scholarly journals The clinical utility of the IRAC component of the Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP)

2018 ◽  
Vol 42 (4) ◽  
pp. 152-156
Author(s):  
Caroline Guest ◽  
Stephen Crockett ◽  
Patrick Little ◽  
Anish Patel
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Retrospective Analysis ◽  
Clinical Utility ◽  
Outcome Measurement ◽  
Clinical Implications ◽  
Referral Process ◽  
Liaison Psychiatry ◽  
Routine Outcome Measurement ◽  
Before And After

Aims and methodThe clinical utility of the multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) has not previously been examined. We sought to establish whether referral accuracy and ability to achieve the reason(s) for referral to our liaison service improved after incorporating the Identify and Rate the Aim of the Contact (IRAC) scale of this tool into our referral process. We carried out a retrospective analysis of electronic case notes of all appropriate referrals to the team before and after this adaption.ResultsAccuracy of referrals to our team improved from 73.8 to 93.7% following intervention. Referral requests that were fully achieved improved from 57.4 to 77.8%, and referral requests that were not achieved decreased from 26.2 to 6.4%.Clinical implicationsThe IRAC component of the FROM-LP measures what it was developed for, and thus has clinical utility supporting its widespread adoption across liaison services in the National Health Service.Declaration of interestNone.

scholarly journals Liaison psychiatry services in Wales

2008 ◽  
Vol 32 (4) ◽  
pp. 134-136 ◽  
Author(s):  
Divya Sakhuja ◽  
Jonathan I. Bisson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Junior Doctor ◽  
Telephone Interview ◽  
Psychological Treatment ◽  
Clinical Psychologist ◽  
Clinical Implications ◽  
Full Time ◽  
Treatment Service ◽  
Liaison Psychiatry

Aims and MethodTo determine the nature of current liaison psychiatry services in Wales, a structured telephone interview was conducted with representatives of all 11 National Health Service trusts.ResultsThree trusts (27%) had no dedicated liaison psychiatry service and only one of the eight (13%) with a service had a full-time consultant liaison psychiatrist. Only two services (25%) had a full-time junior doctor and three (37%) were not multidisciplinary, comprising nursing staff alone. No team had a clinical psychologist and only two (25%) provided a psychological treatment service.Clinical ImplicationsLiaison psychiatry services across Wales are fragmented, under-resourced and unlikely to meet patients' needs. They fall well short of the recommendations of the Royal Colleges of Physicians and Psychiatrists.

Effect of recent changes to the Mental Health Act 1983 on sections and appeals: possible unintended consequences

2011 ◽  
Vol 35 (8) ◽  
pp. 305-307 ◽  
Author(s):  
Tom Walker-Tilley ◽  
Tim Exworthy ◽  
Martin Baggaley ◽  
Laura Wilkinson ◽  
Ramin Nilforooshan
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Unintended Consequences ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Before And After

Aims and methodWe examined the effect on civil sections and the rate of appeals against them of the amendments made to the Mental Health Act 1983 as a result of the Mental Health Act 2007. We gathered data for the year before and after the introduction of these changes.ResultsWe found increased use of Section 2 (56.8% before and 65.8% after (P < 0.001)) and decreased use of Section 3 (39.5% before and 31.2% after (P < 0.001)). The number of appeals against civil sections decreased (697 before and 692 after) but there was an 8.0% increase in the proportion of appeals to mental health tribunals. There was a decrease in admissions under these sections (817 before and 733 after).Clinical implicationsThese changes may be unintended consequences of the new law, resulting in increased workloads for psychiatrists and costs to the National Health Service.

scholarly journals Research productivity of staff in NHS mental health trusts: comparison using the Leiden method

2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Research Productivity ◽  
Social Care ◽  
Clinical Implications ◽  
Clinical Services ◽  
Health And Social Care

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

scholarly journals Postcode lottery? Hospital transfers from one London prison and responsible catchment area

2010 ◽  
Vol 34 (4) ◽  
pp. 140-142 ◽  
Author(s):  
Simon Wilson ◽  
Katrina Chiu ◽  
Janet Parrott ◽  
Andrew Forrester
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Catchment Area ◽  
Clinical Implications ◽  
Hospital Unit ◽  
Transfer Data ◽  
Hospital Transfer

Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.

Validation of the Security Needs Assessment Profile (SNAP) by a national survey of secure units in England

2012 ◽  
Vol 36 (10) ◽  
pp. 366-371 ◽  
Author(s):  
Steffan Davies ◽  
Mick Collins ◽  
Chris Ashwell
Keyword(s):  
Clinical Practice ◽  
National Health Service ◽  
Health Service ◽  
Needs Assessment ◽  
National Health ◽  
National Survey ◽  
Content Validity ◽  
Security Requirements ◽  
Clinical Implications

Aims and methodThe Security Needs Assessment Profile (SNAP) was developed to provide a detailed description of individual patient's security requirements in the then Trent Region of England. A national survey of secure units was undertaken to examine the content validity of the item structure of SNAP and revise the item definitions to reflect more broadly based clinical practice. A follow-up survey sought views on the usefulness of SNAP in clinical practice.ResultsThirty-five secure units from National Health Service and independent sector providers participated. No new security items were generated. All the item definitions were reviewed, many amended, and a small number revised extensively. Units' security profiles were rated on the original and revised instruments.Clinical implicationsThe revised SNAP has been shown to be generalisable across secure services in England; 92% of respondents agreed or strongly agreed that SNAP would be useful in providing a structured security needs assessment.

Routine Outcome Measurement in a Child and Adolescent Mental Health Service: An Evaluation of HoNOSCA

2001 ◽  
Vol 35 (3) ◽  
pp. 370-376 ◽  
Author(s):  
Peter Brann ◽  
Grahame Coleman ◽  
Ernest Luk
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Interrater Reliability ◽  
Outcome Measurement ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Good Reliability ◽  
Routine Outcome Measurement ◽  
Adolescent Mental Health Service

Objective: This paper evaluates a range of properties for a clinician-based instrument designed for routine use in a child and adolescent mental health service (CAMHS). Method: The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a new outcome measure with great promise. Case vignettes were used to examine interrater reliability. HoNOSCA was implemented for routine outpatient use by multidisciplinary staff with a return rate of 84%. The 305 ratings obtained at assessment were analysed by age, gender and diagnosis. Asample of 145 paired ratings with a 3-month interval were examined for the measurement of change over time. Results: Interrater reliability of the total score indicates moderate reliability if absolute scores are used and good reliability if the total score is used for relative comparisons. Most scales have good to very good reliability. The scales discriminated between age and gender in the expected way. HoNOSCA correlated with clinicians’ views of change and was sensitive to change over a 3-month period. The total score seemed a proxy for severity. Conclusion: Routine outcome instruments must be explored in settings where they will be used and with realistic training. HoNOSCA appears to be of value in routine outcome measurement and although questions remain about reliability and validity, the results strongly support further investigation.

scholarly journals Uncertainty among Scottish psychiatrists over NHS continuing care guidance

2009 ◽  
Vol 33 (10) ◽  
pp. 381-383
Author(s):  
Gary S. Stevenson ◽  
Agnieszka Philipson ◽  
Gordon McLaren
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Strong Association ◽  
Postal Questionnaire ◽  
Previous Experience ◽  
Continuing Care ◽  
Clinical Implications ◽  
The South

Aims and MethodTo examine knowledge among Scottish psychiatrists of the 1996 guidance on National Health Service (NHS) responsibility for continuing healthcare, a postal questionnaire was devised and sent to the 132 consultants and specialist registrars in the South-East Scotland Deanery in May 2007.ResultsTwo-thirds of the clinicians (67%, n= 88) responded, 88% of whom had in-patient responsibilities. Only 24% responded positively to an awareness of the current Scottish guidance. There was a strong association between awareness of the guidance and psychiatric speciality, and greater awareness among clinicians with previous experience of a relevant complaint or appeal.Clinical ImplicationsUncertainty about NHS continuing healthcare guidance among practising psychiatrists suggests a need for increased awareness of the issues, with training implications for the new guidance on NHS continuing healthcare in Scotland which became effective in February 2008.

scholarly journals Trainees' views of portfolios in psychiatry

2012 ◽  
Vol 36 (11) ◽  
pp. 427-433 ◽  
Author(s):  
Neel Halder ◽  
Ganesh Subramanian ◽  
Damien Longson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Reflective Practice ◽  
National Health ◽  
Annual Review ◽  
Clinical Implications ◽  
Weekly Basis ◽  
Careful Planning ◽  
Educational Tools ◽  
And Training

Aims and methodPortfolios are now used extensively within the field of psychiatry and our aim was to obtain trainees' feedback on their value. We used a questionnaire to evaluated trainees' priorities, what educational tools they found most helpful, how much time trainees spent on preparing their portfolios and the best and worst aspects of the portfolios.ResultsThe survey was completed by 207 out of 228 trainees (90.8%). The majority (58.4%) rated ‘Passing the ARCP [Annual Review of Competence Progression]’ as their top priority. More trainees found benefit from the feedback of workplace-based assessments (33.3%) than the ratings given (24.1%). Time spent on portfolios on a weekly basis ranged from 5 min to 12 h (the most common answer was 1–2 h). A total of 50.7% felt they did not have enough time to spend on their portfolios. Many found it encouraged reflective practice, but wanted more training for both trainees and trainers on how to use them properly.Clinical implicationsThe expansion of portfolios within the changing National Health Service requires careful planning and training, and perhaps some allocated time to complete them, so that trainees can derive the maximum benefits from the portfolio's intended purpose.

scholarly journals A suitable waiting room? Hospital transfer outcomes and delays from two London prisons

2009 ◽  
Vol 33 (11) ◽  
pp. 409-412 ◽  
Author(s):  
Andrew Forrester ◽  
Christopher Henderson ◽  
Simon Wilson ◽  
Ian Cumming ◽  
Miriam Spyrou ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Clinical Implications ◽  
Waiting Room ◽  
Total Saving ◽  
Hospital Transfer ◽  
Clinical Records ◽  
Timely Treatment

Aims and MethodTo describe a group of prisoners who required transfer to mental health units from two London prisons. Data were collected from prison clinical records.ResultsOverall, 149 patient-prisoners were transferred over a 17-month period. Around a quarter were not previously known to services. the aggregate wait was 36.5 years (averaging between 93 and 102 days per prisoner) and the total saving to the National Health Service (NHS) has been estimated at £6.759 million.Clinical ImplicationsBoth prisons manage a large number of prisoners with untreated psychosis. While in prison, they save the NHS considerable sums of money, but transfer delays prevent timely treatment and could now be legally challenged.

scholarly journals Comparison of liaison psychiatry service models for older patients

2004 ◽  
Vol 28 (5) ◽  
pp. 171-173 ◽  
Author(s):  
Fedza Mujic ◽  
Charlotte Hanlon ◽  
Danny Sullivan ◽  
Gina Waters ◽  
Martin Prince
Keyword(s):  
Older Patients ◽  
Waiting Times ◽  
Psychiatric Services ◽  
Case Mix ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Speed Of Response ◽  
Service Models ◽  
Before And After ◽  
Consultation Model

Aims and MethodAt a London teaching hospital, the existing off-site consultation model psychiatric liaison service for older people was replaced with an on-site liaison model service in December 2000. Several indicators of the functioning of the service were audited using identical methods before and after this change.ResultsThe case-load increased by 50%, but the liaison psychiatrists were more satisfied with the appropriateness of referrals. The case mix did not change. The new service achieved target waiting times more consistently, particularly for urgent referrals. Referring teams were more satisfied with the speed of response, while the new service maintained the salience and clarity of advice.Clinical ImplicationsFindings are on the whole favourable, and support the wider introduction of specialist old-age liaison psychiatric services.

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