Abstract
Aims and MethodIn order to examine the opportunities for senior house officers (SHOs) to undertake emergency psychiatric assessments we conducted a retrospective cohort study of such assessments in a district general hospital.ResultsSenior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P< 0.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested. Senior house officers continue to undertake more assessments out of hours than any other group (P< 0.01).Clinical ImplicationsAlthough the introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for SHOs to undertake emergency assessments has been reduced, particularly with regard to assessment of suicidal risk following self-harm. These results suggest the need for better monitoring of SHO experience, particularly in the light of service developments that have an impact on psychiatric training.
Highlights
Senior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P50.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested
The introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for senior house officers (SHOs) to undertake emergency assessments has been reduced, with regard to assessment of suicidal risk following self-harm. These results suggest the need for better monitoring of SHO experience, in the light of service developments that have an impact on psychiatric training
The case records were examined of all patients aged 16^ 65 years referred from the community (general practitioner (GP), community mental health teams, police) and other hospital services for psychiatric assessment at Wrexham Maelor Hospital (North East Wales National Health Service (NHS) Trust, catchment 280 000) over a 2-month period (December 2002 to January 2003)
Summary
Senior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P50.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested. The introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for SHOs to undertake emergency assessments has been reduced, with regard to assessment of suicidal risk following self-harm These results suggest the need for better monitoring of SHO experience, in the light of service developments that have an impact on psychiatric training. Junior doctors in the UK have experienced reductions in hours spent on call with the introduction of the European Working Time Directive (2004; details available at http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining / WorkingDifferently / EuropeanWorkingTimeDirective/fs/en) This has led to a reduction in exposure to emergency psychiatric assessments. This paper reports the second part of a retrospective study of emergency psychiatric assessments over a 2-month period
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