Audit of Clinic Letters Sent to GP Following CAMHS Outpatient Clinic Appointments at Black Country Partnership NHS Foundation Trust

Abstract

Aims

The aim was to evaluate the quality of clinic letters sent to GP following outpatient appointments by CAMHS Consultants. The audit was based on the guidance of the Royal College of psychiatrist on writing clinic letters .

Methods

Initial Audit was a retrospective audit of 40 randomly selected clinic letters sent to the GP following outpatient appointments in the previous 1 year between June 2021 and Janauary 2022. The Re-AUDIT was with 60 clinic letters sent to the GP following outpatient appointments between June 2022 and December 2022.

Information was then collected about whether the following were included in the letters;

inclusion of diagnosis with ICD code, current medication, indications for medications, allergies, physical measurements, mental state examination, risk assessment, care plan and useful links where relevant.

Results

Overall changes were seen in quality of the GP letter in some specific areas, while some areas showed a decline or no significant changes

In including ICD 10 diagnosis to the GP letters, 100% of letters as compared to 80% in initial audit

Indications for medications were discussed/noted in 56.6% of letters when compared to 32.5% initial audit. Physical measurements were also well documented in 80% of letters. This increased from the previous 55%. Mental state examination and risk assessment also increased from 88.3% from 60%, and 86.6% from 70% respectively.

There was a drop in figures in including Current medication in letters.(100% to 90%) and also in copying patients /carers into letters(from 100% in previous audit to 86.6% in re-audit)

Little of no changes were seen in the quality of letters when observing useful links and allergies. The numbers were very low: allergy status infact dropped from 27.5% to 3.3%. Including useful links and resources in the GP letters only showed a growth from 7.5% to 13.3%.

Conclusion

• • Significance of allergy status and continuous reminder that allergy can start at any age in any service user. Drug interaction also important

• • Clearly stating all treatment including pharmacotherapy and psychological therapies

• • Continuous emphasis of indications for medications and psychoeducation including about commencing, stopping medications and side effects

• • QI project to bring together all useful links and make accessible to clinicians and patients