A Cavendish Square Group publication 17 “ We are all delighted to have the support of the liaison psychiatry service. Our world is much better now that you are here. ” Recent experience in North West London has demonstrated the importance of liaison psychiatry. Provision in the sector had been patchy, with well-resourced liaison psychiatry teams providing round the clock cover at the centrally located Chelsea and Westminster and St Mary’s hospitals in stark contrast to three hospitals in the outer boroughs of Hillingdon, Northwick Park and Central Middlesex who were reliant on visiting crisis teams. With acute Trusts facing cost pressures, NHS North West London commissioned Central and North West London Foundation Trust to develop new liaison psychiatry services and support the achievement of waiting time targets -particularly the four-hour maximum wait in emergency departments. To measure performance, the teams were set three initial targets: people presenting symptoms of mental ill-health at A&E were to be seen within one hour of referral; mental health-related breaches of the emergency department four-hour target were to be cut; and all people aged 65 and over referred to liaison psychiatry were to have a medicines review. The results were encouraging. All of the sites involved in the programme met the target response time of one hour in A&E and breaches of the four hour target dropped by 221 over six months. An interim analysis of the impact on acute length of stay, comparing admissions before and after the start of the project, suggests that on average patients with a mental health diagnosis spent 1.3 days less in hospital. Fewer people also returned to the emergency department, in a positive downward trend. In one example, a patient who had attended Hillingdon Hospital A&E 21 times in four months, presented just twice more after an intervention by the liaison psychiatry service. The third outcome measure − requiring a review of medicines for older adults − reflects concerns about prescribing antipsychotic drugs to people with dementia. It is estimated that two thirds of prescriptions are inappropriate. This is a cause for concern, given the potential side effects and the additional mortality risk due to stroke. In addition to the success of new services in hitting their targets, they have been enthusiastically supported by acute hospital staff and managers. Professor Rory Shaw, Medical Director at the North West London Hospitals Trust, said: “We are all delighted to have the support of the liaison psychiatry service. Our world is much better now that you are here.” This view is supported by Maeve O’Callaghan-Harrington, Deputy Director of Operations, who said that “The psychiatric liaison team is crucial to my role as head of site operations and I feel strongly that our patient journey has improved greatly through this enhanced service.”
London Mental Health Fact Bbook
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