How Advice & Guidance via Consultant Connect is helping to bridge the gap between physical and mental health

In 2019, feedback from mental health clinicians at South London and Maudsley NHS Foundation Trust (SLaM) was received that communication delays and access to specialist acute advice were creating a barrier to providing mental and physical healthcare. As Consultant Connect was already commissioned to operate in South East London ICB, no further costs were incurred, offering a ready-made solution for improving communication, saving clinicians’ time, and improving patient experiences and outcomes. As a result, in 2020, all SLaM inpatient clinicians were given access to Telephone Advice & Guidance (A&G) via Consultant Connect, allowing them to rapidly contact specialist physical health colleagues in Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust and Lewisham and Greenwich NHS Foundation Trust.

In the last 12 months, 62% of A&G queries resulted in the patient receiving physical health care from mental health clinicians, avoiding a cross-site referral or transfer.

Mental health specialists at SLaM also provide Mental Health Medication Telephone A&G, giving local Primary Care clinicians rapid access to experts in psychotropic medicines. This expertise has been established through research and clinical experience, and, in addition, clear, evidence-based information is quickly provided for enquiries. Delivering advice in this way allows clinicians to speak to someone directly rather than via email or post, which can cause significant delays.

Since March 2024*, calls to this line have seen a 100% first-time answer rate, with calls answered within two seconds, on average. Data shows that only 7% of patients required a referral to A&E or a Secondary Care service, allowing 93% of patients to be quickly and safely cared for in the community.

‘I can provide accurate and up-to-date medication information at the end of a phone line. I feel very strongly about the beneficial effects of Telephone A&G, and feedback received from clinicians has been very positive as they receive quick access to practical advice to treat their patients effectively.’

– Petrina Douglas-Hall, Medicines Information Manager at SLaM.

Enhanced A&G provides community mental health professionals at Kent and Medway NHS and Social Care Partnership Trust (KMPT) access to rapid physical health advice from out-of-area NHS consultants on the National Consultant Network (NCN). Clinicians within KMPT can request advice from 14 specialties via Telephone or Photo Messaging to aid them in providing the best patient care and helping to reduce unnecessary hospital transfers for mental health patients with physical health conditions.

Since the launch of the project in December 2023*, community mental health teams have sent 107 messages for specialist advice, 102 of which were sent to cardiology. All messages were responded to within 24 hours, reducing clinical risk and quickly improving patient care. As a result, 99% of cardiology queries resulted in the patient commencing the relevant treatment plan immediately and avoiding a referral.

‘We had been facing challenges accessing specialised advice for patients, which can be a barrier to delivering comprehensive mind and body care, potentially leading to delayed treatment and mental health deterioration. Since the introduction of Consultant Connect, we’ve witnessed positive outcomes for our patients and have received feedback from our consultants: “It was straightforward to use, considering I’m not very tech-savvy! In less than two hours, I got a response, and I was able to initiate treatment promptly. Happy patient, happy doctor!”’

– Jagdip Bahia, Chief Pharmacist at KMPT.

Since June 2021, Primary Care clinicians in Greater Glasgow and Clyde Health Board have had access to the Mental Health Assessment Unit (MHAU) for emergency Mental Health Professional-to-Professional Advice, ensuring healthcare professionals can speak to the right person the first time for clinical input.

More than 700 calls have been received via the service over the past year*, with calls answered within 24 seconds, on average. Overall, 23% of calls resulted in the patient avoiding a referral, and instead receiving medication or non-medication advice to allow them to safely remain in the community.

‘There are many things that are improved by using this service. Due to the nature of the line, a lot of queries are time-sensitive, and the patient and their family want and need a plan. The advice is detailed, I’m guided on what to do next or what can be done, and together, the specialist and I can create a management plan with the patient’s best interests at the centre.’

– Dr Ejike Peterside, GP in Greater Glasgow and Clyde Health Board.

Health visiting and midwifery clinicians in Hywel Dda University Health Board have had access to the Perinatal Mental Health line since 2022. Answered by specialist perinatal mental health professionals, the line is a needs-led, ageless service, taking referrals for any mother antenatally or postnatally with a baby up to 12 months old.

In the last 12 months*, the service has received more than 500 queries, with calls answered within 15 seconds on average. On the whole, 31% of calls resulted in the patient avoiding a referral, either by being signposted to other resources/interventions or through non-medication advice given.  

‘The service via Consultant Connect has enabled us to have a dedicated staff member to answer calls from practitioners about patients before a potential referral. We can screen in those who are appropriate for the service and offer bespoke support packages for those who aren’t. We can give general advice and guidance for those referrals and ascertain more information as needed.

‘This is so beneficial for the patients as it puts them at the heart of the conversation as opposed to passing them onto another service. The patient receives person-centred support, tailored just for them.’

– Jane Whalley, Perinatal and Infant Mental Health Service Manager.