In 2018, Consultant Connect is going to focus on Mental Health. Why? Because, whenever we speak with GPs, mental health is one of the areas they identify that they would like help with the most. It’s also an extremely promising use of telephone Advice & Guidance.
Consultant Connect has been providing a Mental Health Advice and Guidance service for GPs in Oxford since February 2016. This allows GPs with specific patient-based questions to talk directly to the Adult Mental Health team at Oxford Health.
The project was set-up with two lines:
- a Referral Advice line – to allow the Trust to better manage referral demand by allowing GPs to discuss the need and urgency of a referral prior to sending a letter
- a Medications Advice line – manned by local clinical psychiatrists to answer medication based questions.
What did GPs use the line for?
- 60% of calls were for advice about complex management issues (including medication choices but clinical rather than pharmacologically focused advice)
- 16% of calls were for advice about medication (pharmacological issues such as side effects, interactions and supply)
- 16% were for advice about pathways
- The remaining 8% were for acute referrals
The outcome data left after each call to the Referral Advice line showed:
- Referral avoided – 39%
- Routine (4-week) referral made – 15%
- Urgent (1-week) referral made – 22%
- Emergency (4-hour) referral made – 8%
(Note: 16% of calls were marked as not applicable – e.g. they were calls for advice about Children or Older adults etc.)
So, nearly 40% of patients avoided a referral and the remaining 60% were referred with the right level of urgency.
Why does telephone Advice & Guidance have a large impact in Mental Health
Our Medical Director and resident GP, Dr David Griffiths, audited the calls. He found the following:
- Reassurance about urgent referrals is time dependent and therefore favours telephone advice over email
- Consultant advice on complex management is almost always too complicated for email or, at least, a significant part of the discussion would be lost
- Email may work for simple pharmacological or pathway advice, but any complexity or nuance favours the speedy exchange of questions and answers offered by spoken conversations
In summary, it’s a fantastically complicated area and there is no substitute for a clinician-to-clinician conversation.
We are pleased to announce that Jenny Welling-Palmer has joined our team to drive telephone based Advice and Guidance in Mental Health. Jenny previously worked as Managing Director for Beacon UK, an innovative mental health system integrator that works in collaboration with the NHS. Prior to this she held a number of strategic and operational roles in a number of large teaching hospitals. If you are interested in understanding better how our service can help Mental healthcare provision in your area. Please contact us on 01865 261 467 or email firstname.lastname@example.org.