Extending a First Episode Psychosis service to include over 35 year olds : a UK service case study
Poster C77, Wednesday, October%2010, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Richard Whale1,2, Tobias Buxton2, Daniel Bird3, Kathryn Greenwood2,4, Stuart Clark2, James Fallon2; 1Brighton and Sussex Medical School, 2Sussex Partnership NHS Foundation Trust, 3Salomons, Canterbury Christ Church University, 4University of Sussex
In response to NHS England’s direction to extend UK EIP services to those aged 36 to 65 (although evidence is lacking on clinical outcome) Sussex EIP developed a shared care model for this group. Patients were offered a 6 week assessment period led by EIP to promote engagement, minimise DUP and initiate interventions. This was to be followed by shared care with generic adult community mental health services leading for 1 year with access to specialist EIP advice and nationally recommended interventions. A mixed methods data collection was undertaken of demographic, diagnostic, service impact and staff’s qualitative experience for 6 months following service implementation. 13.8% of all referrals to EIP Sussex were aged 36-65 (n=65), with 28 subsequently identified as FEP. There were higher rates of males to females (17:11) in those with confirmed FEP. Urban areas had a higher referral rate. Thematic analysis of EIP clinician’s experience indicated: dissatisfaction with providing a compromised/low fidelity FEP pathway, delays in implementing shared care with EIP taking an extended primary role, significant impact on clinical time, and greater complexity of needs in this older group including co-morbidity, traumatic bereavement, and larger family systems. Increasing the age range of EIP services was associated with greater demand and reduced fidelity to the EIP model. Staggered roll out of the pathway over time, in different geographical locations led to a lower number of referrals than expected. Shared care was overall unsuccessful and further service models for over 35s require exploring.
Topic Area: Service System Development and Reform