scholarly journals A history of liaison psychiatry in the UK

2016 ◽  
Vol 40 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Peter Aitken ◽  
Geoffrey Lloyd ◽  
Richard Mayou ◽  
Christopher Bass ◽  
Michael Sharpe
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Psychological Needs ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
International Collaborations ◽  
Hospital Patients ◽  
History Of ◽  
The Uk ◽  
Improving Patient Care

Aims and methodTo record the development of liaison psychiatry in the UK and to summarise the current levels of activity. We also highlight the challenges the specialty may face if it is to develop further. History since the 1970s is reviewed by early pioneers and those involved in the present day, with a focus on the key role played by members of the Royal College of Psychiatrists.ResultsWe describe the development of training guidelines, the publication of joint documents with other Royal Colleges, establishing international collaborations and defining service specifications. We emphasise the importance of collaboration with other medical organisations, and describe successes and pitfalls.Clinical implicationsMuch has been achieved but challenges remain. Liaison psychiatry has a potentially important role in improving patient care. It needs to adapt to the requirements of the current National Health Service, marshal evidence for cost-effectiveness and persuade healthcare commissioners to fund services that are appropriate for the psychological needs of general hospital patients.

scholarly journals Cost-Effectiveness of Complementary Therapies in the United Kingdom—A Systematic Review†

2006 ◽  
Vol 3 (4) ◽  
pp. 425-432 ◽  
Author(s):  
Peter H. Canter ◽  
Joanna Thompson Coon ◽  
Edzard Ernst
Keyword(s):  
Back Pain ◽  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
Spinal Manipulation ◽  
Conventional Treatment ◽  
Complementary Therapies ◽  
Complementary Therapy ◽  
The Uk ◽  
Effectiveness Studies

Objectives: The aim of this review is to systematically summarize and assess all prospective, controlled, cost-effectiveness studies of complementary therapies carried out in the UK.Data sources: Medline (via PubMed), Embase, CINAHL, Amed (Alternative and Allied Medicine Database, British Library Medical Information Centre), The Cochrane Library, National Health Service Economic Evaluation Database (via Cochrane) and Health Technology Assessments up to October 2005.Review methods: Articles describing prospective, controlled, cost-effectiveness studies of any type of complementary therapy for any medical condition carried out in the UK were included. Data extracted included the main outcomes for health benefit and cost. These data were extracted independently by two authors, described narratively and also presented as a table.Results: Six cost-effectiveness studies of complementary medicine in the UK were identified: four different types of spinal manipulation for back pain, one type of acupuncture for chronic headache and one type of acupuncture for chronic back pain. Four of the six studies compared the complementary therapy with usual conventional treatment in pragmatic, randomized clinical trials without sham or placebo arms. Main outcome measures of effectiveness favored the complementary therapies but in the case of spinal manipulation (four studies) and acupuncture (one study) for back pain, effect sizes were small and of uncertain clinical relevance. The same four studies included a cost-utility analyses in which the incremental cost per quality adjusted life year (QALY) was less than £10 000. The complementary therapy represented an additional health care cost in five of the six studies.Conclusions: Prospective, controlled, cost-effectiveness studies of complementary therapies have been carried out in the UK only for spinal manipulation (four studies) and acupuncture (two studies). The limited data available indicate that the use of these therapies usually represents an additional cost to conventional treatment. Estimates of the incremental cost of achieving improvements in quality of life compare favorably with other treatments approved for use in the National Health Service. Because the specific efficacy of the complementary therapies for these indications remains uncertain, and the studies did not include sham controls, the estimates obtained may represent the cost-effectiveness non-specific effects associated with the complementary therapies.

Adolescent Psychiatry Services

1995 ◽  
Vol 166 (3) ◽  
pp. 306-310 ◽  
Author(s):  
Tony Jaffa
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Adolescent Psychiatry ◽  
Clinical Care ◽  
Psychiatric Services ◽  
High Quality ◽  
History Of ◽  
The Uk ◽  
The Way

BackgroundThe way in which psychiatric services for adolescents in the UK are developing will be affected by recent changes in the organisation of the National Health Service.MethodThe history of these services, and the different opportunities for development are reviewed.ResultsWays in which high-quality clinical care can still be provided are indicated.ConclusionAdolescent psychiatric services should be judged on their ability to provide such care, not merely on their ability to survive.

scholarly journals Liaison psychiatry or psychological medicine?

2003 ◽  
Vol 183 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Geoffrey G. Lloyd ◽  
Richard A. Mayou
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Liaison Psychiatry ◽  
Hospital Patients ◽  
Psychological Medicine ◽  
Substantial Progress ◽  
Delivery Of Medical Care ◽  
The Uk ◽  
Psychiatric Profession ◽  
Behavioural Aspects

Liaison psychiatry has been recognised in many countries as a special interest or sub-speciality of psychiatry concerned with the management of general hospital patients with psychological problems. However, despite increasing awareness of the emotional and behavioural aspects of illness, it has yet to achieve substantial influence within psychiatry and, more importantly, has had only modest effects on the delivery of medical care by physicians and other specialists. Recognition of its potential by planners and commissioners has been disappointing. Regrettably, in the UK and elsewhere, recent changes in the organisation of health care could hinder its development. This paper argues that in order to make substantial progress there is a compelling need to solve a fundamental obstacle – the separation between psychiatric and general medical care. This requires:(a) convincing the psychiatric profession that consultation-liaison is a distinct sub-speciality;(b) continuing efforts by liaison psychiatrists to define their special expertise and to demonstrate that their services are effective and acceptable to medical colleagues and to patients;(c) persuading those who organise health care that liaison psychiatry services need to be provided and administered as an integral component of comprehensive medical care.

scholarly journals The Manchester advanced course in liaison psychiatry

1996 ◽  
Vol 20 (12) ◽  
pp. 736-737
Author(s):  
Alison Puffett ◽  
Bill Williams
Keyword(s):  
Training Programme ◽  
Management Skills ◽  
Case Discussion ◽  
Liaison Psychiatry ◽  
Hospital Patients ◽  
Specialist Knowledge ◽  
The Uk ◽  
Supervision And Training ◽  
Training Opportunities ◽  
And Training

Liaison psychiatry is a relatively new and expanding speciality in the UK. A survey conducted in 1990 revealed widespread inadequacies in the training opportunities and resources in consultation liaison services (Mayou et al, 1990). In spite of a growing recognition of the need for more consultants with designated responsibility for general hospital patients, there is currently no formal training programme and many psychiatric schemes fail to provide satisfactory supervision and training opportunities in liaison psychiatry (House & Creed, 1993). The Manchester University liaison psychiatry course was developed in 1993 and is currently the only advanced liaison training course in the UK. Lasting five days, it provides an opportunity for senior psychiatric trainees to improve their specialist knowledge and to develop clinical, research and management skills in liaison psychiatry. The course does not give a comprehensive review of all aspects of liaison psychiatry but aims to generate ideas and discussion through skills based seminars, case discussion and workshop exercises.

Cost-effectiveness of Coblation compared with cold steel tonsillectomies in the UK

2018 ◽  
Vol 132 (12) ◽  
pp. 1119-1127 ◽  
Author(s):  
J F Guest ◽  
K Rana ◽  
C Hopkins
Keyword(s):  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
Clinical Outcomes ◽  
National Health ◽  
Cost Effective ◽  
Case Scenario ◽  
Paediatric Patients ◽  
The Uk ◽  
The Cost

AbstractObjectiveThis study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.MethodDecision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.ResultsUsing a cold steel procedure instead of Coblation is expected to generate an incremental cost of more than £2000 for each additional avoided haemorrhage, and the probability of cold steel being cost-effective was approximately 0.50. Therefore, the cost-effectiveness of the two techniques was comparable. When the published clinical outcomes were replaced with clinicians’ estimates of current practice, Coblation was found to improve outcome for less cost, and the probability of Coblation being cost-effective was at least 0.70.ConclusionA best-case scenario suggests Coblation affords the National Health Service a cost-effective intervention for tonsillectomy in adult and paediatric patients compared with cold steel procedures. A worst-case scenario suggests Coblation affords the National Health Service an equivalent cost-effective intervention for adult and paediatric patients.

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.

Sign in / Sign up

Export Citation Format

Share Document