TY - JOUR
KW - Attitude of Health Personnel
KW - Cross-Sectional Studies
KW - Delivery of Health Care, Integrated/organization & administration
KW - England
KW - Health Services Research
KW - Humans
KW - Medical Staff, Hospital/psychology
KW - Mental Health Services/organization & administration
KW - Qualitative Research
KW - Quality of Health Care
KW - Consultation-liaison
KW - Hospital psychiatry
KW - Liaison mental health
KW - liaison psychiatry
KW - qualitative
AU - K. Jasmin
AU - A. Walker
AU - E. Guthrie
AU - P. Trigwell
AU - A. Quirk
AU - J. Hewison
AU - C. C. Murray
AU - A. House
A1 - 
AB - BACKGROUND: Liaison psychiatry services provide mental health care for patients in physical healthcare (usually acute hospital) settings including emergency departments. Liaison work involves close collaboration with acute hospital staff so that high quality care can be provided. Services however are patchy, relatively underfunded, heterogeneous and poorly integrated into acute hospital care pathways. METHODS: We carried out in-depth semi-structured interviews with 73 liaison psychiatry and acute hospital staff from 11 different acute hospitals in England. The 11 hospitals were purposively sample to represent hospitals in which four different types of liaison services operated. Staff were identified to ensure diversity according to professional background, sub-specialism within the team, and whether they had a clinical or managerial focus. All interviews were audio-recorded and transcribed. The data were analysed using a best-fit framework analysis. RESULTS: Several key themes emerged in relation to facilitators and barriers to the effective delivery of integrated services. There were problems with continuity of care across the secondary-primary interface; a lack of mental health resources in primary care to support discharge; a lack of shared information systems; a disproportionate length of time spent recording information as opposed to face to face patient contact; and a lack of a shared vision of care. Relatively few facilitators were identified although interviewees reported a focus on patient care. Similar problems were identified across different liaison service types. CONCLUSIONS: The problems that we have identified need to be addressed by both liaison and acute hospital teams, managers and funders, if high quality integrated physical and mental health care is to be provided in the acute hospital setting.
AD - Department of Digital, Media, Culture and Sport, London, UK.; Clinical Research Network National Coordinating Centre, National Institute of Health Research Clinical Research Network, Leeds, UK.; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. e.a.guthrie@leeds.ac.uk.; National Inpatient Centre for Psychological Medicine, Leeds and York Partnership NHS Foundation Trust, Leeds, UK.; College Centre for Quality Improvement, Royal College of Psychiatrists, London, UK.; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
BT - BMC health services research
C5 - Education & Workforce
CP - 1
CY - England
DO - 10.1186/s12913-019-4356-y
IS - 1
JF - BMC health services research
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Liaison psychiatry services provide mental health care for patients in physical healthcare (usually acute hospital) settings including emergency departments. Liaison work involves close collaboration with acute hospital staff so that high quality care can be provided. Services however are patchy, relatively underfunded, heterogeneous and poorly integrated into acute hospital care pathways. METHODS: We carried out in-depth semi-structured interviews with 73 liaison psychiatry and acute hospital staff from 11 different acute hospitals in England. The 11 hospitals were purposively sample to represent hospitals in which four different types of liaison services operated. Staff were identified to ensure diversity according to professional background, sub-specialism within the team, and whether they had a clinical or managerial focus. All interviews were audio-recorded and transcribed. The data were analysed using a best-fit framework analysis. RESULTS: Several key themes emerged in relation to facilitators and barriers to the effective delivery of integrated services. There were problems with continuity of care across the secondary-primary interface; a lack of mental health resources in primary care to support discharge; a lack of shared information systems; a disproportionate length of time spent recording information as opposed to face to face patient contact; and a lack of a shared vision of care. Relatively few facilitators were identified although interviewees reported a focus on patient care. Similar problems were identified across different liaison service types. CONCLUSIONS: The problems that we have identified need to be addressed by both liaison and acute hospital teams, managers and funders, if high quality integrated physical and mental health care is to be provided in the acute hospital setting.
PP - England
PY - 2019
SN - 1472-6963; 1472-6963
SP - 522
T1 - Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service
T2 - BMC health services research
TI - Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service
U1 - Education & Workforce
U2 - 31345212
U3 - 10.1186/s12913-019-4356-y
VL - 19
VO - 1472-6963; 1472-6963
Y1 - 2019
Y2 - Jul 25
ER -