Consultant Connect’s Telephone Advice & Guidance (A&G) was first launched in South East London in 2016 to connect Primary and Secondary Care for rapid specialist advice. The service allows Primary Care clinicians to make calls for specialist advice at the touch of a button without the need to wait on switchboard.
In 2019, feedback from mental health clinicians at South London and Maudsley NHS Foundation Trust (SLaM) was received that communication delays and access to specialist acute advice were creating a barrier to providing mental and physical healthcare. As a result, talks began regarding whether Telephone A&G provided by Consultant Connect could aid mental health clinicians in seeking advice in the same way it is available for clinicians in Primary Care.
The obstacle
Nearly half of all people with mental illnesses also have at least one long-term physical condition, and similarly, 30% of people with long-term physical health conditions also have a mental illness. If mental and physical health is so intertwined, then pathways for mental health clinicians to obtain acute specialist advice from colleagues should be easily accessible, quick, and simple.
Instead, clinicians reported that time to access A&G from acute specialist colleagues detracted from their time available to provide direct care for patients. Current methods of obtaining A&G increased the likelihood of needing to transfer patients with non-emergency physical health conditions to emergency departments, creating unwarranted additional pressures on resources. On top of that, busy acute hospitals would likely provoke further stress, so inpatients with serious mental health and physical issues remaining in a mental health setting for treatment, where appropriate, is preferred.
How it was overcome
As Consultant Connect was already commissioned to operate in South East London, no further costs were incurred for the launch of this pilot, offering a ready-made solution for improving communication, saving clinicians’ time, and improving patient experience and outcomes.
The initial pilot for staff on one older adult mental health ward was planned for March 2020, however, the Covid-19 pandemic led to an increased NHS-wide need to avoid inappropriate inter-hospital transfers and admissions. As a result, later in 2020, all SLaM inpatient clinicians were given access to Consultant Connect Telephone A&G, which connected them with specialist colleagues in Guy’s and St Thomas’ and Lewisham and Greenwich NHS Foundation Trusts.
Following early evaluation findings, in March 2021 King’s College Hospital NHS Foundation Trust provided access to their lines too. The pilot was then extended to all community-based staff in 2021. This was, and remains, the only project to bridge communication between mental health and acute care in this way.
The results
Telephone A&G provided by Consultant Connect is now embedded into routine practice in SLaM, two years after it originally launched, with over 500 clinicians from 16 professional groups registered for the Consultant Connect App. For new staff, Consultant Connect is now also a part of their induction.
The call data found that:
- Over half of all physical health calls placed were for cardiology, diabetes & endocrinology, and haematology. More specifically, 50% and 25% of all A&G calls were to cardiology and diabetes & endocrinology respectively.
- More than 70% of A&G queries resulted in the patient receiving physical health care from mental health clinicians, avoiding referrals or transfers*.
- 61 out of 80 specialties were contacted for specialist advice.
* Based on calls where an outcome was left.
The call data analysis also helped to identify training needs for psychiatry trainee doctors, and as a result, four bespoke physical health educational webinars were produced and delivered based on the most common call topics.
Half of all cardiology calls were related to ECG queries. As such, the existing functionality within the Consultant Connect App to send IG-secure photos and messages is aiming to be switched on at some point in the future to further save time.
In addition to physical health lines, SLaM clinicians also set up their own internal lines, which supported remote working practices.
The project was positively received by both mental health and physical health specialists, with one junior doctor at SLaM saying, ‘Consultant Connect is amazing; it reduces the number of patients I send to hospital and improves the appropriateness of care and referrals.’
‘The Integrating our Mental and Physical Healthcare Systems (IMPHS) team set out a clear vision for what they wanted to achieve right from the beginning of the project. With this vision in mind, we were able to seamlessly integrate SLaM into the existing Telephone A&G project operating in South East London. The team have been a pleasure to work with, and it has been great to see the benefits of such a simple but innovative idea.’
Nick Smith, Account Manager at Consultant Connect.
The success of the project in supporting staff in routine practice to be able to provide more effective and responsive care for their patients was recognised in numerous ways, including as an award finalist at the HSJ Partnership Awards in 2022 for Best Mental Health Partnership with the NHS.
If you have any questions or would like more information about how our Enhanced Advice & Guidance service can support your area, please email hello@consultantconnect.org.uk or call us on 01865 261467.
