Dementia and older people’s mental health 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, Treliske. The service is managed by the dementia and older people’s mental health liaison service contact information clinical lead. They provide a service to all hospital sites, Monday to Friday 9am to 5pm, excluding bank holidays during the escalation of COVID-19. The multi-disciplinary team is made up of registered mental health nurses, a consultant psychiatrist, a core trainee in psychiatry and team administration.

What we do

The liaison service is an essential component of the dementia and older people’s mental health team.

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:

• providing advice and guidance on mental health nursing and care
• providing 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
• 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 such as the 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.

The complex care and dementia 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

We do not see patients:

• who are already on the caseload of the adult integrated community mental health team should be referred to the adult psychiatric liaison service
• presenting with deliberate self-harm (these patients should be referred for initial assessment and risk by the adult psychiatric liaison service for Royal Cornwall Hospital NHS Trust (RCHT) patients and community mental health team’s with other hospital settings)
• who are dependent on alcohol or other substances (these patients should be referred for assessment by the specialist alcohol liaison team within RCHT)
• requiring ongoing psychological therapies and interventions

Referral to the service

We accept referrals from professionals in health and social care.

Referrals to the service must be completed via Maxims (internal hospital referral system). Select psychiatric liaison service, then 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. Email completed referrals forms to the complex care and dementia liaison team. Complete a referral before you complete the single electronic referral form.

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 on the same working day when possible. Call 01872 252 930 if you have an urgent enquiry.