scholarly journals A survey of liaison psychiatry services in general hospitals and accident and emergency departments: do we have the balance right?

2006 ◽  
Vol 30 (7) ◽  
pp. 260-263 ◽  
Author(s):  
Tamsin Kewley ◽  
Jim Bolton
Keyword(s):  
Service Provision ◽  
Telephone Survey ◽  
Working Hours ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Accident And Emergency ◽  
Hospital Patients ◽  
Crisis Services ◽  
Patient Groups

Aims and MethodBy use of a telephone survey, we aimed to investigate liaison psychiatry services of all 29 general hospitals in Greater London. We specifically enquired about services to accident and emergency (A&E) departments.ResultsWe identified wide variations in staffing, working hours and patient groups seen. Fourteen services (48%) worked over 24 h and 4 (14%) had specific A&E teams. Twelve services (41%) had established or planned working links with community crisis services.Clinical ImplicationsGenerally staff numbers fell below national recommendations and there were frequent gaps in service provision. The recent focus on emergency care has lead to an increase in A&E services, but there is a risk that liaison psychiatry services for other general hospital patients are being neglected.

scholarly journals London's liaison psychiatry services: survey of service provision

2015 ◽  
Vol 39 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Smitha Naidu ◽  
Jim Bolton ◽  
Jared Smith
Keyword(s):  
Service Provision ◽  
Service Development ◽  
Clinical Implications ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Staffing Levels ◽  
Similar Survey ◽  
Service Policy ◽  
The Cost

Aims and methodTo describe the liaison psychiatry services of all 30 general hospitals in Greater London and to determine whether services met national recommendations. The results were compared with a similar survey conducted 8 years previously to determine whether there had been significant service development.ResultsWe identified wide variations in service provision across London. Fifteen hospitals (50%) had 24-hour services and one had no service. There had been a significant increase in services that assessed older adults. Increases in the size of teams and consultant psychiatry staff were not significant.Clinical implicationsDespite an increasing emphasis on the effectiveness of liaison psychiatry services, no London hospital had staffing levels consistent with national recommendations. Recent evidence for the cost-effectiveness of liaison psychiatry and an emphasis on parity between physical and mental health in National Health Service policy may provide further impetus for growth.

P02-270 “Education, education, education-” adult liaison psychiatry (consultation-liaison): Can service development fulfil educational needs?

2011 ◽  
Vol 26 (S2) ◽  
pp. 866-866
Author(s):  
Y. Abbasi ◽  
A. Pang ◽  
S. Vishwanath ◽  
S. Sarkar ◽  
M. Broadhurst ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Service Provision ◽  
Substance Misuse ◽  
Working Hours ◽  
Educational Needs ◽  
Service Development ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Educational Value ◽  
Set Up

IntroductionLiaison Psychiatry is primarily concerned with the detection and treatment of psychiatric disorders within the general hospitals. 1A study2 also highlighted the presence of only 45.5 core trainee posts in this speciality nationally.Aims & objectiveTo survey the liaison psychiatry service recently set up as a service provision at a psychiatry unit in North Derbyshire.MethodsWe retrospectively reviewed all case notes of patients who had been assessed from January 2007 to June 2009 by the consultation-liaison service.ResultsA total of 136 patients had been assessed since this service began in September 2007. Majority of the patients (72%) were between the ages of 31 to 65 years, while the gender was equally distributed. 51% were referred from the medical ward and most of them had been referred by core trainee. 95% of the referral was during working hours and 74% of the patients were assessed within 24 hours. Their diagnosis was variable, for e.g. 29% had depression, 19% had substance misuse problems, 8% had psychosis etc. 66% of patients were managed by medication advice, psycho-education and referral to CMHT/GP.ConclusionsLiaison psychiatry was established for service provision, but it is apparent that it fulfilled both clinical and educational needs, despite the challenges. Adequate experience can be gained with a well supervised service. The overall educational value of designing and implementing a new service as a trainee cannot be overstated; it is something which is difficult to learn in classrooms.

scholarly journals Liaison psychiatry in Scotland: the present service

1989 ◽  
Vol 13 (11) ◽  
pp. 606-608 ◽  
Author(s):  
Helen M. Anderson
Keyword(s):  
Interest Group ◽  
Royal College ◽  
Special Interest ◽  
Service Provision ◽  
Clinical Impact ◽  
Level Of Service ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Ongoing Research ◽  
Set Up

The term ‘liaison psychiatry’ is becoming increasingly popular. Indeed, the Royal College of Psychiatrists has set up a special interest group, the Liaison Psychiatry Group, which has a growing membership. There appear to be developments in training and in service provision but it is difficult to assess their clinical impact. Ongoing research is required to quantify the actual level of service provided to general hospitals.

scholarly journals Liaison psychiatry services in Wales

2018 ◽  
Vol 43 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Tayyeb A. Tahir ◽  
Adam Watkins ◽  
Philip Slack ◽  
Phil Chick ◽  
William Lee ◽  
...  
Keyword(s):  
Public Health ◽  
Service Provision ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Systematic Data ◽  
Staffing Levels ◽  
The Past ◽  
Set Up ◽  
Systematic Data Collection ◽  
Health Boards

Aims and methodRecent funding from Welsh Government for mental health has helped to develop liaison psychiatry services in Wales. Systematic data collection was undertaken to map the liaison psychiatry services in Wales in collaboration with the Royal College of Psychiatrists in Wales and Public Health Wales 1000 Lives Improvement. A questionnaire was designed and circulated to all the health boards in Wales to gather information to map liaison psychiatry services in Wales. Up-to-date information was confirmed in January 2018, via email.ResultsOver the past 2 years, liaison psychiatry services have been set up in six out of seven health boards in Wales. Staffing levels have increased and the remit of services has broadened.Clinical implicationsMapping has highlighted that liaison psychiatry services in Wales continue to evolve. It will be important to continue to monitor these developments and their effects. Comparison with services in England will provide a useful comparison of service provision. A particular challenge will be to establish and monitor liaison psychiatry standards in Wales.Declaration of interestNone.

A survey of liaison psychiatry services in the south-west of England

2003 ◽  
Vol 27 (3) ◽  
pp. 90-92 ◽  
Author(s):  
Alison Howe ◽  
Julie Hendry ◽  
John Potokar
Keyword(s):  
Mental Health ◽  
Unmet Need ◽  
Postal Survey ◽  
Clinical Implications ◽  
The South ◽  
Liaison Psychiatry ◽  
South West ◽  
Accident And Emergency ◽  
Self Harm ◽  
Clinical Directors

Aims and MethodA postal survey was conducted to establish an overview of liaison psychiatry services in the south-west of England. Questionnaires were sent to all clinical directors of medicine, accident and emergency, and mental health in trusts which provide acute medical services.ResultsThirty-six questionnaires were returned (77%), covering 17 out of 18 trusts providing acute services. Five trusts (28%) have a comprehensive dedicated liaison psychiatry service. A further six trusts (33%) have a service for deliberate self-harm only. Many respondents were critical of what they perceived to be an inadequate service. Five trusts had introduced a service in the 12 months preceding the survey.Clinical ImplicationsAn unmet need for liaison psychiatry services is clearly perceived across the south-west of England.

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 A survey of liaison psychiatry services in the south-west of England

2003 ◽  
Vol 27 (03) ◽  
pp. 90-92
Author(s):  
Alison Howe ◽  
Julie Hendry ◽  
John Potokar
Keyword(s):  
Mental Health ◽  
Unmet Need ◽  
Postal Survey ◽  
Clinical Implications ◽  
The South ◽  
Liaison Psychiatry ◽  
South West ◽  
Accident And Emergency ◽  
Self Harm ◽  
Clinical Directors

Aims and Method A postal survey was conducted to establish an overview of liaison psychiatry services in the south-west of England. Questionnaires were sent to all clinical directors of medicine, accident and emergency, and mental health in trusts which provide acute medical services. Results Thirty-six questionnaires were returned (77%), covering 17 out of 18 trusts providing acute services. Five trusts (28%) have a comprehensive dedicated liaison psychiatry service. A further six trusts (33%) have a service for deliberate self-harm only. Many respondents were critical of what they perceived to be an inadequate service. Five trusts had introduced a service in the 12 months preceding the survey. Clinical Implications An unmet need for liaison psychiatry services is clearly perceived across the south-west of England.

scholarly journals Providing a liaison psychiatry service in the absence of a consultant liaison psychiatrist

2008 ◽  
Vol 32 (8) ◽  
pp. 295-298
Author(s):  
Claire Flahavan ◽  
Claire Flahavan
Keyword(s):  
Service Delivery ◽  
Service Provision ◽  
Substance Misuse ◽  
Clinical Implications ◽  
Liaison Psychiatry ◽  
Local Hospital ◽  
Consultation Service ◽  
Affective Symptoms ◽  
Self Harm ◽  
Referring Physicians

Aims and MethodLiaison psychiatry services in Ireland are currently unequally distributed. In the absence of a specialist liaison psychiatry team, general adult psychiatrists may provide a consultation service to their local hospital. Demographic and clinical characteristics pertaining to all psychiatric consultations at the Louth County Hospital were collected over 12 months to examine one such local service and to highlight the challenges of this mode of service delivery.ResultsA total of 232 consults were audited. the most frequent reasons for referral were assessment following deliberate self-harm (38%), affective symptoms (28%) and alcohol or substance misuse (25%). This differs from documented referral patterns to specialist liaison teams. Referring physicians had a low diagnostic ‘hit-rate’ with respect to affective disorders. Difficulties in service provision included poor communication by referring teams and time constraints due to other sectoral commitments.Clinical ImplicationsRefinements to service delivery may be beneficial in managing the workload more effectively. Priority should be placed on fostering communication with non-psychiatric colleagues.

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

scholarly journals Liaison psychiatry services in south England

2010 ◽  
Vol 34 (7) ◽  
pp. 270-273 ◽  
Author(s):  
Jackie Gordon ◽  
Sonia Wolf
Keyword(s):  
Royal College ◽  
Full Time ◽  
The South ◽  
Liaison Psychiatry ◽  
Hospital Size ◽  
Staffing Levels ◽  
The Past ◽  
Patient Groups ◽  
The Uk ◽  
And Function

Aims and methodTo investigate liaison psychiatry services across 38 acute trusts in the south of England. We used a telephone survey and compared the results to service structure and function as recommended by the Royal College of Physicians and the Royal College of Psychiatrists.ResultsApproximately two-thirds of trusts surveyed had a dedicated liaison service and this was not significantly related to hospital size. Most liaison teams were understaffed in all disciplines and only a third had a full-time consultant. Services for specialist patient groups were generally well provided for; 37% of teams had been created in the past 5 years and 33% were planning to increase their staffing levels in future.Clinical implicationsLiaison services in the south of England are similar to those in other parts of the UK that have been surveyed. Although the services did not meet the Colleges' recommendations, our study shows some recent growth and development in this specialty.

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