written by Else Guthrie in September 2018
The health service in the UK is now determined separately by each of the home nations (England, Scotland, Wales and Northern Ireland).
The main developments in psychosomatic medicine are occurring in England. NHS England has decided to invest about £120 million in Liaison Mental Health Services (the new term for Consultation-Liaison Psychiatry Services) across England. There is a national target that by 20/21 at least 50% of all hospitals in England should have liaison services that are staffed to national standards and see emergency referrals within 1 hour of attendance at an Emergency Department or within 1 hour of referral from a hospital ward. Urgent referrals will be seen within 24 hours. The main focus is acute work, and there is no real provision in the plans for less acute treatment pathways. Several centres around the country are developing primary care liaison teams (with consultant liaison psychiatrists embedded in the teams) to treat people with complex physical and mental health needs. There are examples of these new services in the NE, Hull, Oldham, Stockport, Nottingham, Birmingham, Brighton, Bradford etc. All are slightly different and have developed because of local needs, rather than national policy drivers. Michael Sharpe’s developments of integrated care are continuing in Oxford. There are three large research projects in the liaison field in the UK.
Liaison Psychiatry: Measurement And Evaluation of Service Types, Referral patterns and Outcomes LP-MAESTRO £1,131,506.40 lead Allan House;
How can we best address prolonged acute hospital stays in older inpatients with medical-psychiatric multimorbidity?: A pragmatic multicentre randomised controlled trial to compare the effectiveness and cost-effectiveness of Proactive Liaison Psychiatry with usual care. Lead Michael Sharpe.£1,992,654.32; and a further project evaluating the role of symptom clinics in primary care for people with medically unexplained symptoms (Chris Burton lead).