4 results
Establishing a Memorial Trust Overseas (Kashmir) for the Promotion of Health, Awareness and Education
- Zafrina Majid
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S30
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Aims
To promote physical and mental health in underprivileged communities; (II) to increase awareness on health matters in the community and students.
MethodsMay 25th 2011, remains etched in author's mind. Her brother, Dr Syed Arshad Abbas, had a fatal accident while on duty. In 2012 family established a Memorial Trust. Since then, the following are provided:
1. A free medical health camp twice a year. Patients receive free consultation, free medication and referral to secondary or tertiary services.
2. An ambulance service available all times.
3. Two blood donation events, 2012 in collaboration with Red Cross and 2022, in collaboration with an international charity and the hospital of Baramulla.
4. Sponsorship to students, from primary school to university, with a mentoring scheme for university students.
5. Mental Health awareness programme every year in different Universities.
Results1. To date, 3122 patients were seen at the camps. Medical and psychiatric specialist services are offered face to face or virtual. Depression, Anxiety Disorder and PTSD are the most prevalent disorders. There is an increase in substance use in youth. Polypharmacy is common practice.
2. Ambulance catered for 2404 patients. The first patient was an 11-year-old boy, with acute abdomen. He was transferred to tertiary hospital and operated within three hours.
3. Second blood donation event has broken the World Record of number of donations in one day. A database of regional donors was set up. Screening has identified two women with anaemia, highlighted health inequalities which were reported to local government.
4. Sponsored and mentored university students have completed their degrees and secured placements in tertiary hospitals.
5. Mental Health awareness programme identified the need for counselling services in universities and need for similar programmes.
ConclusionThis project has given an opportunity to turn loss into positive and a grief into hope. It will help family to move on by providing to the local community. Being a medic trained in UK the author was able to utilize skills into serving her home community, put vision into action and fulfil Hippocratic oath.
Mentorship Scheme at Surrey & Borders NHS Foundation Trust
- Zafrina Majid, Patrick Cremin, Jeremy Mudunkotuwe
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S30
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- Article
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Aims
To establish a mentorship programme for all grade of Psychiatrists working within Surrey and Borders Partnership Trust.
MethodsRSPsych guidance was used to establish a mentoring programme within Surrey and Borders Partnership Trust.
A core leadership team was identified and established, this included the Director of Medical Education, a Higher Specialist Trainee, and a Core Trainee.
The decision was made to structure the programme to involve all grades of doctor within the trust, with pairing of Mentor and Mentees tailored to mentee needs. Support from the core team will also be offered to both Mentees and Mentors on a regular and drop in basis, as well as support groups for each group.
The programme was then advertised using a trust email list and training days were held via Microsoft Teams and delivered by the West Midland Mentoring Team RCPsych.
The programme is due to launch in February 2023 with expected widespread engagement, followed by evaluation survey.
ResultsWe received a good response from all grades of doctors targeted in the Mentorship Scheme.
Following this a prelaunch meeting, facilitated by the core leadership team, was organised for all those involved in the scheme.
This meeting outlined the aims of the scheme and support available to both Mentors and Mentees.
The Mentors and Mentees have now been paired and the scheme will be launching in February 2023.
ConclusionBurnout is a significant and highly prevalent phenomenon within the Psychiatric community.
Mentorship is shown to reduce rates of burnout as well as improving staff well-being, productivity and retention.
Following RCPsych guidance this project aims to establish a mentorship programme for all psychiatrists within the Surrey and Borders NHS Trust.
The Surrey & Borders Mentorship Scheme will launch in February 2023.
Antipsychotic Cardiometabolic Monitoring: Systemic Gaps and Hidden Groups
- Tanya Ansari, Zafrina Majid, Ashma Mohamed, Martin Schmidt
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S103
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Aims
To determine whether there are any gaps in cardiometabolic monitoring within primary or secondary care for people prescribed antipsychotic medication. A well-established system of cardiometabolic monitoring and checks has been implemented for patients with psychosis and bipolar in secondary care. It was unclear whether patients without these diagnoses were receiving the same level of monitoring.
MethodsData were collected retrospectively from case notes of service users under CMHRS Reigate. We included all patients from three GP practices (100 patients) and identified all who were prescribed antipsychotics and their diagnoses. The GP practices were contacted to determine whether a system was in place to flag physical health monitoring requirements for service users on antipsychotics regardless of diagnosis. The results were used to calculate the potential number of patients across the entire trust who were at risk of not receiving cardiometabolic monitoring.
Results24/100 patients were prescribed antipsychotics without a diagnosis of psychosis or bipolar. 11/24 had a diagnosis of Emotionally Unstable Personality Disorder. Quetiapine was the commonest antipsychotic. None received routine cardiometabolic monitoring.
The total caseload for all 11 adult community teams in the Trust is 2434. If prescribing and monitoring practices are similar 584 individuals may be affected.
2/3 GP practices responded. Both confirmed that they would only conduct cardiometabolic monitoring when taking over prescribing/on discharge from secondary care if specifically requested to do so.
ConclusionThis service improvement project has identified a significant group of patients who aren't automatically offered cardiometabolic monitoring in secondary care.
Private correspondence from Professor David Taylor confirms that these patients would also benefit from monitoring when prescribed doses that are more likely to cause adverse effects (Quetiapine > 150mg/Olanzapine >5 mg Risperidone >2mg)
Secondary services need to identify these patients and include them in routine cardiometabolic monitoring.
Secondary services need to work closely with primary care to ensure that responsibility for checks is agreed and handed over when necessary.
Audit of Prolactin Levels Monitoring for Inpatients on Antipsychotics in SABP
- Zafrina Majid, Amit Fulmali, Bruce Tamilson, Ruth Bloxam, Deeksha Varma, Lubna Abdallah, Khalid Mirza
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S165
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- Article
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Aims
To establish whether our practice is meeting NICE and Maudsley guidelines in establishing baseline prolactin levels in an inpatient set-up before starting treatment with antipsychotic medications with a medium or high-risk of causing hyperprolactinaemia.
MethodsData were collected retrospectively from case notes of 127 patients from 9 wards at Surrey and Borders Partnership NHS Foundation Trust (SABP).
We reviewed if the baseline prolactin was measured for inpatients before commencing on antipsychotics with medium or high risk of hyperprolactinemia.
We reviewed if patients with elevated prolactin levels were assessed and managed appropriately.
ResultsSABP is currently achieving 43% in recording serum prolactin levels for inpatients who are on antipsychotics with medium or high-risk of hyperprolactinemia respectively.
Inpatient ward 76 patients out of total 127 were on antipsychotics with medium to high-risk of developing hyperprolactinemia.33 patients had their serum prolactin checked bringing the compliance to 43%,2 patients were excluded due to incomplete data bringing the sample size to 31.
3 had elevated prolactin. Out of 3 patients,1 patient was managed appropriately with MRI brain, followed by change of antipsychotic medication and repeat prolactin levels. For 1 patient, prolactin
level was rechecked. Unfortunately, no documentation of assessment of symptoms of hyperprolactinemia was found in all three patients case notes.
ConclusionThe trust is falling short of meeting NICE and Maudsley guidelines of monitoring prolactin level. It is possible to introduce a robust system within the Trust so that we are complaint with a NICE and Maudsley prolactin monitoring guidelines.
We need to local Trust guidelines for management of hyperprolactinaemia in line with NICE and Maudsley guideline of monitoring prolactin levels.
Safety netting advice and leaflets explaining symptoms of hyperprolactinaemia should be provided to all the patients on antipsychotics with medium to high risk of developing hyperprolactinemia.