Leeds Liaison MH Service – NCCMH
The liaison mental health service in Leeds offers assessment and some follow-up for people aged 16-65 years who present with mental health problems. This service is included in NCCMH guidelines.
The liaison mental health service in Leeds offers assessment and some follow-up for people aged 16-65 years who present with mental health problems.
The Leeds psychiatric service consists of the following sub teams:
- An acute liaison psychiatric service (ALPS) provided 24/7 for ED and self-harm presentations
- An older adult liaison psychiatry service for people aged 65 and over provided 9am-5pm, 7 days a week
- A working-age in-reach service provided to people in the general hospital aged 18-64 (who have not self-harmed)
- A liaison psychiatry outpatient service provides a range of specialist mental
health input aimed at improving the health outcomes of people with long-term physical health conditions, complicated by the presence of a mental health problem. There are three consultants, one specialty doctor, one core trainee and three higher specialist trainees who provide medical outpatient sessions (this equates to approximately 8.5 sessions a week). There are also three WTE band 6 therapists and one WTE band 7 CBT therapist who provide outpatient clinics. - An addiction service offering in-reach and ED cover, provided by three WTE clinicians from Monday to Friday between the hours of 9am–5pm, for all primary drug or alcohol- related issues.
The ALPS delivers training for staff, providing staff with an induction programme as well as a quarterly liaison psychiatry group. The ALPS service provides a monthly teaching session for in-reach staff, and staff from both teams attend weekly educational meetings to discuss a range of topics such as recent challenges and lessons learned.
The Leeds liaison service offers biopsychosocial assessments in the ED, and provides people with a care plan and signposting leaflet upon discharge. The service does not offer rapid follow-up care: some follow-up is provided, but most is provided by other services. For people seen by the in-reach sub-team, approximately 6% are followed-up in the outpatient clinic, 15% are discharged to community mental health teams, 9% are admitted to mental health wards, 1% of people are discharged to social care for follow-up, and 6% are referred to an appropriate alcohol and drugs service.
The views of patients are collected through a feedback form provided to all people when they are discharged. The Clinical Global Impression Scale (CGI) is used for all people who the service sees more than once.
The Leeds liaison service is currently under a process of redesign, with a view to improving the service. The service is working towards ensuring:
- there is appropriate seniority available 24/7
- an increase in staffing numbers
- creation of a steering group to look at issues such as duplication of records
- streamlining the referral process for general hospital staff.
A breakdown of staff numbers is provided in Table 4.
Table 4: Leeds – breakdown of staff numbers in service
|
Age group |
Occupation/speciality |
Staff numbers (whole time equivalent – WTE) |
|
In-reach service for working-age adults |
Band 6 nurse(s) |
0.8 |
|
Speciality doctor(s) |
1 |
|
|
Consultant(s) |
1 |
|
|
Acute liaison psychiatry service (ALPS) |
Consultant(s) |
0.1 |
|
Band 6 nurse(s) |
17 |
|
|
Band 7 nurse(s) |
2 |
|
|
Older adult liaison psychiatry service |
Specialist doctor(s) |
1 |
|
Consultant(s) |
1.2 |
|
|
Band 6 nurse(s) |
8 |
|
|
Band 7 nurse(s) |
0.8 |
|
|
Health support worker(s) |
1 |