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Liaison services - collaborative working

General Adult Psychiatry, New Bridge House, 130 Hobmoor Road, Birmingham B10 9JH, email gmashil{at}yahoo.co.uk

Dhruba Bagchi, Consultant in Liaison Psychiatry

New Bridge House, Birmingham

We read with interest Kewley & Bolton’s survey on liaison psychiatry (Psychiatric Bulletin, July 2006, 30, 260-263) and the related correspondence of Pitman & Catalán (Psychiatric Bulletin, January 2007, 31, 33). In the wake of threats to close or merge liaison service with crisis resolution teams, it is imperative not to compromise patient care. The liaison psychiatry service in Birmingham Heartlands Hospital has developed a way of working to adhere to the time targets in accident and emergency (A & E) departments which neither compromises psychosocial assessment (National Institute for Clinical Excellence, 2004) nor overburdens the existing psychiatric services.

The protocol for psychiatric assessment is based on the SAD PERSONS scale (Juhnke, 1994) and has been devised in consultation with the A & E department. The A & E department is responsible for initiating the psychosocial assessment and classifying patients either as high or low priority, based on needs and risks. The majority of psychiatric patients attending A & E departments out of hours are needing assessment and treatment for self-harm. The patients who are deemed high priority are referred to the local crisis resolution teams for emergency assessment. Low-priority patients are referred after medical assessment to the psychiatry clinic in the A & E department on the next working day. This efficient collaboration reduces the number of ‘did not wait’ patients and possibly avoids breaching A & E waiting time targets.

In a 6-month period, 46% of psychiatric patients attending the A & E department out of hours have been referred to the clinic. If this way of collaborative working can be adapted to meet local hospital needs, it might address some of the concerns raised by Kewley & Bolton.

References

JUHNKE, G. (1994) SAD PERSONS Scale review. Measurement and evaluation. Counselling and Development, 27, 325 -327.

NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (2004) Self-Harm. The Short-Term Physical and Psychological Management and Secondary Prevention of Self-Harm in Primary and Secondary Care. NICE. http://www.nice.org.uk/pdf/CG016NICEguideline.pdf

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Masil, S. Articles by Bagchi, D. Search for Related Content PubMed Articles by Masil, S. Articles by Bagchi, D.