3 results
EVALUATION of VIDEO CONSULTATIONS in COMMUNITY MENTAL HEALTH SETTING- Pilot Project of Service Evaluation
- Sadia Tabassum Javaid, Ravindra Belgamwar
-
- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S96-S97
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
To evaluate the overall experience and satisfaction with Attend Anywhere video consultations in adult CMHT. The increased use of the digital world is evident via Ofcom Tele Report 2019. UK Government's Five Year Forward View and initiatives, such as ‘Digital First’, aim to reduce face-to-face consultations. Past reports have shown video consultations to be non-inferior to face-to-face consultations in systematic reviews and qualitative studies.The contagious nature of the COVID-19 outbreak limited face-to-face consultations. This led to video consultations via Attend Anywhere (AA). AA is accessed anywhere via the web on Google or Safari with a good internet connection. It provides a single, consistent entry point with an online waiting area on the service's webpage.
Methods1. Two separate questionnaires were designed, one each for service users and staff, to capture relevant information at the end of AA consultation. Additional clinical questions for staff included.
2. Data were collected anonymously for 2 months from 1st April 2020.
ResultsTotal respondent 44= 20 service users and 24 staff.
1. For Service Users:
The respondents’ age range was 19-62 years, 80% females. The majority were follow-ups with three new assessments. About half of them had previous contact with the staff. 15 consultations were carried out by the doctor, four by the psychologist, and one was a joint doctor-psychologist consultation.
95% reported their overall experience to be very good-good. 90% found it easy to use: 95% said they would use it again.
2. For Staff:
The respondents’ age range was 30-50 years, 87% females. The majority were follow-up assessments with one-third new. 16/24 respondents were doctors and eight psychologists. 58% had a previous meeting with service users.
83% reported the overall experience as very good to good: one third felt it's time-saving. 100% reported it's easy to use, would re-use and recommend to others.
For clinical questions, the responses were very good-good as Rapport 87%; Risk assessment 83%; care plan 83%; History taking 78%; Mental state/Cognition 66% and providing support 65%.
ConclusionOverall, the majority of respondents at an Adult CMHT found video consultations easy to use with readiness to use them again. Video consultations offer several advantages over telephone reviews, e.g. for developing rapport, assessing mental state, etc.
These data are limited to the pilot project and a detailed review is planned for qualitative information with a larger cohort. Following this successful pilot and promising results, video consultations have been rolled out to other trust clinical areas.
Audit on Baseline Physical and Metabolic Investigations Before Prescribing Antipsychotics in Children and Adolescent With Psychosis and Schizophrenia
- Sadia Tabassum Javaid, Lubna Latif
-
- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S163
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
INTRODUCTION: The term ‘psychosis’ is used in NICE guidelines to refer to the group of psychotic disorders that includes schizophrenia, schizoaffective disorder, schizophreniform disorder, and delusional disorder as identified by the International Classification of Diseases – 10th revision (ICD 10; World Health Organization, 1992).BACKGROUND: Children and young people with psychosis and schizophrenia have poorer physical health than the general population as get older. Life expectancy is reduced by 16 to 25 years (Brown et al., 2010; Parks et al 2006).AIMS & OBJECTIVES: To compare the west-midlands child psychiatrist practice with the standard NICE clinical guidelines on baseline physical and metabolic investigations before prescribing antipsychotics in children and adolescents. To compare if fulfilling criteria. Early detection and intervention in order to delay or possibly prevent the onset of psychosis and schizophrenia. To improve the services.
Methods• The sample was collected via ‘WEST MIDLANDS CAMHS CONSULTANT SURVEY’.
• Information collection through the questionnaire.
• Nine members of the west midlands CAMHS Consultant CLENT group participated in 2019.
Results• Indications to use antipsychotics, Record keeping and Assessment of nutritional status & level of physical activity: 100%.
• Pulse and B.P check: 88.9% yes, 11% not always.
• Weight and Height plotted on growth chart: 77.8% yes, 22% not always.
• Antipsychotics (must be initiated by suitably qualified health care professional with expertise in prescribing: 33% consultant, 55% doctor, 11.1% doctor or nurse.
• Assessment of movement disorders was done by 44.4%always, 11.1% never and 44.4% sometimes.
• Lipid Profile was checked by 44.4% always, 11.1% never and 44.4% sometimes.
• Fasting blood Glucose and Hb1ac check: 33.3% yes, 66.7% never and 33.3% sometimes.
ConclusionData collected suggest meeting the set standards for indications of antipsychotics, record keeping and physical activity checks but not in other domains.
Recommendations:
• To create a checklist Performa for physical / metabolic Health Checks for children and adolescent initiated on antipsychotic medications under the care of CAMHS.
• Clinicians to stay up to date with NICE guidelines.
• To regularly monitor physical health and blood test before prescribing antipsychotics.
• To re-audit after introducing Performa in our CAMHS centre, if effective to introduce it in other local CAMHS centres after negotiation with them.
Audit of On-Call Assessments (Acute and Urgent Care)
- Sadia Tabassum Javaid, Darret Watts, Mike Jorsh, Mehr Muhammad Usman, Laura Stevenson, Oluwafemi Popoola, Corrina Bentley, Sam Dawson, A Briacu
-
- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S163-S164
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
BACKGROUND: Local algorithms are in place which outline the required process for arranging a Mental Health Act assessment. It requires one doctor from the patient's allocated care team or Trust on-call consultant during the working hours and one doctor from the on-call team (registrar/Consultant- if no registrar) during out of hours. Concerns were raised that on-call doctors were not always asked to participate in assessments in accordance with Trust protocol. AIMS: To improve the on-call assessment process at Northstaffs Combined Healthcare NHS Trust (NSCHT). OBJECTIVES: To determine: Whether NSCHT doctors from the on-call rota participate in Mental Health Act assessments, as appropriate. Any patterns relating to day, time of day or location of assessment which correlate with on-call doctors not participating in assessments appropriately. Any areas where the required standards relating to on-call assessments are not being met. As well to take this opportunity to note down how long was admission following mental health act assessment and if any role of substance misuse.
MethodsAll assessments undertaken during November and December 2020 were identified by the Mental Health Law Team. This resulted in a total for analysis of n=141 cases. Data collection was undertaken by Working Group members using a form devised by the Clinical Audit Department and entered online for analysis. Analysis was subsequently undertaken using SPSS and validated according to departmental protocol.
ResultsMHAA was done 35% inpatient, 30% Section 136 Suite, 14% community, 12% UHNM, 3% access, 2% police custody and 4% in other areas/ out of areas. Outcome were that 45% detained under section 2 MHA, 35% on section 3 MHA, 2% admitted informally and 18% neither detained nor admitted. 26% of the time substance misuse (acute / chronic) formed part of assessment.
Conclusion• Overall results showed that at least one NSCHT doctor was involved in 91% of assessments undertaken, with roughly two thirds of doctors being Consultants and one third Registrars.
• Focusing on assessments undertaken in the Section 136 suite, at least one NSCHT doctor was involved in 92% of assessments undertaken, with roughly half of doctors being Consultants and half Registrars.
• Focusing on out of hours assessments, at least one NSCHT doctor was involved in 89% of assessments undertaken, with roughly two thirds of doctors being Consultants and one third Registrars.
Recommendations:
• To amend the Section 136 form to add the role of the doctor in the assessment.
• Results to be presented and discussed at the Mental Health Law Governance Group-completed.
• Results to be presented to the Acute and Urgent Care Directorate-completed.
• Executive Summary to be presented to the Clinical Effectiveness Group-completed.