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Guidance for commissioners of liaison mental health services to acute hospitals 1
Joint Commissioning Panel
for Mental Health
www.jcpmh.info
Guidance for commissioners of
liaison mental health
services to acute hospitals
Volume
Two:
Practical
mental health
commissioning
Joint Commissioning Panel for Mental Health www.jcpmh.info Co-chaired by: Membership:
2 Practical Mental Health Commissioning
Contents
Executive Introduction What are Why is acute
summary acute liaison liaison important
services? to commissioners?
04 05 05
What do we What would Supporting Resources
know about the a good liaison the delivery and references
current provision service look like? of the mental
of acute liaison health strategy
services?
07 09 12 14
Guidance for commissioners of liaison mental health services to acute hospitals 3
Executive summary
• Physical and mental health are • A liaison service should be an integral
inextricably intertwined. Long-term part of the services provided by acute
conditions (LTCs), such as diabetes, hospital trusts – trusts that have
are associated with high rates of mental incorporated a liaison service have
illness. Some 70% of NHS spend goes demonstrated much better cost-
on the treatment of LTCs, a great deal effectiveness.
of which currently involves treatment
• Commissioning of acute liaison
in acute hospitals.
services should be universally included
• Psychological stress is often expressed in contracts for the provision of
as physical symptoms, which are an acute hospital services and concord
example of medically unexplained to standards set by professional and
symptoms (MUS). regulatory authorities.
• The mental health needs of a patient • Acute liaison services should have the
in a physical health care setting often resources and skills needed to support
remain undiagnosed and therefore all age groups.
untreated. To optimise the physical
• Liaison services may, over time, extend
health care of patients, it is essential
their remit to help primary mental health
that their mental health and wellbeing
care to manage people with LTCs and
are addressed at the same time.
MUS, in order to avoid unnecessary
• Liaison services should be provided admissions to secondary care.
throughout the acute hospital, including
in A&E departments. Services should
be provided to meet the needs of
patients with a mental disorder
secondary to their physical disorder,
or a physical disorder alongside their
mental disorder, and for patients
(particularly those with MUS) where
it is impossible to separate the two.
• Acute liaison services operate within
existing (often ad hoc) local networks
of other generic and disorder-specific
clinical health psychology and
multidisciplinary services. This should
be mapped out by commissioners so
that acute liaison becomes a primary
partner in the effective management
of the emotional and adjustment/
behavioural needs of all patients
presenting to acute services.
4 Practical Mental Health Commissioning
Introduction
The Joint Commissioning Panel The JCP-MH has two primary aims: How will this guide help you?
for Mental Health (JCP-MH) • to bring together service users, carers, This guide has been written
(www.jcpmh.info) is a new clinicians, commissioners, managers and by a group of acute liaison
collaboration co-chaired by others to work towards values-based
experts in consultation with
commissioning
the Royal College of General patients and carers.
Practitioners and the Royal • to integrate scientific evidence, service
user and carer experience and viewpoints, The content is primarily evidence-based but
College of Psychiatrists, ideas deemed to be best practice by expert
and innovative service evaluations in
which brings together leading order to produce the best possible advice consensus have also been included. By the
organisations and individuals on commissioning the design and delivery end of this guide, readers should be more
with an interest in commissioning of high quality mental health, learning familiar with the concept of acute liaison
for mental health and learning disabilities, and public mental health and better equipped to:
disabilities. These include: and wellbeing services.
• understand what a good quality,
The JCP-MH: modern, acute liaison service looks like
• Service users and carers • understand why a good acute liaison
• Department of Health • has published Practical Mental Health
service delivers the objectives of the
• Association of Directors Commissioning,2 a briefing on the key
mental health strategy and the Quality,
of Adult Social Services values and principles for effective mental
Innovation, Productivity and Prevention
• NHS Confederation health commissioning
(QIPP) challenge – not only in itself but
• Mind • provides practical guidance and a also by enabling changes in other parts of
• Rethink Mental Illness developing framework for mental health the system.
• National Survivor User Network • will support commissioners of public
This guide also addresses issues relating
• National Involvement Partnership mental health to deliver the best
to the commissioning of acute liaison
• Royal College of Nursing possible outcomes for community
services. It describes:
• Afiya Trust health and wellbeing
• British Psychological Society • the benefits of liaison services
• has published a series of short guides
• Representatives of the English • the optimum liaison psychiatry team
describing ‘what good looks like’ in
Strategic Health Authorities • the mental health needs in acute care
various mental health service settings.
• Mental Health Providers Forum settings that a liaison service addresses
• New Savoy Partnership Who is this guide for? • why a liaison service is important for
• Representation from commissioners of acute hospital services.
Specialised Commissioning This guide describes what
This guide draws on, and refers to,
• Healthcare Financial ‘good looks like’ for a modern previously published guidance including:
Management Association. acute liaison service. It
• the Royal College of Psychiatrists
The JCP-MH is part of the implementation should be of value to Clinical
College Centre for Quality Improvement
arm of the government mental health Commissioning Groups (who PLAN standards3
strategy No Health without Mental Health.1 will be commissioning secondary • the Royal College of Psychiatrists
services, both specialist mental CCQI Mental Health Policy
and acute). Implementation Guide for Liaison
Psychiatry and Psychological Medicine
in the General Hospital4
• the Royal College of Psychiatrists
briefing No Health without Mental
Health: the Supporting Evidence5
• the NHS Confederation briefing
Healthy Mind, Healthy Body.6
Guidance for commissioners of liaison mental health services to acute hospitals 5
What are acute Why is acute liaison important
liaison services? to commissioners?
An acute liaison service The problems acute liaison Mental and physical health
are closely linked
is designed to provide addresses are common:
services for: • mental disorder accounts for around Mental illness increases risk
• people in acute settings (inpatient or five per cent of A&E attendances, 25% of physical illness and
outpatient) who have, or are at risk of primary care attendances, 30% of complicates its management.
of, mental disorder acute inpatient bed occupancy and 30% Depression is associated with:
of acute readmissions7
• people presenting at A&E with urgent • reduced life expectancy of 10.6 years
mental health care needs • self-harm accounts for between
in men and 7.2 years in women12
150,000 and 170,000 A&E attendances
• people being treated in acute settings • increased risk of coronary heart disease13
per year in England8
with co-morbid physical disorders such
• MUS may account for up to 50% of • four-fold increased risk of myocardial
as long-term conditions (LTCs) and
acute hospital outpatient activity9 infarction (MI) and four-fold increased
mental disorder
risk of death within six months of
• people being treated in acute hospital • 13–20% of all hospital admissions and
myocardial infarction14
settings for physical disorders caused up to 30% of hospital admissions via
A&E at weekends are related to alcohol10 • two-fold increased risk of type 2
by alcohol or substance misuse
diabetes15
• people whose physical health care is • in England, alcohol-related hospital
admissions doubled in the 11 years up • three-fold increased risk of non-
causing mental health problems
to 2007, and alcohol-related deaths also compliance with treatment
• people in acute settings with medically recommendations.16
doubled in the 15 years to 200611
unexplained symptoms (MUS).
• one quarter of all patients admitted to Schizophrenia is associated with:
The service aims to increase the detection, hospital with a physical illness also have
recognition and early treatment of • reduced life expectancy of 20.5 years
a mental health condition that, in most in men and 16.4 years in women17
impaired mental wellbeing and mental cases, is not treated while the patient is
disorder to: • three-fold increased death rate from
in hospital6
respiratory disease18
• reduce excess morbidity and mortality • most patients who frequently re-attend
associated with co-morbid mental and • two-fold increased risk of obesity, two
A&E departments do so because of an
physical disorder to three-fold increased risk of smoking,
untreated mental health problem6
two-fold increased risk of diabetes,
• reduce excess lengths of stay in acute • two thirds of NHS beds are occupied two to three-fold increased risk of
settings associated with co-morbid by older people, up to 60% of whom hypertension, five-fold increased risk
mental and physical disorder have or will develop a mental disorder of dyslipidaemia and two to three-fold
• reduce risk of harm to the individual and during their admission.6 increased risk of metabolic syndrome.19
others in the acute hospital by adequate
risk assessment and management Substance use disorder is associated
with 13.6 year reduced life expectancy
• reduce overall costs of care by reducing
for men and 14.8 years for women.12
time spent in A&E departments and
general hospital beds, and minimising Smoking is the main cause of preventable
medical investigations and use of death in the general population. People
medical and surgical outpatient facilities with a mental disorder smoke much more
• ensure that care is delivered in the than people without a mental disorder:
least restrictive and disruptive manner they consume 42% of all tobacco
possible. consumed in England.20
6 Practical Mental Health Commissioning
Why is acute liaison important to commissioners? (continued)
Physical illness increases the risk of Integrated mental Liaison services are important in facilitating
mental illness. Depression is more common and physical health care collaborative care approaches to both
in those with a chronic physical illness.21 mental and physical health conditions.
The close links between
Risk of depression is doubled for people Closer working between primary and
with diabetes, hypertension, coronary mental and physical health secondary care staff is particularly
artery disease and heart failure, and highlight the importance of important in improving the confidence
tripled in those with stroke, end-stage an integrated approach to of specialist mental health staff in
renal failure and chronic obstructive treating physical and mental identifying, preventing and intervening
pulmonary disease.22 illness. However, traditionally early with physical health problems, and
vice versa (see the companion primary
Depression is more than seven times mental and physical health
mental health care commissioning guide).
more common among people with two care have been commissioned
or more chronic physical conditions.23 separately; it is rare that the The quality and productivity
One in five people newly diagnosed with challenge (QIPP)
cancer or first hospitalised with a heart
needs of patients with mental
attack will develop depression or anxiety and physical health problems Commissioners are required
within one year.24 are provided for through a to improve quality while
Children with physical illness are at
single funding stream. at the same time increasing
increased risk of emotional or conduct Mental health and physical health productivity (QIPP). Liaison
disorder.25 are closely linked. Liaison services services provide an excellent
provide commissioners with a means to opportunity to do this by:
address this in the acute hospital setting.
• improving clinical outcomes
Liaison services can significantly reduce
incidence of mental illness associated • reducing admissions to and lengths of
with physical illness and vice versa, stay in acute settings
thereby reducing the burden on both • ensuring patients with co-morbid long-
primary and secondary care. The focus term conditions receive better treatment
of Improving Access to Psychological while using fewer health care resources
Therapies (IAPT) has been extended to • treating and reducing costs for patients
cover psychological interventions for with MUS
LTC co-morbidity and MUS.
• reducing psychological distress following
Mental illness can frequently cause self-harm, and reducing suicide.
or aggravate physical disorder. These
disorders are seen and treated in acute
hospital settings. The commissioners of
acute hospital services should therefore
be responsible for commissioning acute
liaison services to meet this need.
Guidance for commissioners of liaison mental health services to acute hospitals 7
What do we know about the
current provision of acute liaison services?
There is currently no single, • participation in Mental Health Act • assessment, management and
uniform model for liaison services and Mental Capacity Act assessments, signposting of patients with alcohol and
and performing risk assessments for substance misuse disorders.
across the country. Where such harm to self and others
services exist, they are often The service could bring the
• expert advice on capacity to consent following benefits:
provided by the local mental for medical treatment in complex cases
health trust within the estate of involving both physical and mental • increased mental health care capacity
the acute hospital trust, which health problems within the acute hospital through
collaboration
may present logistical and • acting as a Responsible Clinician
operational challenges. under the Mental Health Act for people • improved wellbeing of staff in acute
detained under the Act, and receiving hospital settings, by relieving the anxiety
Liaison services are commonly these staff sometimes feel when dealing
care in the acute hospital
commissioned by the commissioners of with patients with complex needs –
mental health services (rather than the • rapid response to requests for
this may in turn help reduce levels
commissioners of acute hospital care). assessment in the A&E department and
of sickness absence
This is despite the fact that the acute trust on acute hospital wards (assessment and
management of people who have self- • improved patient self-management
should be providing them, and the quality
harmed forms a significant proportion of their care
and productivity benefits that derive from
the service are realised within the acute of this responsibility) • improved physical care of people
hospital setting. • development of care plans with mental disorder
post-assessment • reduced stigma associated with
Most acute liaison services • arranging appropriate follow-up mental health care.
could provide the following: post-discharge
• advice, training and coaching on • assessment of people with MUS
the management of mental health • management of people with MUS
problems to other professionals in who require a higher level of input
the acute hospital than can be provided by lower
• biopsychosocial assessment, intensity services such as IAPT – in
formulation and diagnosis for people association with primary care, specialist
identified by acute hospital staff medical teams and other specialist
as experiencing impaired mental multidisciplinary teams (eg. chronic
wellbeing or whose physical symptoms fatigue syndrome/ME services)
are unexplained • contributing to the management
• brief interventions, advice and of people with long-term physical
signposting to services in a range conditions in collaboration with primary
of agencies for patients in acute care and specialist physical health
hospital settings multidisciplinary teams (eg. diabetes
psychology and dietetics)
• assistance with the management
of people with long-term physical
conditions
8 Practical Mental Health Commissioning
What do we know about the current provision of acute liaison services? (continued)
Models of acute liaison service • chronic pain management teams and
vary greatly, from those that chronic fatigue teams, operating over a
wider area than a single acute hospital
provide a ‘core’ adult mental
• cancer network of psychosocial support
health liaison service to those
professionals, organised to support
that cater for more complex sophisticated training arrangements for
needs (learning disability, medical and nursing oncology staff (and
dementia, children and young often including liaison psychiatrists)
people). However there is a • cardiac and pulmonary rehabilitation
considerable body of work that teams.
describes what liaison services Existing liaison services tend typically to
should do, how they should be be for adults with mental health needs,
organised and what standards and not for children and young people.
they should achieve. An important development would be
for commissioners to commission liaison
Liaison psychiatry provision is often patchy, services that are age-inclusive. The liaison
despite its core role in risk management needs of children and young adults may
and in facilitating good physical health differ in some respects from those of
care. The picture is further complicated by adults and older people but the principles
the range of other services that provide and benefits are applicable across all ages.
behavioural input to physical health This all-age approach will present
care. Liaison services have a unique and challenges to the way in which services
essential role in providing broad cover are currently organised but is important
across health care settings, and in their if the ambition of the English mental
capacity to handle the most severe and health strategy is to be realised through
risky mental health problems. However, the commissioning process.
commissioners will also need to consider
the range of other services that provide Furthermore, the current patchy nature
evidence-based talking therapies and of liaison services commissioning leads
rehabilitation for physical health problems, to patchy provision. There should be
including MUS and LTCs. These include: universal agreement to commission liaison
services as part of the acute hospital care
• clinical health psychology embedded commissioning process.
in medical teams, such as oncology,
diabetes, renal, rheumatology or
respiratory teams and providing
specialist talking therapies, assessment,
consultation, training and research
Guidance for commissioners of liaison mental health services to acute hospitals 9
What would a good liaison service look like?
Model of service delivery Key components of the service • broad capacity building across the health
and social care system so that mental
A good liaison service functions A comprehensive liaison service health is much more readily recognised
best as a discrete, specialised, will have the following features: as a concomitant to physical health
fully integrated team comprising • ability to work closely with the acute (liaison clinicians should be able to assess
multi-professional health care hospital through integrated governance, physical health as well as mental health,
staff, under single leadership open (pre-referral) discussion with the manage mental health issues, recognise
the remit of their capabilities, and refer
and management. hospital’s principal referring units, a
single point of referral and the capacity to psychiatric services when appropriate)
A core service should be based on the to serve the agreed hospital population • provision of supervision, liaison and
following principles: direct clinical activity outside the acute
• provision of comprehensive assessment
• staff members sole (or main) and formulation, including risk setting and into primary care when care
responsibility is to the acute liaison team assessment and joint assessment where pathways for patients with MUS, LTCs
appropriate, using recognised formal or other issues require consistency of
• the team includes adequate skill mix
instruments to provide diagnosis and care in order to avoid deterioration or
• the team has strong links with specialist re-admission
formulation that leads to an agreed plan
mental health services and good general
that is communicated in a timely manner • all-age inclusive services, including
knowledge of local resources
• capacity to engage effectively with liaison services for children, older people
• there is clear and explicit responsibility and adults with dementia
the patient in a safe place that allows
for all patients in the acute hospital
a positive therapeutic relationship to • holistic and culturally responsive
setting
be built services.
• there is one set of integrated
• provision of a range of interventions
multi-professional healthcare notes
including signposting, support,
• consultant medical staff are fully
psychosocial interventions, therapeutic
integrated.
interview, brief psychotherapeutic
interventions, and pharmacotherapy
• effective liaison with other parts of
the health system, including general
practice, crisis and in-patient teams,
specialist mental health teams, social
services, emergency services and non-
statutory agencies10 Practical Mental Health Commissioning
What would a good liaison service look like? (continued)
Standards Table 1: Examples of levels and skill mix for a team serving a general
hospital with 650 beds and 750 new self-harm patients per year.
Commissioners will need to (Mental Health Policy Implementation Guide, 2008)
commission liaison services
that can demonstrate that they
role grade time comment
meet the recognised standards
for the service. Medical Consultant Whole time Consultant involvement is essential,
including managing risk, providing
These are set out in the Royal College supervision and training, and offering
of Psychiatrists College Centre for expertise on psychopharmacological
Quality Improvement (CCQI) Plan treatment, complex patients, capacity
standards,3 against which liaison services and the Mental Health Act.
may be accredited. These are not
Nursing Band 8 Whole time One of the nursing roles should be as
currently mandatory. It is suggested
team leader.
that the PLAN accreditation process
becomes a commissioning requirement, Nursing Band 7 3x The nurses operate as autonomous
with the joining fee included in the whole time practitioners, undertaking assessments,
commissioning process. and brief treatment interventions, and
liaising with mental health teams in
The optimum liaison team primary care. Those working with older
adults will become involved in detailed
To provide the breadth discharge planning.
of services set out above, Clinical Band 8 1 May be provided from health
a range of staff operating Psychology psychology team, but should be
within a multidisciplinary an integral part of a liaison team
team is essential. to provide supervision, training
and delivery of brief psychological
Table 1 sets out the absolute minimum treatments.
staff requirements to provide an adult
Team PA Band 4 1.5 x Core to referral management,
care liaison service working office-
whole time information gathering and
hours within an acute hospital with 650
communication.
beds, as described in the Royal College
of Psychiatrists Mental Health Policy
Implementation Guide.4
• adults with complex needs The model of acute liaison services
additional staffing requirements outlined in this guide will require a number
• older-age adults –all senior staff will need
experience in older people’s mental health, of additional therapists with experience
If liaison professionals are to and all teams should have the necessary of working with people with MUS. These
provide teaching, training and requirements to allow training of juniors therapists may come from a variety of
support to colleagues within and students for all professional groups backgrounds, including social work,
occupational therapy and physiotherapy
their team and throughout the • CAMHS – child and adolescent mental
general hospital, the staffing health services to general hospitals should For examples of guidance on appropriate
ratios above would need to be be provided by specialist multidisciplinary staffing levels for older-age adults and
CAMHS liaison teams, but current other population groups please see
increased to allow for this.
provision is patchy and further investment references26-31,as well as the existing
Similarly, a greater number of staff will be is required. JCP-MH series of guides on commissioning
needed to provide a comprehensive office (www.jcpmh.info).
hours liaison service for:Guidance for commissioners of liaison mental health services to acute hospitals 11
Outcomes RAID is a new model for acute liaison Quality indicators have confirmed good
services developed by Birmingham and patient feedback on improved holistic care
The quality outcomes of Solihull Mental Health Foundation Trust in acute care settings. Staff feedback has
liaison services include: and the University of Staffordshire. It confirmed that the team is popular and has
• improved service user experience has been piloted at Birmingham’s City built capacity and confidence in managing
and care outcomes Hospital, an inner city general hospital patients with mental health issues,
with some 600 beds.31 reduced violence and improved morale (as
• improved access to mental health care
evidenced in the annual staff survey).
for a population with high morbidity The service offers consultation and liaison
• reduced emergency department waiting to A&E, the medical assessment unit and In terms of hospital efficiency, waiting
times for people with mental illness the medical, maternity and surgical wards, times for mental health patients in A&E
with response targets of one hour for A&E have been reduced by 70%, which is
• reduced admissions, re-admissions
and 24 hours for inpatients. reflected in an overall improvement in
and lengths of stay
A&E waiting times.
• reduced use of acute beds by patients RAID builds on existing liaison services,
with dementia adding health and social care capacity to The service is to expand across the
the liaison team, plus specialist skills in Birmingham acute care health economy
• reduced risk of adverse events
older adults and addictions – as such, it is to cover five acute hospitals with 3,600
• enhanced knowledge and skills of a complete, all-age mental health service beds in total. Throughout this expansion
acute hospital clinicians within an acute trust. it will be subject to ongoing evaluation.
• improved compliance of acute trusts
RAID is viable at a cost of circa £1 million
with legal requirements under the
for a hospital of circa 600 beds.
Mental Health Act (2007) and Mental
Capacity Act (2005) Economic evaluation of RAID, undertaken
• improved compliance with NHS by the London School of Economics, has
Litigation Authority Risk Management demonstrated that it can achieve the
Standards and the Clinical Negligence following outcomes, over and above
Scheme for Trusts (CNST). traditional liaison services:
• reduce admissions, leading to a
RAID: an example of
reduction in daily bed requirement
service innovation
of 44 beds per day, saving the NHS
The Rapid Assessment Interface £3.55 million per annum through
and Discharge (RAID) service is decommissioning acute beds
an age-inclusive, drugs/alcohol • reduce discharges to institutional care
inclusive, consultant-led service for elderly people by 50%, saving local
authorities £3 million per annum in
that is fully integrated into the contributions to residential care
structure and function of an
• produce a consequent cost-to-return
acute hospital in Birmingham. It ratio of £1 to £4.
has shown dramatic reductions
in bed use,particularly use of
acute/elderly ward beds by
patients with dementia.12 Practical Mental Health Commissioning
Supporting the delivery of the mental health strategy
The JCP-MH believes that Shared objective 4:
commissioning that leads to More people will have a positive
good acute liaison services, experience of care and support.
as described in this guide, By addressing both physical and mental
will support the delivery of health needs together, acute liaison
the mental health strategy1 services can improve the likelihood of
in a number of ways. patients experiencing more holistic and
positive care in acute hospital settings.
Shared objective 1:
More people will have Shared objective 5:
good mental health. Fewer people will suffer
avoidable harm.
Commissioning acute liaison services will
increase the number of people receiving One of the key components of a
appropriate care and support and reduce good liaison service is to assess the
the number developing mental illness. This risk of self-harm and harm to others.
is because they provide early identification, Commissioners should look to a liaison
diagnosis, and either treatment or referral, service to both provide short-term
for people with mental health needs interventions and appropriate onward
admitted to acute hospital. referral and signposting. Reducing
outpatient attendance, hospital admissions
Shared objective 2: and readmissions protects patients from
avoidable harm.
More people with mental
health problems will recover. Shared objective 6:
A patient’s road to recovery is often Fewer people will experience
made more difficult by the co-morbidity stigma and discrimination.
of physical and mental health needs.
By commissioning a liaison service that By commissioning services that recognise
addresses both physical and mental mental and physical health as inseparable
health needs together, the prospects and inter-related, commissioners will be
of recovery are enhanced. actively addressing the stigma that derives
from the artificial separation of physical
Shared objective 3: and mental health and increasing public
and professional understanding of their
More people with mental
frequent coexistence.
health problems will have
good physical health.
Ensuring that a person’s mental health
needs are also addressed when they are
in an acute hospital for treatment for their
physical health needs removes one of
the potential barriers to provision of
good physical health care. Liaison
services can reduce the risk of self-harm
and suicide while also addressing the
long-term conditions and medically
unexplained symptoms with which
many patients present.Guidance for commissioners of liaison mental health services to acute hospitals 13
Liaison Expert Reference Group Members
• Paul Gill (ERG Chair) • Rebecca Harrington Development process
Consultant Psychiatrist Assistant Director This guide has been written by a group
Sheffield Liaison Psychiatry Service (Strategic Planning and Joint of liaison care experts, in consultation
Sheffield Health and Social Care Commissioning) with patients and carers. Each member
NHS Foundation Trust London Borough of Camden of the Joint Commissioning Panel for
& Camden PCT Mental Health received drafts of the guide
• Jonathan Campion for review and revision, and advice was
Consultant Psychiatrist • Lance McCracken sought from external partner organisations
South London and Maudsley Consultant Clinical Psychologist and individual experts. Final revisions
NHS Foundation Trust Bath Centre for Pain Services to the guide were made by the Chair
Royal National Hospital for of the Expert Reference Group in
• Mike Clarke Rheumatic Diseases collaboration with the JCP’s Editorial Board
London School of Economics (comprised of the two co-chairs of the
and Political Science • Stella Morris JCP-MH, one user representative, one
Consultant Psychiatrist carer representative, and technical and
• Chris Fitch Humber NHS Foundation Trust project management support staff).
Research and Policy Fellow
Royal College of Psychiatrists • Kieron Murphy
Director of Delivery
• Jeremy Gauntlett-Gilbert Joint Commissioning Panel
Senior Clinical Psychologist for Mental Health
Bath Centre for Pain Services
Royal National Hospital for • Chris Naylor
Rheumatic Diseases Fellow (Health Policy)
King’s Fund
• Annemarie Smith
Carer Representative14 Practical Mental Health Commissioning
Resources References
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www.jcpmh.info a cross-government mental health
www.nhsconfed.org/Publications/
outcomes strategy for people of all ages.
This website describes the function Documents/Briefing_179_
London: Department of Health.
and intended outputs of the JCP-MH Healthy_mind_healthy_body_MHN.pdf
This briefing explains how liaison 2 Bennett, A., Appleton, S., Jackson, C.
Quality standards for liaison psychiatry services can transform (eds) (2011). Practical mental health
psychiatry services (2nd ed). quality and productivity in acute commissioning. London: JCP-MH.
Royal College of Psychiatrists settings. It sets out some good practice www.rcpsych.ac.uk/pdf/JCP-MH%20
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www.rcpsych.ac.uk/pdf/PIG2.pdf that should underpin these services. of Psychiatrists. www.rcpsych.ac.uk/pdf/
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Department of Health
that should be in place in a liaison team if 5 Royal College of Psychiatrists (2007).
mental health website
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www.dh.gov.uk/en/Healthcare/ supporting evidence. London: Academy
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