Referral criteria

            Referral Criteria for Clinical Health Psychological Services 2014

Lindsay Royan: Consultant Clinical Psychologist, Professional Lead for Clinical Health Psychological Services and Head of Adult Psychological Services (Barking & Dagenham), NELFT

Marc Kingsley: Consultant Clinical Psychologist, Care Pathway Lead for Clinical Health Psychological Services, NELFT.

The Clinical Health Psychological Service at NELFT is a psychological service at NELFT, with the aim of promoting the assessment and treatment of patients aged 18 and above who present with psychological distress and impairment as a result of a physical health condition. Currently, as we are not a full service, our referral criteria are set out below, covering the following areas:

Havering

  • Cancer - Patients with a diagnosis of cancer who are receiving treatment from BHRUT (Queens or King George Hospitals)
  • Cardiac Rehab - Patients attending the cardiac rehab programme at Queens Hospital, BHRUT.
  • Sickle Cell disease, Thalassemia and related conditions - Patients and families living with sickle cell and thalassemia related conditions receiving treatment at from BHRUT Haematology Service.
  • Limb Loss - Patients who are referred to the Long Term Conditions Centre, Harold Wood, for psychological support with adjustment to limb loss, and not under secondary mental health services.
  • Maternity & Gynaecology: Patients attending maternity and gynaecology services at BHRUT (Queens and KGH).

NELFT has not yet been commissioned to offer community clinical health psychological provision to long- term health conditions in Havering.

Redbridge:

  • Cancer - Patients with a diagnosis of cancer who are receiving treatment from BHRUT (Queens or King George Hospitals).
  • Cardiac Rehab - Patients attending the cardiac rehab programme at Queens Hospital, BHRUT.
  • Sickle Cell disease, Thalassaemia and related conditions - Patients and families living with sickle cell and thalassaemia related conditions receiving treatment at from BHRUT Haematology Service.
  • Limb Loss - Patients who are referred to the Long Term Conditions Centre, Harold Wood, for psychological support with adjustment to limb loss, and who are not under secondary mental health services.
  • Maxillo-facial - Patients who have been referred to Whipps Cross Oral Surgery/ Orthodontics  team (Maxillofacial surgery) for psychological support with orthognatic treatment, and who are not under secondary mental health services.
  • Maternity& Gynaecology: Patients attending maternity and gynaecology services at BHRUT (Queens and KGH).

NELFT has not yet been commissioned to offer community clinical health psychological provision to long- term health conditions in Redbridge.

Barking and Dagenham

  • Cancer - Patients with a diagnosis of cancer who are receiving treatment from BHRUT (Queens or King George Hospitals).
  • Cardiac Rehab - Patients attending the cardiac rehab programme at Queens Hospital, BHRUT.
  • Sickle Cell, Thalassemia and related conditions - Patients and families living with sickle cell and thalassemia related conditions receiving treatment at from BHRUT Haematology Service.
  • COPD – Patients attending the COPD services and presenting with depression, anxiety and psychological distress as a result of their condition
  • Coronary Heart Disease (CHD) - Patients attending the CHD services and presenting with depression, anxiety and psychological distress as a result of their condition
  • Diabetes – Patients attending the diabetes services and presenting with depression, anxiety and psychological distress as a result of their condition
  • Limb Loss - Patients who are referred to the Long Term Conditions Centre, Harold Wood, for psychological support with adjustment to limb loss, and who are not under secondary mental health services
  • Maternity& Gynaecology: Patients attending maternity and gynaecology services at BHRUT (Queens and KGH)

Waltham Forest

  • Cancer - Patients with a diagnosis of cancer who are receiving active treatment and those with a palliative diagnosis from the Haematology team at the Day Centre (Whipps Cross Hospital, Barts University Trust) but not under the care of the Margaret Centre (hospice). 
  • Limb Loss - Patients who are referred to the Long Term Conditions Centre, Harold Wood, for psychological support with adjustment to limb loss, and who are not under secondary mental health services.
  • General - Depression, anxiety and psychological distress as presenting difficulties directly related to a physical health condition.
  • Maxillofacial - Patients who have been referred to the Oral Surgery/ Orthodontics  team (Maxillofacial surgery)at Barts University Trust (Whipps Cross Hospital) for psychological support with orthognatic treatment, and who are not under secondary mental health services.
  • Long Term Conditions – Patients under the care of the ICM service with mild-moderate psychological distress.
  • Pain - There are a number of specialist services that offer specialist input from a multi-disciplinary team to help clients learn how to cope and live with chronic pain and clients should initially be considered for referral to these specialist services.  Referral to pain management programmes are to be made by the GP. 

Brentwood, Basildon and Thurrock

  • Cancer - Patients and carers with a diagnosis of cancer who are receiving treatment from BHRUT (Queens or King George Hospitals)
  • Limb Loss - Patients and carers who are referred to the Long Term Conditions Centre, Harold Wood, for psychological support with adjustment to limb loss, and who are not under secondary mental health services.
  • Maternity& Gynaecology: Patients attending maternity and gynaecology services at BHRUT (Queens and KGH).
  • Consultation - Psychological Consultation to non-psychological staff in the form of away days, and specific clinical health psychological training sessions.

Exclusion Criteria

  • Patients who have drug and/or alcohol problems should be referred to specialist drug and alcohol services such as the Community Drugs and Alcohol team (CDAT).
  • Patients who have an existing secondary mental health condition, in combination with a long term physical health condition/s, are referred to their secondary mental health psychology service, to ensure that their treatment is maintained within the containment of the broader mental health service.  This includes those patients at acute risk of suicide and/or self-harm.
  • This is also the case where there is a concomitant physical health problem, but is not a triggering or maintaining factor in the primary mental health condition.

Links with other services

Links with Eating Disorder Service

Patients, whose psychological distress is clearly lined to a diagnosed eating disorder, should be referred to the Trust’s Eating Disorder Service.

Links with Adult Cognitive Disorders Service

We are open to a discussion regarding patients who have psychological distress as a consequence of a neurological condition. Such referrals, however, would need to be considered on an individual case basis. The specialist adult cognitive disorders service would best undertake initial neuropsychological testing at NELFT prior to a referral into the clinical health psychology service. The Trust’s Memory Services are currently commissioned to see people with neuro-degenerative conditions only.

Links with IAPT Services

IAPT provides psychological input to clients with long term physical health conditions (diabetes; COPD; CHD), medically unexplained symptoms (MUS), and chronic pain and depression or anxiety.

Clients can be transferred between IAPT and specialist clinical health psychological services depending on where their needs can best be met.  This can be decided on a case- by -case discussion.  Either service may refer the client on to secondary care mental health services if their needs can better be met there.

Link Working/Signposting:

We are willing to discuss cases with mental health colleagues, in terms of consultation and feedback. We have dedicated one hour per month to each area, where a clinical health psychological therapist will be available to offer consultation and support to staff working within IAPT and secondary care psychological services.