Studying the factors associated with increased number of admissions among psychosis cases especially in the COVID era, is critical to reduce unnecessary hospitalization with all its subsequent burdens. Aim: This study was part of an EPUT service review and also a quality improvement project of Cambridge chief resident management and leadership development program, which is a joint-program between the Judge business school and Cambridge university. Methods: Data was extracted from the digital records of Mid and East Essex psychosis teams. The Mid Essex psychosis team covers specialist psychosis services in Braintree, Chelmsford, Maldon and its surroundings. East Essex psychosis team covers specialist psychosis services in Colchester, Clacton-on-Sea and its surroundings. Results: 15% of the patients in the sample were under CTO. Patients who were under CTO had significantly higher total number of admissions compared to those not under CTO (p=0.014). Similarly, the 2 groups showed a statistically significant difference in the number of formal admissions and the number of pre-COVID admissions per year, which were higher in the CTO group (p=0.005, p=0.021 respectively). 20% of the patients in the sample were receiving clozapine. Clozapine patients had significantly higher total number of admissions compared to non-clozapine patients (p=0.003). Similarly, the 2 groups showed a statistically significant difference in the number of formal admissions, which was higher in the clozapine group (p=0.011). Patients who had changes in care due to COVID (telephone and video consultations) when compared to patients who had care as usual showed a significant difference in the number of admissions during the first year of the COVID pandemic. The number of COVID admissions was significantly less in patients who had changes due to COVID. (p=0.034). In line with the results from comparisons, clozapine was associated with higher total number of admissions (p=0.001) and number of formal admissions (p=0.001). These associations had large effect sizes (partial Eta2=0.25 and 0.257 respectively). Similarly, CTO was associated with higher number of formal admissions (p=0.027). This association had medium effect size ((partial Eta2=0.129). In addition, changes in care due to COVID-19 were associated with less number of admissions during the first year of the COVID pandemic (p=0.006, partial Eta2=0.189, large effect size). Forensic history was associated with higher number of formal admissions (p=0.042, partial Eta2=0.11, medium effect size). PBR cluster score was directly correlated with both the total number of admissions (p=0.016) and the number of formal admissions (p=0.021). Conclusions: CTO, clozapine use and forensic history were associated with higher risk of hospital admission in patients with psychosis. Whereas, having supportive network, receiving psychological intervention and documentation of early relapse signs were associated with lower risk of admission. Furthermore, preliminary evidence shows that telepsychiatry is a suitable alternative to standard care during the COVID-19 pandemic.