1498 – Patient Characteristics, Service Usage And Continuity-of-care Over One Year Of a Representative Cohort Of People With a Diagnosis Of Severe Mental Illness Across England

Abstract

Aims

This presentation describes and analyses patient characteristics and service usage over one year of a cohort of people with a diagnosis of severe mental illness across England, including contacts with primary and secondary care and continuity- of-care.

Methods

Data were collected from primary care patient notes (n=1150) by trained nurses from 64 practices in England, covering all service contacts from 1st April 2008 to 31st March 2009.

Results

The estimated national rate of patients seen only in primary care was 31.1% and rates of schizophrenia and bipolar disorder were 56.8% and 37.9%. Patients had 7,961 consultations within primary care and 1,993 contacts with mental health services (20% of the total). Of those seen in secondary care, 61% had at most two secondary care contacts recorded in primary care notes. Median consultation rates with GPs were lower than have been reported for previous years and were only slightly above the general population. Relational continuity in primary care was poor for 21% of patients (Modified Modified Continuity Index =< 0.5), and for almost a third of new referrals to mental health services the primary care record contained no information on the referral outcome.

Conclusions

Primary care is centrally involved in the care of people with serious mental illness, but primary care and cross- boundary continuity is poor for a substantial proportion. Research is needed to determine the impact of poor continuity on patient outcomes, and above all, the impact of new collaborative ways of working at the primary/secondary care interface