King’s Health Partners | Behavioural and Developmental Psychiatry: Clinical Academic Group Outcomes Psychological Medicine Clinical Academic Group King’s Health Partners n King’s Health Partners brings together: n three of the UKs leading NHS Foundation Trusts n a university ranked 8th in the world for clinical, pre-clinical and health n 4.2m patient contacts each year n over 36,000 staff n more than 25,000 students n a combined annual turnover of £3.1bn n services provided across central and south London and beyond, including nine mental health and physical healthcare hospitals and many community sites n a comprehensive portfolio of high quality clinical services with international recognition in cancer, diabetes, mental health, regenerative medicine, transplantation, cardiac and clinical neurosciences n a major trauma centre and two hyper-acute stroke units King’s Health Partners | Psychological Medicine Clinical Academic Group About King’s Health Partners King’s Health Partners Academic Health Sciences n increase the value of the care we provide and Centre brings together one of the world’s top the outcomes we achieve for our patients and research-led universities, King’s College London, service users and three of London’s most prestigious and highly regarded NHS Foundation Trusts – Guy’s and n integrate care across local primary, St Thomas’, King’s College Hospital and South secondary and social care services to make it London and Maudsley. easier for people to get the care and support they need Our partnership provides a powerful combination of complex clinical specialties that cover a wide n improve the public health of our local range of physical and mental health conditions community by tackling inequalities and and a breadth of research expertise that spans supporting people to live healthy lives disciplines from medicine and biomedical sciences to the social sciences and humanities. n bring together our collective strength and expertise in a range of specialist There are three parts to our mission: excellence areas to deliver world-leading care, in research, education and clinical care. research and education To support our mission, we are delivering We are uniquely structured to deliver our mission programmes of work to: for excellence. Our 21 Clinical Academic Groups (CAGs) bring together all the clinical services n join up mental and physical healthcare so that and staff from the three trusts with the relevant we treat the whole person, mind and body academic departments of King’s College London. 01 King’s Health Partners | Psychological Medicine Clinical Academic Group Foreword At King’s Health Partners we are committed to The primary purpose of King’s Health Partners is to improving outcomes for our patients and service improve health and wellbeing locally and globally. users and achieving maximum value for money We must deliver this goal in a challenging economic in everything we do. We believe that being open environment with rising demand for, and costs and transparent about the care and outcomes we of, healthcare. We will only achieve sustainable deliver results in a culture of improvement across health improvement if we strive always to increase our partnership. value. We define value in terms of outcomes that matter to patients, over the full cycle of care, This is why we are publishing a series of outcomes divided by the cost of producing those outcomes. books that will help patients, service users, carers, By publishing outcomes books we have more referring clinicians and commissioners to make better information to support us measuring the value informed decisions, and our staff to drive up the of the healthcare we provide. quality of the care we provide. The books report key outcomes for treatments provided by our 21 Clinical Our goal is to increase the depth and breadth of Academic Groups (CAGs). CAGs form the building reporting each year. Books will be updated regularly blocks of our Academic Health Sciences Centre. By to demonstrate progress against our mission to bringing together our clinical and academic staff achieve world-class research, education and clinical across teaching, training and research, we can use care. We hope you find these data valuable. their combined expertise to achieve better outcomes Please send comments and suggestions to us for our patients and service users. at [email protected] Our books are designed for a clinical and lay For more information please visit our website audience and contain a summary of patient at www.kingshealthpartners.org volumes and measures (e.g. length of stay, re- Professor John Moxham, Director of Clinical admissions, patient experience), clinical outcomes, educational activities, technological and research Strategy, King’s Health Partners innovations and publications. They also focus March 2017 on other important measures, such as staff satisfaction and wellbeing. 02 King’s Health Partners | Psychological Medicine Clinical Academic Group Foreword from CAG Leadership The Psychological Medicine CAG is central to the The CAG structure changed in July 2016 to form King’s Health Partners mission in having a major the new Psychological Medicine and Integrated focus on delivering research and clinical care across Care CAG. This was the result of a merger of mental and physical health. The CAG comprises the Mood, Anxiety and Personality CAG and of academic and clinical staff working within the Liaison and Specialist services of the old King’s College London, clinical services within Psychological Medicine CAG. We hope the book the secondary care setting providing front end gives an overview of our clinical services, research crisis function and tertiary specialist services with highlights and the strategic vision of our CAG a focus on physical/psychological interface of the within King’s Health Partners and will provide South London & Maudsley NHS Foundation Trust. a foundation for the future measurement of This book highlights the clinical outcomes of the the progress and delivery of the Psychological diverse range of services across the CAG and more Medicine and Integrated Care CAG. importantly the service user experiences based on information obtained from 2013 to 2015. Ranga Rao, Clinical Director Apart from providing high quality of services, Matthew Hotopf, Academic Director demonstrating clinical outcomes that are meaningful for service users and clinicians and Steve Davidson, Service Director that can be measured as part of the routine clinical activity forms an integral part of our governance strategy. 03 King’s Health Partners | Psychological Medicine Clinical Academic Group Contents The value of partnership at King’s Health Partners 05 Introduction 08 CAG leadership 10 Our vision and strategy 11 Our services 13 Introduction to service user and carer engagement and experience 19 Introduction to clinical outcome measures 22 CASCAID service 25 Psychosexual service 34 Eating disorders care pathway 42 Mother and baby/Perinatal services 55 Chronic fatigue service 68 Quality and safety measures across the Complex Care Pathway 79 Mental health liaison 82 Triage services 84 Home treatment teams 92 Quality and safety measure for crisis care pathway 100 Neuropsychiatry 104 Research in focus 109 Neuro-radiology 111 MRI 112 Research in focus for neuropsychiatry 113 Staff satisfaction 118 Education and training 121 Academic research and innovations 128 04 King’s Health Partners | Psychological Medicine Clinical Academic Group The value of partnership at King’s Health Partners The mind and body are inseparable, and mental mental ill health improves physical health outcomes and physical health conditions are often connected. and vice versa. The average life expectancy for someone with Right across our partnership, we are committed a long-term mental health illness is much shorter to joining up and delivering excellent mental and than for someone without, often due in part to physical healthcare, research and education so smoking, obesity, diabetes or alcohol misuse. that we treat the whole person, by: Likewise, many people with long-term physical health conditions suffer from depression or n screening all patients with chronic physical other mental health conditions. diseases for mental health conditions, and using the learning from this to improve the Despite this, health services separate care into care we provide physical and mental and often fail to share patient information. n improving our understanding of the physical health needs of people with severe mental At King’s Health Partners we are working to ill health overcome these barriers by treating the whole person. We are committed to caring for vulnerable n addressing the traditional distinctions between patients with both physical and mental ill health in the mind and body in research and education an integrated manner with better, faster diagnosis allowing us to train students and staff to and treatment because we know that addressing deliver more integrated care 05 King’s Health Partners | Psychological Medicine Clinical Academic Group n better organising and expanding current Alcohol strategy – key aims training provision for physical and psychiatric comorbidity n developing appropriate resources for clinical staff and patients n working with our local commissioners to find new ways of paying for integrated services n developing and implementing training for all staff on harmful drinking supporting early n linking IT systems across our partner trusts identification and intervention