treatment. Eighty-one per cent of patients came from the middle to high areas of deprivation. Interventions were generally brief (average length of treatment is 5 sessions) with 82% of patients attending for less than 8 sessions. Improved outcomes were associated with staying in treatment to completion and being treated for anxiety disorders. Conclusions Within the service people are seen with a wide range of psychological problems, many from areas of middle to high deprivation. Examination of attendance rates show that a large proportion never attended or dropped out, with just less than half completing treatment. The service is beneficial to the majority of those who attend, particularly those patients who complete treatment. Interventions were generally brief and were not confined to the 'worried well'. The study has provided data which can be used for standard setting for our own and similar services
