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Comorbidity in physical/mental health

Prof Michael Sharpe

Professor Michael Sharpe

Comorbidity Network Strategic Leadmichael.sharpe@psych.ox.ac.uk
 Our vision is for a revolution in medical care. Psychological care will be integrated with medical care and based around the needs of the patient. 

About the comorbidity clinical network

Oxford AHSN Physical/Mental Comorbidity Clinical Network Strategic Lead Professor Michael Sharpe explains the importance of integrating treatment for patients who have both mental and physical health needs.

This network closed in March 2016

Integrated care for body and mind

Patients with medical conditions commonly suffer from mental as well as physical problems (this is called mental and physical comorbidity). Medical services, including acute hospitals, are ill-equipped to deal with comorbid mental problems such as depression, delirium and dementia, and medically unexplained symptoms, in part because of the historical and geographical separation of psychiatry from the rest of medicine. The need for integration of mental health expertise into medical services has consequently become an NHS priority.

Psychological medicine services specialise in delivering integrated care in non-mental health settings. However, uncertainty remains as to the best model of care for psychological medicine services, and how to measure the contribution these services make to patient care in general hospitals. The Oxford AHSN Physical-Mental Comorbidity Clinical Network sought to answer these questions, with the aim of improving services and reducing variability in the region for medical patients with mental illness. The network undertook a range of projects between May 2014 and April 2016.

Raising awareness

We aimed to increase awareness of the challenge of mental-physical comorbidity for patients, their families and the NHS. To do this we delivered five highly successful regional educational events. These high profile meetings brought internationally recognised speakers to the Oxford AHSN area and enabled stakeholders to network. We used video clips on our website to allow patients, clinicians and members of the public to freely access educational materials online.

Thames Valley Perinatal Mental Health Network

In 2015 the Oxford AHSN Physical-Mental Comorbidity Clinical Network collaborated with the Thames Valley Children and Maternity Strategic Clinical Network to create the Thames Valley Perinatal Mental Health Network. This network comprises representatives from NHS provider and commissioner stakeholders from across the region, with input from patient, family, third sector providers and Health Education England.

One of the first tasks of this network was to map current services for women who are pregnant and have recently had a baby who also suffer with mental illness. This survey provides the basis for the network’s priorities in 2016/17. The report, which also sets out key recommendations for commissioners and providers, can be found here.

Network of regional liaison psychiatrists

The Oxford AHSN Physical-Mental Comorbidity Clinical Network was successful in creating a network of consultant liaison psychiatrists from the across the region – there was no formal collaboration between clinicians working in the Oxford AHSN region before this time. This network provides a platform for enhanced collaboration between these services and a foundation for clinical leaders in this field to contribute to regional service developments.

Guidance for the design and commissioning of psychological medicine services

Our network created a regional map of existing service provision for patients with medical illnesses who also have mental illness. We included a focus on services for maternity patients and patients with cancer, to reflect national priority areas. We also piloted a service evaluation tool with more than 300 patients across the Oxford AHSN area and completed two literature reviews.

These projects have together enabled us to develop a framework for improving services for patients with physical and mental illness, with the aim of reducing inequalities in service provision and improving quality and coordination of services across the region. How these aims can be achieved is presented in a report due for publication in April 2016.

 

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