PROTOCOL FOR MANAGING CHILD and ADOLESCENT MENTAL HEALTH (CAMHS) OUT-OF-HOURS REFERRALS IN GREATER GLASGOW AND CLYDE Document: Final Date: MAY 2017 Review: MAY 2019 1 Page Summary Access to CAMHS from Emergency Departments 3 1.0 Model of Service 4 1.1 Referral Criteria 5 1.2 Referral Contact Details 5 1.3 Transfer of Patient Protocol 6 1.4 Bed Management Systems 7 1.5 Self-Harm Management 7 1.6 Suitability of Units for Young People 8 1.7 RHC Paediatric Support 8 1.8 Psychiatric Nursing Support for Patients in General Wards 8 1.9 Lone Working – All Staff Groups 9 1.10 Handover 9 1.11 Communication - Out of Hours Service to Day Service Teams 10 1.12 Referral Information 10 2. 0 Social Work Out-of-Hours Contact Details 11 3.0 Day Time Emergency Services in Glasgow and Clyde 11 4.0 Child and Adolescent Mental Health Services in Greater 12 Glasgow and Clyde - Contact Details 5.0 Useful Telephone Numbers 13 2 Access to Child and Adolescent Mental Health Services for patients presenting at QUEEN ELIZABETH UNIVERSITY HOSPITAL - EMERGENCY DEPARTMENT UNDER 12 years of age OVER 12 years of age DAY TIME Paediatric Liaison Team via Monday – Friday 0141 201 0000 09.00 – 17.00 Can offer advice or assessment in ED for patients 0-18 years OUT OF HOURS Contact CAMHS 2nd On call Contact 1st on Call Monday – Friday Via Via 17.00 – 09.00 am 0141 201 0000 local Psychiatric Hospital as per Post Can offer advice or assessment Code list Saturday, Sunday and out of hours for Glasgow Can offer advice or assessment out of Public Holidays patients under 12 years of age. hours for Glasgow patients over 12 09.00am–09.00am years. GLASGOW ROYAL INFIRMARY HOSPITAL - EMERGENCY DEPARTMENT UNDER 12 years of age OVER 12 years of age DAY TIME Paediatric Liaison Team via Monday – Friday 0141 201 0000 09.00 – 17.00 Can offer advice or assessment in ED for patients 0-18 years OUT OF HOURS Contact CAMHS 2nd On call Contact 1st on Call Monday – Friday Via Via 17.00 – 09.00 am 0141 201 0000 local Psychiatric Hospital as per Post Can offer advice or assessment Code list Saturday, Sunday and out of hours for Glasgow Can offer advice or assessment out of Public Holidays patients under 12 years of age. hours for Glasgow patients over 12 09.00am–09.00am years. ROYAL ALEXANDRA HOSPITAL – EMERGENCY DEPARTMENT UNDER 12 years of age OVER 12 years of age DAY TIME Local CAMHS Team Monday – Friday Renfrewshire CAMHS - 0141 314 8981 09.00 – 17.00 Can offer advice or assessment for patients 0-18 years OUT OF HOURS Contact CAMHS 2nd On call Contact 1st on Call Monday – Friday Via Via 17.00 – 09.00 am 0141 201 0000 local Psychiatric Hospital as per Post Can offer advice or assessment Code list Saturday, Sunday and out of hours for Glasgow Can offer advice or assessment out of Public Holidays patients under 12 years of age. hours for Glasgow patients over 12 09.00am–09.00am years. INVERCLYDE HOSPITAL – EMERGENCY DEPARTMENT UNDER 12 years of age OVER 12 years of age DAY TIME Local CAMHS Teams Monday – Friday Inverclyde CAMHS 09.00 – 17.00 01475 504447 Can offer advice or assessment for patients 0-18 years OUT OF HOURS Contact CAMHS 2nd On call Contact 1st on Call Monday – Friday Via - Via 17.00 – 09.00 am 0141 201 0000 local Psychiatric Hospital as per Post Can offer advice or assessment Code list Saturday, Sunday and out of hours for Glasgow Can offer advice or assessment out of Public Holidays patients under 12 years of age. hours for Glasgow patients over 12 09.00am–09.00am years. 3 1. MODEL OF SERVICE The base doctor (1st on-call) in general adult psychiatry will take initial responsibility for young people aged between 12 – 17 years of age *except for paediatric inpatients in Paisley and the Royal Hospital for Children. These paediatric facilities have direct access to the 2nd on-call in Child and Adolescent Psychiatry whatever the age of the patient. The 1st on-call doctor will be provided with advice from the NIC in Skye House and supervision by the 2nd on call (higher trainee) in Child and Adolescent Psychiatry and Consultants in Child and Adolescent Psychiatry in Greater Glasgow and Clyde will provide a 3rd on-call. Under 12 years old Greater Glasgow and Clyde All referrals of children are taken by the 2nd on-call ST4-6 in Child and Adolescent Psychiatry accessed via the Royal Hospital for Children switchboard. Children under the age of 12 referred by all referrers including GEMS, Social Work, Paediatrics at the Royal Hospital for Children site and at the Royal Alexandra Hospital in Paisley will be managed by the 2nd on-call in CAMHS. Glasgow under 12’s will be seen at the Royal Hospital for Children and all Clyde under 12’s will be seen at Paediatrics at the Royal Alexandra Hospital, Paisley. 12 – 17 year olds Greater Glasgow and Clyde * except for paediatric patients – see above Referrals for clinical assessment will be undertaken by the 1st on-call at their base site. Referrals that present at Emergency Departments including those aged over 12 years at the Royal Hospital for Children (RHC) will be transferred to the sector psychiatric site for assessment by the 1st on-call. If the patient cannot travel to the psychiatric base site then the 1st on-call will discuss with the NIC how best to proceed. This may occur if the young person has been admitted to the ward of the Royal Hospital for Children or a district general hospital and for Psychiatric/medical/surgical reasons cannot be transferred. This may require the 2nd on-call to undertake psychiatric assessment in the Royal Hospital for Children or the District General Hospital. If the patient presents to an Emergency Department and refuses to travel or is generally non- compliant with regard to assessment, Emergency Department medical staff will make a clinical decision whether to discharge the patient without assessment. If it is felt that it is unsafe to transfer a young person to the adult psychiatric hospital for assessment, the 1st and NIC should discuss this to find the best way forward. It may be that a psychiatric assessment by the 2nd on-call is required. If the 1st On-Call requires a second opinion from the 2nd On-Call there will be a discussion between the 1st and 2nd On-Call as to where this will take place. Note: 16 and 17 years olds living in Cardross and G84 postcodes will be transferred to an Adult Mental Health team responsible for these postcodes (this is due to the fact that Argyll and Bute HSCP CAMHS team will not be increasing the age range. West Dunbartonshire CAMHS have withdrawn service to Argyll and Bute as of May 2012. 4 1.1 REFERRAL CRITERIA Age Range Referrers Glasgow and Clyde general hospital wards and Emergency 0 – 17 years inclusive in departments Greater Glasgow and Clyde GEMS Social Work standby service Police Surgeon Patients from other Health Board areas are generally not accepted unless presenting to a Glasgow and Clyde Emergency Department or as a current inpatient. Referrers of patients resident in Glasgow and Clyde who present at sites in other Health Board areas should be advised to contact the CAMH Service for that area. Referrals from other Health Boards may be considered if the referrer is a Consultant Child and Adolescent Psychiatrist seeking inpatient admission of a child or young person in an emergency. Inpatient units are hosted on behalf of national and regional commissioners. Consideration for admission to the inpatient units would depend upon the bed status and the nature of the referral and such referrals should be discussed with the on-call Consultant Child and Adolescent Psychiatrist for Greater Glasgow and Clyde. Self referrals are not accepted. Referrals from staff at secure units are not accepted. Secure units should refer to GEMS. Please note that we do not offer an Out-of-Hours service to Argyll and Bute patients but we will see any patient who presents to Inverclyde Royal Hospital Emergency Department Out- of-Hours. 1.2 REFERRAL CONTACT DETAILS First point of contact for all Referrals is Royal Hospital for Children switchboard: 0141 201 0000 The Royal Hospital for Children switchboard will differentiate between under 12’s and 12–17 year olds - re-directing under 12’s in North and South Clyde to the Royal Alexandra Hospital and directing 12–17 year olds in Glasgow and Clyde to the appropriate base psychiatric hospital. 5 1.3 TRANSFER OF PATIENT PROTOCOL A safe and efficient system to transport patients between sites for assessments has been agreed: Under 12 Years Old Can only be transferred to the Royal Hospital for Children or Paediatrics Ward at the Royal Alexandra Hospital. 12 – 17 years olds Greater Glasgow and Clyde Most District General Hospital sites have no 1st on-call available and young people (over 12) presenting there should be transferred to the appropriate site as below. Stobhill Hospital (Skye House) has a resident first on-call available. Presenting at …. Transfer to …. Glasgow Royal Infirmary (unless postcode sector of Parkhead Hospital Stobhill Hospital) Glasgow Royal Infirmary (postcode sector of Stobhill Skye House, Stobhill Hospital Hospital) Royal Alexandra Hospital (unless postcode sector of Dykebar Hospital Leverndale Hospital or Gartnavel Royal Hospital Royal Alexandra Hospital (postcode sector of Leverndale Hospital or Gartnavel Royal Leverndale Hospital or Gartnavel Royal Hospital) Hospital* depending on postcode Queen Elizabeth University Hospital Local adult psychiatric hospital depending on postcode.