Eastern & Coastal Kent Liaison Psychiatry Service
Referral Protocol response out of hours
Introduction
This protocol is written for KMPT staff and describes the responsibilities of
staff acting on behalf of the Liaison Psychiatry Service out of hours.
This service has integrated older adult, adult and A&E liaison and covers the
A&E departments at William Harvey Hospital, Queen Elizabeth The Queen
Mother and the Emergency Care Centres at KCH as well as all the wards.
The aim of the service is to ensure timely access to specialist mental health
assessment, advice and management for patients presenting to East Kent
Hospitals with psychological or psychiatric problems. This will be achieved by
providing a standardised service to East Kent Hospital University Trust staff
and patients and for follow-up reviews to take place if required. A separate
protocol is available for referrers.
Out of Hours - Relates to the periods:
 5pm to midnight weekdays
 9am to midnight weekends and bank holidays
 Midnight to 9am
Only urgent referrals should be made out of hours and a standard has been
set by commissioners and both Trusts that people will be assessed within 2
hours.
Co-ordination
Co-ordination of referrals will be undertaken from 5pm to midnight weekdays
and 9am to midnight weekends by an identified Liaison Nurse and midnight to
9am by the Crisis Resolution Home Treatment (CRHT) shift co-ordinator on
behalf of the Liaison Psychiatry Service.
Out of hours co-ordination will involve:
 Contacting the referrer within 30 minutes of receiving a page.
 Completing a referral form (Appendix 1) and faxing to Liaison base.
 Psychiatric trainees should be offered support if required.
The Liaison Nurses will verbally handover the following to the appropriate
psychiatric trainee:
 All ward referrals.
 A&E referrals of people aged 65 with organic illness
 A&E referrals which cannot be completed by Liaison Nurses due to
capacity of workload
 A&E referrals received after 11pm that cannot be completed before
midnight
The CRHT shift co-ordinator will verbally handover all referrals to the
appropriate psychiatric trainee.
LPS Out of hours protocol Nov 2011 KL/CC
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Eastern & Coastal Kent Liaison Psychiatry Service
Referral Protocol response out of hours
Recording Assessments
Assessments must be recorded on Rio as described in the Out of Hours
flowchart for Liaison Staff and the Out of Hours flowchart for on call doctors.
Any assessments that cannot be recorded on Rio due to lack of time or
technical problems should be handwritten and entered when next on duty. It
is advisable to fax the handwritten copy to the Liaison office informing of when
an electronic entry is likely to be done in case an enquiry is made before the
clinician is next on duty. The Liaison Team Secretaries are not able to input
for clinicians.
Please refer to out of hours flowcharts for details of
documentation required.
The co-ordinator (either Liaison Nurse or Crisis Resolution Home Treatment)
is responsible for faxing the completed referral forms to the liaison base (fax
no. 01227 868728). These are monitored to measure compliance with
response times and Rio. Any issues will be addressed by Liaison Psychiatry
Service management team.
Home Treatment
The Liaison Nurses can accept for home treatment on behalf of the CRHT
Team, however, if the psychiatric trainee has assessed a person after
midnight as requiring home treatment and a further assessment is required by
CRHT, it may be appropriate for this to be passed to the Liaison Nurse (by
CRHT) coming on duty at 9am, particularly if they can attend before CRHT.
Hospital Admission
When a decision has been reached by CRHT that a person requires
admission to a mental health unit, the target transfer time agreed is 4 hours.
If required, mental health staff when possible should remain in the
department/ward to support the general hospital staff and patient until the
transfer has taken place. The Liaison Psychiatry Service should be advised in
hours and a handover arranged.
Resources
Within each A&E/ECC department there is an identified liaison room with PC
and access to Rio, KMPT staff zone and email. In addition, there is a
resource file which contains details of community teams etc, including fax and
telephone numbers
Support
Anyone undertaking an assessment out of hours on behalf of the Liaison
Psychiatry Service can call upon psychiatric trainees; CRHT Team; Liaison
Nurses; Psychiatric Manager on-call; Consultant Psychiatrist; CAMHS; KCC
for advice or support if required.
Escalation
Any issues that cannot be resolved should be raised or directed to the
Psychiatric on-call Manager via the hospital switchboard.
LPS Out of hours protocol Nov 2011 KL/CC
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