1 shaping a new mental health liaison service for older people colin hughes consultant nurse - older...
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Shaping a new mental health liaison service for older
people
Colin HughesColin HughesConsultant Nurse - Older Consultant Nurse - Older People (Mental Health)People (Mental Health)
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Chesterfield Royal Hospital NHS
Foundation Trust:549 acute beds
Walton Hospital Derbyshire County
PCT:94 rehabilitation and
acute admission avoidance beds
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Do the Do the
‘‘Who Cares Wins’Who Cares Wins’ calculation:calculation:
120 will have depression120 will have depression
84 will have delirium 84 will have delirium 130 will have dementia 130 will have dementia
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No. ward referrals per year
162 171187 194
183
110 103 97 87 8465
76 81 90
66
0
50
100
150
200
250
1.11.00-31.10.01
1.11.01-31.10.02
1.11.02-31.10.03
1.11.03-31.10.04
1.11.04-31.10.05
CRHFT
Walton
Other
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The set upThe set up CN works in partnership as a team with the CN works in partnership as a team with the
medical psychiatric staff (Dr Sykes, Dr medical psychiatric staff (Dr Sykes, Dr Whittingham and Dr George) of Derbyshire Whittingham and Dr George) of Derbyshire Mental Health Services NHS TrustMental Health Services NHS Trust
single point of entry for liaison referrals to single point of entry for liaison referrals to an enhanced service (the psychiatrists’ an enhanced service (the psychiatrists’ office)office)
CN leads change:CN leads change: consultation to liaisonconsultation to liaison
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No. ward referrals to old and new service
173
70
243
273
95
368
0
50
100
150
200
250
300
350
400
CRHFT Walton CRHFT/Walton
1.6.04-31.5.05
1.7.05-31.6.06
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Number of ward referrals from CRH/Walton per monthJune 2004-December 2006
0
5
10
15
20
25
30
35
40
45
50
Jun-
04
Jul-0
4
Aug
-04
Sep
-04
Oct
-04
Nov
-04
Dec
-04
Jan-
05
Feb
-05
Mar
-05
Apr
-05
May
-05
Jun-
05
Jul-0
5
Aug
-05
Sep
-05
Oct
-05
Nov
-05
Dec
-05
Jan-
06
Feb
-06
Mar
-06
Apr
-06
May
-06
Jun-
06
Jul-0
6
Aug
-06
Sep
-06
Oct
-06
Nov
-06
Dec
-06
CPH started 20 June 2005
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No. of referrals seen by the CN between 20 June 2005 and
30 June 2006 380 referred to mental health 380 referred to mental health
service from CRHFT and Waltonservice from CRHFT and Walton 190 assigned to the CN (50% of 190 assigned to the CN (50% of
CRHFT and Walton referrals)CRHFT and Walton referrals)
167 assessed by the CN167 assessed by the CN 66 follow up contacts66 follow up contacts 23 Not seen for various reasons23 Not seen for various reasons
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Response time for referrals(Including 11 urgent referrals)
21 2330
40
28
15
3 41 2
0
10
20
30
40
50
0 1 2 3 4 5 6 7 8 9
No. of Working Days
No
. o
f R
efer
rals
Mean average = 2.8 working days66% of the routine referrals were seen within 3 working days84% within 4 working days.
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Placement outcomes by diagnosis
Outcome of 97 patients with dementia:Outcome of 97 patients with dementia:HomeHome 5252 (52.6%)(52.6%)TransferredTransferred 1919 (19.6%)(19.6%)
Residential/nursing home 10Residential/nursing home 10HomeHome 6 6DiedDied 3 3
DiedDied 1212 (12.4%)(12.4%)Residential/nursing homeResidential/nursing home 1414 (14.4%)(14.4%)
Outcome of 70 patients, not dementia:Outcome of 70 patients, not dementia:HomeHome 4040 (57.1%)(57.1%)TransferredTransferred 1515 (21.4%)(21.4%)
Still inpatient at 30/9/06 1Still inpatient at 30/9/06 1Residential/nursing home 4Residential/nursing home 4HomeHome 6 6DiedDied 4 4
DiedDied 77 (10.0%)(10.0%)Residential/nursing homeResidential/nursing home 88 (11.4%)(11.4%)
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Attitude of Consultant Attitude of Consultant PhysiciansPhysicians
How satisfied are you with the speed of response of the service?
0%
10%
20%
30%
40%
50%
Before (n=16) 6.7% 13.3% 46.7% 33.3%
After (n=18) 22.2% 38.9% 33.3% 5.6%
very satisfiedsomewhat satisfied
somewhat dissatisfied
very dissatisfied
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Attitude of Consultant Attitude of Consultant PhysiciansPhysicians
How satisfied are you with the current service overall?
0%
10%
20%
30%
40%
50%
60%
Before (n=16) 0.0% 50.0% 37.5% 12.5%
After (n=18) 22.2% 55.6% 16.7% 5.6%
very satisfiedsomewhat satisfied
somewhat dissatisfied
very dissatisfied
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