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.
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
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 – firstname.lastname@example.org.
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.
Community Specialist Palliative Care Services
Community Specialist Palliative Care Services (SPCS) are resources for health care professionals in all community care settings to access expert support for patients facing a life threatening condition irrespective of diagnosis.
In particular for:
- Management and monitoring of persistent and/or transient symptoms
- Management of complex emotional/psychological issues
- Management of complex social/family issues
- Planning end of life care .
It is important to recognise that the above are not mutually exclusive.
What is the Specialist Palliative Care Service
The team comprises of experienced registered nurses who have additional specialist knowledge and experience and work to Specialist Palliative Care Competencies. In addition to managing a clinical caseload within agreed boundaries and protocols they have a role within teaching, consultancy and research. The team work with other Specialist Palliative Care providers to try to help all healthcare professionals provide holistic palliative care.
The aim of the service
To ensure that all patients with complex palliative care needs receive high quality symptom control assessments, psychological support and advice to meet their individual needs.
When you telephone the service you will speak to a member of the Cornwall NHS switchboard who will take your message and pass it on to the nurse covering your area; messages are collected by the nurses regularly throughout the day. Please note this is not an emergency service – any urgent calls need to go to your GP surgery/On- call Doctor Service.
The nursing team work closely with a range of health professionals in the community, hospital and other statutory agencies such as Department of Adult Care and Support. We will seek your permission before sharing your personal information with other professionals. At times we may be accompanied by students as part of their training.
Ongoing care by the team may not necessarily be needed, assessment will guide this. Patients may be referred on to other services if appropriate.
Our service is available between 9 am and 4:30 pm seven days a week including bank holidays.