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Where patients on a ward can access Liaison Psychiatry, patients in a 'virtual ward' should too: the Ealing model of integrated care

Authors:

Christopher Hilton ,

Ksenia Marjanovic-Deverill,

Mohini Parmar

Abstract

No health without mental health: Around ½ of acute hospital inpatients suffer from depression, dementia or delirium. When unrecognised / untreated, mental health problems lead to poorer health outcomes and increased length of stay. Estimated cost per year to NHS £13.5bn on extra spending on physical health services.

In response to this, NHS England has set an expectation all acute trusts will have in place liaison psychiatry services for all ages appropriate to the size, acuity and specialty of the hospital by 2020.

In parallel with these developments, across the country acute care services are being reconfigured to support greater numbers of patients to be treated closer to home, with the development of intermediate care services operating a 'virtual ward', home treatment model.

Ealing model of integrated mental health care: In Ealing, West London Mental Health NHS Trust, supported by local commissioners, piloted the integration of liaison psychiatry specialist nurses into intermediate care teams working alongside general nurses, physio and occupational therapists to support the identification, assessment and treatment of mental health comorbidities in patients in this sub-acute setting.

Data from pilots in 2013-14 and 2014-15 led to the incorporation of an integrated mental health approach in a newly commissioned integrated intermediate care service, Home ward Ealing, provided by a consortium of health and social care providers, led by the mental health trust.

In 2013-14 the mental health worker inputted into the care of 22% patients being seen in intermediate care, and 82% of patients seen said their *care improved* as a result of all HCPs enquiring about their emotional wellbeing. In 2015-16, mental health staff inputted into the care of *38% of all patients in the service*, and saw 18% for face to face intervention. Feedback from patients, carers and referrers was positive.

Home ward Ealing: The new fully integrated model of care in the re-specified *Home ward Ealing* service is expected to abolish the exclusion of patients on the basis of mental illness or cognitive impairment and to ensure that patients in intermediate care _virtual_ ward settings have access to the same liaison psychiatry expertise as those in inpatient wards. 

How to Cite: Hilton C, Marjanovic-Deverill K, Parmar M. Where patients on a ward can access Liaison Psychiatry, patients in a 'virtual ward' should too: the Ealing model of integrated care. International Journal of Integrated Care. 2016;16(6):A195. DOI: http://doi.org/10.5334/ijic.2743
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Published on 16 Dec 2016.

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