POLICY REF NO: SABP/SERVICE IMPROVEMENT/0024 POLICY NAME OF POLICY: REASON FOR THE POLICY: WHAT THE POLICY WILL ACHIEVE: WHO NEEDS TO KNOW ABOUT IT: DATE APPROVED: VERSION NUMBER: APPROVING COMMITTEE: DATE OF IMPLEMENTATION: DATE OF FORMAL REVIEW: AUTHOR/REVIEWER: DIRECTORATE RESPONSIBLE: DISTRIBUTION: Referral of known patients from general adult psychiatry into psychiatry of old age services To ensure appropriate, nondiscriminatory care for older adults with mental health problems Define responsibilities for the care of older adults with mental health problems, in accordance with the National Service Framework for Older People. All Directorates clinical and managerial staff 20th February 2007 1.0 Service Improvement Committee 1 st March 2007 An extension has been granted to July 2019 Cathie Sammon, Nurse Consultant for Older Adults Nursing and service user involvement Older Adult and Adult Directorates, General Managers, Medical Advisory Committees, Modern Matrons. 1 of 6 pages
REFERRAL OF KNOWN PATIENTS FROM GENERAL ADULT PSYCHIATRY INTO PSYCHIATRY OF OLD AGE SERVICES POLICY 1.0 PURPOSE This policy and accompanying procedure sets out clear guidelines to ensure that there is appropriate, non-discriminatory care for older adults with mental health problems. 2.0 POLICY STATEMENT Standard One of the National Service Framework (NSF), for Older People, aims to ensure that older people are never unfairly discriminated against in accessing NHS or Social Care services, as a result of their age. The NSF goes on to define age discrimination in terms of decision-making that takes account of a patient s chronological age, and not solely the patient s needs. It is generally agreed that the most appropriate professionals to care for a person with stable mental health needs, as they become older, are those who already know them. If these needs change, transfer of their care to older peoples services may be appropriate, as detailed in the procedure below for the referral of known patients from general adult psychiatry into psychiatry of old age services. 2 of 6 pages
PROCEDURE REF NO: SABP/SERVICE IMPROVEMENT0024/PROCEDURE01 PROCEDURE NAME OF POLICY OR PROCEDURE REASON FOR POLICY OR PROCEDURE WHAT THE POLICY WILL ACHIEVE: WHO NEEDS TO KNOW ABOUT IT? DATE APPROVED VERSION NUMBER APPROVING COMMITTEE DATE OF IMPLEMENTATION DATE OF FORMAL REVIEW AUTHOR/REVIEWER: RESPONSIBLE DIRECTORATE DISTRIBUTION Referral of known patients from general adult psychiatry into psychiatry of old age services To ensure appropriate, nondiscriminatory care for older adults with mental health problems Define responsibilities for the care of older adults with mental health problems, in accordance with the National Service Framework for Older People. All Directorates clinical and managerial staff 20 th February 2007 1.0 Service Improvement Committee 1 st March 2007 An extension has been granted to July 2019 Cathie Sammon, Nurse Consultant, for Older Adults Nursing and service user involvement Older Adult and Adult Directorates, General Managers, Medical Advisory Committees, Modern Matrons 3 of 6 pages
REFERRAL OF KNOWN PATIENTS FROM GENERAL ADULT PSYCHIATRY INTO PSYCHIATRY OF OLD AGE SERVICES PROCEDURE 1.0 INTRODUCTION This procedure should be read in conjunction with the policy for referral of known patients from general adult psychiatry into psychiatry of old age services. It defines responsibilities for the care of older adults with mental health problems, in accordance with the National Service Framework for Older People. 2.1 PROCEDURE STATEMENT 2.2 Definition of a Graduate Elderly Person A graduate patient with respect to Old Age Psychiatry Services is a person over 65 years who has a pre-existing mental health problem or prior episodes of mental illness. This procedure describes the circumstances of that person s graduation into Older Adult s services and in keeping with good practice as identified in the National Service Framework for Older People. Procedure Statement for Graduate Elderly Person. 2.2 The Older Adults Service is responsible for all Adults over the age of 65 years referred to the Trust with no previous contact with the Adult Psychiatric Services. 2.3 If the graduate patient s problems are mainly physical then the Adult team should refer to the Physicians and not Older Adults Service. 2.4 The service will take responsibility for Graduate Elderly patients who have had no previous contact with any of the Adult Mental Health services during the previous year. 2.5 The Older Adult services will normally expect to be responsible for the care of Graduate Elderly patients where individuals have developed a new additional age related psychiatric illness, usually, dementia; where they are in receipt of a complex package of services that older people use; are living in residential or nursing home care for older people; are 4 of 6 pages
physically frail, and especially if under the care of the geriatric physicians with complex problems 2.6 Following a CPA review with Adult services and members of the Older Adults service, it will be determined where the patient s needs, including cultural and ethnic needs where relevant, will be best met in conjunction with both services and the patient. 2.7 All transfers of graduate patients must be done from team to team and not via the patient s GP. Previous consultant to consultant discussion of cases may be helpful prior to formal referral. 2.8 Any difficulties in agreeing transfers should be resolved locally by the lead consultants in general adult and old age psychiatry, with input from the practice coordinators where appropriate. 2.9 The Older Adult service will take on responsibility for the graduate elderly patient once The Older Adults Service has carried out a multi-disciplinary Assessment. A CPA review has been carried out, regarding the transfer of care, and a care plan identified. For any patient over the age of 75 years who has a mental health problem Patient and Carer have been informed, involved and their wishes regarding the transfer have been taken into account 2.10 Patients should not be transferred to older peoples services during a crisis so unnecessary distress is avoided. 2.11 The older adults service will take responsibility for any patient under the age of 65 years who has a clear diagnosis of dementia. 2.12 Patients with Korsakoff s syndrome, or other non-progressive brain diseases, should be assessed on an individual basis for the appropriate service. References Department of Health (1999) National Service Framework for Mental Health: Modern Standards and Service Models. London: Department of Health. (2001) National Service Framework for Older People. London: Department of Health. Royal College of Psychiatrists London(2002) Caring for people who enter old age with enduring or relapsing mental illness ( graduates ) Council Report CR110 5 of 6 pages
Department of Health (2006) Mental Capacity Act Best Practice Tool. London Department of Health 6 of 6 pages