Theo Boardman-Pretty & George Gillett
I am in my third year of Core Psychiatry Training at South London & Maudsley NHS Trust (SLaM), and am currently working in the National & Specialist OCD, BDD & Related Disorders service for children and young people. I have an interest in addressing the physical health burden of those with mental health problems, and I am currently also working on projects regarding the monitoring of SSRI side effects and the assessment and management of gender-based violence in users of psychiatric services. I have a keen interest in teaching and have led multiple educational projects at SLaM / King’s College London School of Medicine.
Dr George Gillett
Dr Gillett junior doctor at South London and Maudsley NHS Foundation Trust and Academic Clinical Fellow affiliated with King’s College London. His research interests include precision psychiatry and the use of digital technologies in mental health. He has previously held a Digital Fellowship in Healthcare, funded by the Topol Programme, Health Education England.
Dr Gillett also has a keen interest in public engagement. He has written for a number of media publications on topics related to healthcare and served as a member of the Royal College of Psychiatrists’ Public Engagement Editorial Board.
People with severe mental illnesses have poorer physical health and a reduced life expectancy compared to the general population. Two novel interventions, Consultant Connect (CC) and a Physical Health Clinic (PHC), were introduced in June 2020 at South London and Maudsley NHS Foundation Trust (SLaM) to improve integration between mental and physical healthcare systems and patient outcomes.
CC is an App that enables direct telephone access to specialist Consultants in local, acute hospitals for brief advice and guidance. All clinicians working at SLaM have access. The PHC is available to 12 adult mental health wards across SLaM. Referrers can request advice for various physical health complaints. A Consultant Physician responds by e-mail, telephone, or in person.
We report an ongoing prospective evaluation of the implementation and service impacts of the two interventions.
Implementation of both interventions is being assessed by uptake data, validated measures of acceptability, appropriateness and feasibility and qualitative data collected via semi-structured interviews with users, using co-designed topic guides. A sample of users (n=10) will be interviewed per intervention. The ERIC implementation strategies framework will guide the assessment of implementation strategies for both interventions.
From June 2020 to-date, CC has been used >1800 times; there have been >450 user downloads/registrations; >60 specialist services have been contacted. The PHC has received >80 referrals; from 35 referrers (32 medical / 3 nursing); from 12/12 inpatient wards included in the pilot. The above data are being mapped against the ERIC strategies to determine which strategies yielded higher uptake. Qualitative data collection is ongoing. We will update on our findings so far.
Integration of mental and physical health services is one potential approach to reduce the mortality gap in people with SMI. Our results can inform future service developments by providing insights into clinical and implementation effectiveness.