Evaluation of the Primary Care Mental Health Specialist role: Final Report

This report details an evaluation to assess the impact of the new primary care mental health specialist (PCMHS) role in Kent and Medway. The evaluation was undertaken by the Centre for Health Services Studies (CHSS) at the University of Kent and was conducted June 2013 to December 2014. The evaluation was commissioned by NHS Kent and Medway and supported by Kent and Medway Commissioning Support. The evaluation encompasses six CCG areas across Kent and Medway, with 13 PCMHS employed in these areas (see Table 1-1 for breakdown). The number of posts per CCG is dependent on the amount CCGs invest (roughly equating to population size), rather than prevalence of illness. The PCMHS have been seconded from Kent and Medway NHS and Social Care Partnership Trust (KMPT) for the duration of the pilot, and are either community psychiatric nurses (CPN) or occupational therapists (OT) by profession. The majority of PCMHS are hosted by a voluntary organisation (mcch); three are hosted by GP practices and two by a community Interest Company, Invicta CIC. The main objectives of the evaluation are: 1. To assess the impact on patients by capturing their experience of the service; 2. To assess the impact by capturing experiences of those delivering the service (i.e., PCMHS); 3. To assess the impact by capturing experiences of other professions who work alongside the service (i.e., mental health professionals in secondary care, GPs); 4. To assess the economic cost of the new service via a unit cost analysis

Managing the needs of frequent attenders of urgent care services: a case management approach

BACKGROUND: Currently we are experiencing record numbers of visits to Emergency Departments (EDs) in England with an increase of 4.1% from last year. This is also alongside the worst performance for treating patients within 4 hours of arriving at an Emergency Department (Gardner, 2019). A new Frequent Service User Manager (FSUM) service was set up in West Kent to address the issue of those frequently attending EDs and support the well being of these patients. AIM: To evaluate a new service to address Frequent Service Use of Urgent Care Services. METHODS: Service data on demographics, loneliness, anxiety, quality of life, and urgent health care usage was obtained for those most frequently attending (n=22) a West Kent Emergency Department. Interviews were carried out with a sample of these patients (n=4) to capture their experiences of using the service. RESULTS: The main presenting symptoms for attending the Emergency Department were pain and alcohol related conditions. After 12 months, loneliness, anxiety and use of urgent care services had reduced. Quality of Life improved from baseline to 4 months but then stabilised at 12 months. The results highlight the important role FSUMs can play in supporting those that frequently attend Emergency Departments

Evaluation of a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care: the role of Primary Care Mental Health Specialists

We aimed to evaluate a pilot service to facilitate discharge of patients with stable long-term mental health needs from secondary to primary care. Patients with stable long-term mental health conditions are often not discharged from secondary mental health services when no longer needed due to insufficient systems and processes to enable safe, effective, recovery-focussed treatment and support. The Primary Care Mental Health Specialist (PCMHS) Service was developed to address this gap; new PCMHS posts were introduced to act as a conduit for patients being discharged from secondary care and a single point of referral back into secondary care, should it be required. The two-year pilot, across six Clinical Commissioning Groups in South East England, began in March 2013. Interviews were conducted with all PCMHS employed in the pilot service (n=13) and a sample of service users (n=12). The views of professionals working alongside the service, including GPs, Psychiatrists and Mental Health Nurses, were captured using a brief online questionnaire (n=50). Time and Activity Recording Sheets were used to capture data required for economic analysis. Our findings indicate that the service is working well from the perspective of patients; staff employed within the service and professionals working alongside the service. Patients described the service as a ‘safety net’ they could fall back on in case of difficulties, whereas staff used the analogy of a ‘bridge’ to describe the way the service improved communication and collaboration between the various professionals and organisations involved in the patient’s care. Improvements in well-being were seen to result from increased support for those transitioning from secondary to primary care, a more pro-active approach to relapse prevention and increased engagement in daily activities. Each PCMHS covered 36 patients in a one-month period, with a unit cost of £73.01 per patient

The Kent, Surrey and Sussex Health Psychology Network 2013 and 2014 conferences

The Kent, Surrey and Sussex Health Psychology Network (KSSHPN) was established in 2008 to provide a forum for local health psychologists, students and trainees to network and share experiences and knowledge. The KSSHPN represents members from different areas of health psychology working in a range of settings. It aims to: increase awareness of health psychology as a profession; demonstrate the diversity of skills and roles health psychologists can have; improve links between academia, the NHS and industry; emphasise local resources for research support and funding; and develop training and continuing professional development opportunities. Organising a one-day conference appeared to be a promising way to support these aims