Patient Pathway

 

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The registration forms includes several wellbeing assessments questionnaires which enable us to identify an early risk assessment including clinical factors for the patient and those that might affect the wider services of health and social care, including risk of harm to patient and client.

 

Assessment and Case Management

Contact (via phone or email)

Engagement and Suitability assessment

In-depth assessment

Develop care/treatment plan or signpost to other services

MDT discussion

Case management or treatment

Further specialist assessment OR treatment package

Each patient will have an initial consultation to review suitability for the service and how we might help identify what therapy is required. Where a detailed history and examination would be undertaken.

Even though many of our patients present with illnesses similar to those of non-practitioners (depression, anxiety, post-traumatic stress disorder), the context in which their problems sit is different. So often the underlying cause of their illness is due to a combination of work-related stresses, family difficulties, a recent life event, a complaint or adverse outcome at work. As such we take a detailed history of a patient’s work, training and other professional issues. At the end of the assessment we formulate what the issues are, taking into account any predisposing, precipitating, perpetuating and protective factors there might be for each individual patient.

The clinical presentation and professional issues identified are presented by the case-clinician to the next available MDT meeting (these are held daily) consisting of lead clinicians, psychiatry and therapeutic practitioners. Together, the case-clinician along with the MDT, would agree the diagnoses, treatment plan and case management parameters. The MDT would also support decisions concerning discharge or onward referral as needed. Following MDT the lead clinician will contact the patient with an update and arrange access to therapy, or ongoing care as appropriate.

The MDT also discuss the level of risk the patient is posing – to themselves, their own patients or their organisation. Depending on the problem and severity, patients are risk-rated as either green (lowest), amber or red (greatest). The risk category determines how often the patient is seen and how proactive we are at following them up. The process of ascribing a risk-status to our patients ensures that we look in depth at each patients individual issues and how these might impact on their behaviour and the support they need (e.g. suicide risk or risk of breaking down at work).