Exploring Service Use and Patients' Pathways in a Community Neuropsychiatry Clinic, a Service Evaluation: What Does the Data Tell Us?

Results:

93% of referred patients were of working age, with 4 referrals aged under 18.Most were female (64%) and 80% were white British. 129 patients had working status recorded: 52% received welfare benefits. 75% had social support; mostly from family. Most referrals came from Primary Care and Neurology.

70% of referrals had a functional neurological disorder (FND) (30% non-epileptic attack disorder (NEAD), 40% other FND). Other diagnoses included epilepsy (n=8), traumatic brain injury (n=1), Huntington’s disease (n=2), MS (n=2) and Tourette's/tic disorder (n=4). 103 patients (62%) had previous psychological history and 59% had previous mental health service contact. 67% were prescribed psychotropic medications at referral. The most common comorbid mental health problem was anxiety (45 patients, 27%), 37 patients had depression (22%). 16 patients were autistic (10%). 70% had previous physical health problems; 39% previous neurological problems, 18% non-neurological problems and 43% both.

All referrals received multidisciplinary team (MDT) review; 52% of referrals were accepted following this. Mean waiting time between received referral and MDT discussion was 10 days. Most patients (52%) had documented investigations at referral. Of these, 81% had brain imaging or EEG completed. Mean waiting time for initial assessment/triage was 52 days; most patients were triaged by specialist nurse. 14% of referrals were discharged post-triage, mostly to primary care/self-help. Average length of stay within the service was 233 days. During the period evaluated, 19% of patients were receiving psychotherapy (11% 1:1 therapy, 8% group). 16 patients were referred to neurophysiology. 36% were prescribed medication during their treatment, mostly antidepressants. Of discharged patients, 67% were discharged to GP and 15% to community mental health services.