The Sunderland Psychiatric Liaison team is a multi-disciplinary specialist team that delivers an around the clock (24/7) service to support patients presenting to Sunderland Royal Hospital with co-morbid mental health problems. The service offers a comprehensive range of mental health specialities to meet the mental health needs of all patients.
What We Did
Mental Health is a major cause of poor health, wellbeing and quality of life. Nationally 5% of all A&E attendances are due to mental illness; and 25% of all patients admitted to hospital have co-morbidities.
The Sunderland Psychiatric Liaison team is a multi-disciplinary specialist team that delivers an around the clock (24/7) service to support patients presenting to Sunderland Royal Hospital with co-morbid mental health problems. The service offers a comprehensive range of mental health specialities to meet the mental health needs of all patients, including those who self-harm, have substance misuse issues or have mental health difficulties commonly associated with old age, including dementia and delirium.
At the heart of the initiative is assisting with the early detection and diagnosis of co-morbidities, and facilitating access to the most appropriate care pathway for longer term support (if required), regardless of address, age, condition and severity of the presenting complaint. The service offers a rapid response, with a target time of one hour within which to assess patients referred from A & E, and a 24 hour target to assess inpatients referred from the Acute Trust wards. The team are currently commissioned to see people aged 16 and over. We are currently recruiting Children and Young Peoples Nurses to enable our service to offer an ageless response.
The Sunderland Liaison team works closely with Wear Recovery, (drugs & alcohol specialist organisation), and also has strong links with Changing Lives, (a housing organisation) especially when working within the ED. The team have good relations with Dementia Delirium Outreach Team (DDOT) and Dementia Friends especially when working with individuals referred from inpatient wards in the acute hospital. We have close links with COPD specialist nurses and perinatal and stroke wards.
We work closely with voluntary and statutory agencies within Sunderland, NTW urgent care and planned care services. Also have strong links with IAPT.
By integrating psychiatry and psychology fully into medical care, the Liaison team together with our partners, are able to promote and improve patient wellbeing and health outcomes. We increase patient knowledge through advice and support, and enable patients to feel more empowered.
Following assessment, some service users who clinicians feel may benefit from further input by our team, are offered opportunities to have follow-up sessions. Service users are offered choice regarding date and time of appointments, as well as location, as appointments can be offered at their home, or in a clinic. The clinics that we offer include: Liaison Psychiatry; COPD; Medically Unexplained Physiological Symptoms; Self-Harm Follow Up; and, Nurse Consultant clinic offering EMDR, DBT and specialist focused therapy.
Following admission to hospital, and assessment by members of the Liaison team, individuals are asked if they would like a significant other and/or a relative to be involved in their care by our team. We recognise that being admitted to hospital can be a very difficult time, and involving carers at this point is essential in the care and wellbeing of a person.
The Sunderland Liaison team employ a Peer Support Worker; their role within the team is to promote hope for recovery, encourage future plans, use recovery tools such as Wellness Recovery Action Plan (WRAP), offer feedback from a patient’s journey perspective and generally support the person’s mental health recovery journey. The team are the only Liaison Psychiatry Team in the country has that have this role to offer and this is working very well.
Looking Back/Challenges Faced
The Sunderland Liaison team evolves day by day, especially since becoming a 24/7 service in January 2014. If we knew that the team was going to develop the way it has done, with more staff being employed, something we would have done differently would be to have obtained better accommodation for the team so that we had more space, greater access to computers & phones, and further secluded areas for meetings, to make it more comfortable for our staff and patients. We would also have considered employing a Social Worker within the team.
Whilst we have good links with the hospital Social Workers, we recognise that it would be more effective, and would benefit our patients more if we had a Social Worker directly employed within our team
One of the greatest challenges the Sunderland Liaison team has experienced is challenging stigma and negative attitudes within the acute hospital regarding mental health presentations. The team are passionate to influence positive attitudes and values with regards to mental health issues and psychological well-being. We are continually, through day to day joint working and formal/informal training, educating staff and developing their skills in relation to mental health, to support and improve the management of patients with co-morbid mental health conditions.
Education is an integral part of our role and the team deliver training on F1 rotation, preceptorship nurses, in patient wards and we have a large rotation of student nurses, doctors, paramedics and police students.
The Sunderland Liaison team are committed to ensuring that all patients receive the same care and treatment as anybody else. The relationships we have, and the support and recognition we receive from the acute hospital staff fills us with confidence that this service will continue, regardless of who is leading. Recently, we received some brilliant feedback from the acute staff: “I have received numerous pieces of positive feedback from Emergency Department nursing and medical colleagues regarding the enhanced service which our Psychiatric Liaison Colleagues are now providing 24/7. I would wholeheartedly echo these and I feel this is a fantastic development which is certainly positively impacting on the timely specialist assessment and management of patients presenting to the ED with possible mental health needs.”
The Sunderland Liaison team have quarterly meetings where we look at where we can improve the service and look at what needs to expand so we can offer the best care to the service users we work with. The team regularly meets for ‘taking stock’ sessions, and we also have fortnightly ‘Leads meetings’ and ‘Team Meetings’ which allows all staff to have the opportunity to understand where the team is currently, and where we are aiming to be.
Our success is being recognised, having come runner-up of the ‘Partnership Award’ and runner-up of the ‘Clinical Team of the Year’ at NTW’s Shine the Light awards; and were winners of the Best of Health Award for Team of the Year at the Sunderland Echo Awards.
The Sunderland Psychiatric Liaison Team have also received PLAN accreditation by the Royal College of Psychiatrists with ‘Excellence’ which is a fantastic achievement we are very proud of.