Covid 19 referral Information

Covid 19 Referral Guidance to Complex Care and Dementia Psychiatric Liaison Service

These guidelines apply to ALL acute and community hospitals throughout Cornwall.

The Team

We are a nationally recognised Psychiatric Liaison Accreditation Network (PLAN) accredited service.  The team is based at Royal Cornwall Hospital (RCHT), Treliske.  The service is managed by the Complex Care and Dementia Liaison Service Clinical Lead.  The team will provide a service to all hospital sites Monday to Friday 09:00-17:00hrs excluding bank holidays during the escalation of Covid 19.The multi-disciplinary team comprises Registered Mental Health Nurses (RMNs), Consultant Psychiatrist, Core trainee in Psychiatry and team administration.

What we do

The Liaison Service is an essential component of the Complex Care and Dementia Service line.  We meet patients with many different mental health problems, such as:

  • Being worried about memory
  • Patients living with dementia with complex needs
  • Patients experiencing delirium with complex needs and behaviours
  • Problems with worry, stress or depression
  • Medically unexplained physical health problems
  • Psychosis

The Liaison Service provides comprehensive both telephone triage, advice and support as well as,  face to face mental health assessment of the patient and management advice to the referring team.  We communicate effectively with all those involved in the persons’ care including family members where appropriate to ensure our advice is based upon all relevant information available regarding the patient’s presentation and background history.  This is with a view to:

  • Provide advice and guidance on mental health nursing and care.
  • Provide advice and guidance on treatment options including appropriate use of psychotropic medication, taking into account local policy and only with the support of the Doctors in the multi-disciplinary team.
  • Ensuring that a patient’s mental health issues do not unnecessarily contribute to prolonged hospital admissions.
  • Improving detection and treatment of pain and other physical factors that may contribute to confusion and Behavioural and Psychological Symptoms of Dementia (BPSDs).
  • Offering advice and support to Carers.
  • Contributing to prompt and effective discharge planning for patients with mental health needs in liaison with the Onward Care Team.
  • Legal and National frameworks (Mental Health Act, Mental Capacity Act, including best interests consideration, Deprivation of Liberty safeguards and processes around safeguarding of vulnerable adults).

In providing ongoing assessment and treatment whilst the patient remains in the hospital, we work collaboratively with health care professionals in the general hospital setting to meet the needs of the patient and promote patient centred care.  During this time, the hospital wards clinicians have overall responsibility for the patients’ care until discharge.

The team also support complex discharge planning and where appropriate arrange community follow up.  After discharge the patients GP (and other relevant agencies) will be notified by way of an assessment letter to ensure continuity of care.

CC&D Psychiatric Liaison Service or the medical team can signpost the patient into other appropriate services.

Who we see

  • Patients who are confused due to suspected or known dementia, of any age.
  • Patients with functional mental illness who are 75 years or over.

Who we do not see

  • Patients who are already on the caseload of the Adult Integrated Community Mental Health Team (ICMHT) should be referred to the Adult Psychiatric Liaison Service. 
  • Patients presenting with deliberate self-harm (these patients should be referred for initial assessment and risk by the Adult Psychiatric Liaison service for RCHT patients and CMHT’s with other hospital settings).
  • Patients who are dependent on alcohol or other substances (these patients should be referred for assessment by the specialist Alcohol Liaison team within RCHT).
  • Patients requiring ongoing psychological therapies/interventions.

Referral to the service

We accept referrals from professionals in health and social care.

Referrals to the service can must be completed via Maxims (internal hospital referral system) selecting “Psychiatric Liaison Service” – Complex Care and Dementia.  This is the preferred route.

If refers do not have access to Maxims referrals should be made using the team referral form.  This should be sent to the team’s generic email address – cft.ccdliaison@nhs.net.

We aim to make contact with all referrers to the service for an initial telephone triage  by the end of the following working day.  However we will endeavour to respond to more urgent referrals in particular from the Emergency Department (ED) on the same working day where at all possible.  Urgent enquires can be made via telephone – 01872 252930.

Acute Care at Home West Contact Information

Central and West Team
Truro Health Park
Infirmary Hill
Truro, TR1 2JA
01872 221415

 E-mail:  cpn-tr.acah-west@nhs.net

Availability

8am – 10pm seven days a week

Acute Care at Home

The Acute Care at Home service provides advanced nursing care and support to patients in their own homes. The aim is to prevent an admission or support an early discharge from hospital.

Acute Care at Home are a team of highly qualified, experienced nurses who can provide advanced assessment skills and treatment to patients in their own homes.  This will avoid a patient being admitted to an acute setting.

Inclusion criteria:

  • The patient must be over the age of 18.
  • The patient has telephone access at home.
  • The patient must agree to treatment being given at home.

Types of conditions that can be managed by the team include:

  • Chest Infections / Bronchiectasis / COPD
  • Cellulitis / Osteomyelitis
  • Heart failure / Endocarditis
  • Pneumonia / Tonsillitis
  • Urinary Tract Infection / Pyelonephritis
  • Post-operative infections
  • Discitis
  • Liver Abscess
  • Meningitis
  • Hyperemesis
  • Nebuliser Therapy (short term use).
  • Blood Transfusions & Platelets (for house bound patients only).

The team is skilled in providing intensive nursing support at home.  Skills include:

  • IV Therapy (including re-hydration, antibiotics, anti-emetics and diuretics)
  • Respiratory and cardiovascular assessment and examination
  • Cannulation
  • Phlebotomy
  • We currently offer a maximum BD service.

General Information for Referrers:

  • The Acute Care at Home Team is available from 8am – 10pm, 7 days a week.
  • A co-ordinator is in the office Monday – Friday and there is an answerphone for non-urgent messages. We can also be contacted via Bodmin Switchboard (01208 251300).
  • We hold weekly ward round meetings where we discuss each of our patient’s with Dr Evans – Microbiologist and Dr Holland – ITU Consultant.

Referrals

Any health professional can make a referral to the team however, the patient’s GP needs to have assessed community patients within 24 hours of referral. The GP must be prepared to maintain medical responsibility while the patient is treated by the team; or, in the case of out of hours until the patient’s own GP is available.

Resources

Blood Transfusion Form

GP Consent Form

Prescription and Venous Thromboembolism Risk Assessment Form