Patients in City and Hackney CCG on antipsychotic medication, without a diagnosis of psychosis, to be reviewed with the following aims:
This has been planned as a four stage process review process. Project planning meetings have been held to pilot the project and this has been evaluated. A multidisciplinary approach has been implemented to include Practice Support Pharmacists (PSPs), GPs and Primary Care Liaison psychiatrists to work together to review patients who are on antipsychotics without a coded diagnosis.
Funding has been identified from the GP Confederation as part of the MH budget to support this piece of work.
Approximately 1100 patients registered with GP practices in City and Hackney are on anti-psychotic medication without a coded or recorded diagnosis of a psychotic disorder. Further analysis showed that many of the patients are not receiving regular physical or clinical health checks. Review of antipsychotic medication, clinical and physical health monitoring and confirmation of diagnosis for this group of patients has been identified as a priority area to be taken forward over the next year by the GP Confederation in collaboration with City and Hackney CCG.
Patients will benefit from this project. The reviews will be undertaken by PSPs, GPs and Primary Care Liaison Psychiatrists. The main aim is to identify is there is a clinical diagnosis for the medication and whether the patient still requires antipsychotic therapy. In addition if therapy is still required, the review also includes whether patients have been supported with non pharmacological interventions.
The main outcomes is that patients are on antipsychotic therapy according to guidelines and their diagnosis has been confirmed. In addition those patients requiring therapy are also signposted to additional non-pharmacological support services. Patients who have been identified as not needing antipsychotic medication have a gradual reduction in the dose of their medication with regular review and signposting to additional support services where required.
Resources will be required to provide funding for:
A pilot was undertaken to review the process and finalise the resources required for the main project and to modify the process of review. The pilot report evaluation has been attached and also a flow diagram of the process to be used for the 4 stages of the review project.
