BMJ 2013;347:f7641 doi: 10.1136/bmj.f7641 (Published 20 December 2013)
Page 1 of 1
News
NEWS Improved liaison psychiatry services could save the NHS millions, says report Keir Stone-Brown London
The NHS could potentially save millions of pounds a year if every acute hospital had appropriate liaison psychiatry services, according to a new report from the Royal College of Psychiatrists. Liaison psychiatry for every acute trust—which is supported by six professional bodies including the Royal College of General Practitioners, Royal College of Physicians, and Royal College of Nursing—calls for an integrated approach to the mental health needs of patients being treated for physical conditions.1 Liaison psychiatric teams are called on by hospital staff when patients are being treated for physical conditions and staff feel that patientswould benefit from a psychiatric assessment.
The report says that enacting its guidelines would reduce patient readmission rates, reduce average length of patient stays, as well as many other cost saving advantages. Janet Butler, cochair of the working group that produced the report, said: “This report shows that liaison psychiatry is a crucial service for every acute trust. This will improve quality of care and safety for patients as well as improving efficiency that is vital to the sustainability of our hospital systems.”
The estimated extra cost to physical healthcare providers from comorbid mental health problems is £6bn (€7.2bn; $9.8bn) per year or 15% of total expenditure. For a typical general hospital of 500 beds, this is £25m per year.2 Butler estimated savings would be similar to those found in a 2012 report commissioned by the NHS confederation, which cited possible savings of up to £5m per hospital if appropriate liaison psychiatry services were developed.3
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Michael Sharpe, honorary consultant in psychological medicine and adviser to Oxford University Hospitals Trust, supported these claims. “Integrating mental healthcare effectively into physical healthcare could provide the holy grail of better outcomes at a lower cost. It is something that has worked very well so far, here, in Oxford,” he said.
Currently, liaison psychiatry services vary greatly across different acute trusts. One example is the liaison psychiatry team at the University Hospitals Bristol Trust, which has one full time and one part time consultant covering several hospitals including the Bristol Royal Infirmary. Nicola Taylor, consultant liaison psychiatrist at the trust, said: “We are wildly understaffed to cover five campuses. Ideally we would have a staff grade doctor covering each ward round.” Alistair Douglas, president of the Society for Acute Medicine, went further. “In the majority of hospitals current services are patchy, fragmented and often difficult to access. Adopting the guidelines in this report will go a long way to achieving better care for these patients.” 1 2 3
Royal College of Psychiatrists. Liaison psychiatry for every acute hospital—integrated mental and physical healthcare. December 2013. www.rcpsych.ac.uk. Parsonage M, Fossey M, Tutty C. Liaison psychiatry in the modern NHS. Centre for Mental Health, 2012. NHS Confederation and Centre for Mental Health. Briefing: liaison psychiatry—the way ahead. 2012. www.nhsconfed.org/Publications/Documents/Liaison-psychiatry-the-wayahead.pdf.
Cite this as: BMJ 2013;347:f7641 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Improved liaison psychiatry services could save the NHS millions, says report Keir Stone-Brown London
The NHS could potentially save millions of pounds a year if every acute hospital had appropriate liaison psychiatry services, according to a new report from the Royal College of Psychiatrists. Liaison psychiatry for every acute trust—which is supported by six professional bodies including the Royal College of General Practitioners, Royal College of Physicians, and Royal College of Nursing—calls for an integrated approach to the mental health needs of patients being treated for physical conditions.1 Liaison psychiatric teams are called on by hospital staff when patients are being treated for physical conditions and staff feel that patientswould benefit from a psychiatric assessment.
The report says that enacting its guidelines would reduce patient readmission rates, reduce average length of patient stays, as well as many other cost saving advantages. Janet Butler, cochair of the working group that produced the report, said: “This report shows that liaison psychiatry is a crucial service for every acute trust. This will improve quality of care and safety for patients as well as improving efficiency that is vital to the sustainability of our hospital systems.”
The estimated extra cost to physical healthcare providers from comorbid mental health problems is £6bn (€7.2bn; $9.8bn) per year or 15% of total expenditure. For a typical general hospital of 500 beds, this is £25m per year.2 Butler estimated savings would be similar to those found in a 2012 report commissioned by the NHS confederation, which cited possible savings of up to £5m per hospital if appropriate liaison psychiatry services were developed.3
For personal use only: See rights and reprints http://www.bmj.com/permissions
Michael Sharpe, honorary consultant in psychological medicine and adviser to Oxford University Hospitals Trust, supported these claims. “Integrating mental healthcare effectively into physical healthcare could provide the holy grail of better outcomes at a lower cost. It is something that has worked very well so far, here, in Oxford,” he said.
Currently, liaison psychiatry services vary greatly across different acute trusts. One example is the liaison psychiatry team at the University Hospitals Bristol Trust, which has one full time and one part time consultant covering several hospitals including the Bristol Royal Infirmary. Nicola Taylor, consultant liaison psychiatrist at the trust, said: “We are wildly understaffed to cover five campuses. Ideally we would have a staff grade doctor covering each ward round.” Alistair Douglas, president of the Society for Acute Medicine, went further. “In the majority of hospitals current services are patchy, fragmented and often difficult to access. Adopting the guidelines in this report will go a long way to achieving better care for these patients.” 1 2 3
Royal College of Psychiatrists. Liaison psychiatry for every acute hospital—integrated mental and physical healthcare. December 2013. www.rcpsych.ac.uk. Parsonage M, Fossey M, Tutty C. Liaison psychiatry in the modern NHS. Centre for Mental Health, 2012. NHS Confederation and Centre for Mental Health. Briefing: liaison psychiatry—the way ahead. 2012. www.nhsconfed.org/Publications/Documents/Liaison-psychiatry-the-wayahead.pdf.
Cite this as: BMJ 2013;347:f7641 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
