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Roles of general adult psychiatrists in follow-up clinics

Senior House Officer, Rotherham District General Hospital, Moorgate Road, Rotherham S60 2UD, email: sunilmehta{at}doctors.org.uk

Abhijeetha Salvaji

Specialist Registrar, Rotherham District General Hospital

Riadh Abed

Consultant Psychiatrist, Rotherham District General Hospital

Declaration of interest

The Doncaster and South Humber Healthcare Trust is one of the consultant development sites for New Ways of Working.

AIMS AND METHOD

Core features of New Ways of Working include concentrating on service users with complex needs, acting in a consultative role and carrying out interventions that are timely rather than routine. In this service-mapping exercise a retrospective analysis of 150 case notes was performed to evaluate clinical activity in general adult out-patient clinics and to attempt to measure the complexity of the workload.

RESULTS

Analysis of care programme approach (CPA) level revealed that 40% of patients were not on CPA and 16% of patients were on enhanced CPA. Only a third of the sample had a non-medical care coordinator. Absolutely no changes were made to the management plan in around half of the sample. A minority of patients needed to be seen acutely, within a month, or had their appointment brought forward.

CLINICAL IMPLICATIONS

Current out-patient activity of consultant teams does not appear to be consistent with New Ways of Working. Psychiatrists will be required to reflect on their roles in out-patient clinics to avoid ‘routine’ appointments and to use their time more efficiently.

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