Royal College of Psychiatrists in Northern Ireland Spring Meeting
2015
Thursday May 7th
Royal College of Psychiatrists President Professor Sir Simon Wessely opened the conference
with a talk titled “If I knew then what I know now”. He reflected on some of his early
experiences in Psychiatry in an entertaining and engaging manner, including a letter he
received from a colleague saying “could you please see this man, there’s nothing wrong with
him.” He highlighted the high prevalence of medically unexplained symptoms and the
stigma faced by psychiatric patients.
Dr Carol Emerson, Consultant GUM and HIV in Belfast Trust, presented the changing
demographics of HIV in Northern Ireland and highlighted in the benefits of early diagnosis.
She recommended that Psychiatrists should strongly consider HIV testing in cases where it
was even a low likelihood differential diagnosis. She described the association between selfharm, substance misuse and depression both pre- and post- HIV diagnosis.
Dr Catherine Taggart, Liaison Consultant Psychiatrist in Belfast Trust, and Dr David Coyle,
ST4 General Adult Psychiatry, presented the development of an HIV Liaison Clinic in the
Royal Victoria Hospital. The clinic runs on a fortnightly basis providing new patient
assessments and limited review. The clinical profile included adjustment difficulties to
diagnosis, exacerbation of personality traits, low mood, anxiety and alcohol and substance
misuse. Ideas for development included interfacing with psychology and further staff
training.
We returned after lunch to a presentation by Dr Anthony Lewis, Consultant in Diabetes,
Endocrinology and Acute Medicine, titled “Recognising and treating the deteriorating
patient”. Dr Lewis emphasised the importance of this skill in psychiatric patients by
highlighting physical comorbidity and reduced life expectancy. He also described the
National Early Warning System, the Systemic Inflammatory Response Syndrome,
management of the ill patient, and Acute Kidney Injury.
Dr Stephen Bergin, Consultant in Public Health at the Public Health Agency, presented the
Service Framework for Mental Health and Wellbeing. The Service Framework includes the
development of Key Performance Indicators which will be used to measure Trust
performance on Mental Health Services. The consultation will take place later this year and
Psychiatrists were encouraged to air their views.
Dr Michael Mannion, Consultant Psychiatrist, presented developments in the field on
Informatics in Mental Health. He began with an interesting review of changes in
documentation including a look back to the time when there was one ledger for a whole
hospital. He described some of the current difficulties with paper based information
systems and some of the developments in informatics including the Northern Ireland
Electronic Care Record. Future developments were described including paperless systems,
teleconferencing and virtual clinics.
Friday May 8th
Dr Mark Harbinson, Consultant Cardiologist in Belfast Trust, opened Friday with a
presentation on “The Cardiac Health of our Patients”. He presented the elevated cardiac risk
in the mentally ill, risk factors for cardiac disease and tools for calculating and
communicating cardiac risk. He then presented the detection and management of clozapine
induced myocarditis and cardiomyopathy. He ended the presentation by highlighting the
once rejected but now accepted association between stress and cardiac disease.
Dr Maria O’Kane, Consultant Psychiatrist in Self Harm Team and Associate Medical Director
of Belfast Trust, set the context of Quality Improvement and Patient Safety. She set the
context for Quality Improvement and Patient Safety projects including recent NHS reports
including the Francis Report and the Berwick Report. The STEP programme for Higher
Specialist Trainees to train in Quality Improvement methodology and undertake Quality
Improvement projects was presented.
Quality Improvement Projects were presented by Dr Ruth Carville, CT2, Dr Chris Southwell,
ST5 Psychiatry of Old Age, and Dr Lauren Edgar, ST6 Psychiatry of Old Age. Dr Carville
presented the development of a Patient Management Plan leaflet for Emergency
Department Mental Health Assessments. She outlined the context in which the project
arose, the use of PDSA methodology, and feedback following implementation. Dr Chris
Southwell presented a project to improve the recognition of delirium in care homes. Dr
Lauren Edgar presented the development of a Psychiatry of Old Age Patient Information
leaflet using the PDSA cycle and a Gantt timetable.
The meeting was concluded by a talk from Dr Fred Browne, Consultant Forensic Psychiatrist,
which had the same title as the opening talk “if I knew then what I know now…..” Dr Browne
gave insightful and personal reflections on his reasons for entering Psychiatry, changes
throughout his career, and what he thought was important i.e. spending time with patients.
Dr Phil Campbell
ST5 Forensic Psychiatry