Older Adults Primary Care Psychology Service Southwark

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Older Adults Primary Care Psychology
Service(Southwark)

• Dr Grace Wong (Clinical Psychologist)
• Project Lead
• Dr Miriam Burke (Consultant Clinical
  Psychologist)
• Southwark Primary Care Psychology Services
• Mr Steve Boddington (Consultant Clinical
  Psychologist)
• Borough Lead Psychologist Older Adults
  Directorate

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Context

• NSF for Older People (2001)
• Treatment Choice in Psychological Therapies
  Counselling (DOH, 2001)
• Clinical Psychology Services for Older People in
  Primary Care (British Psychological Society,
  2002)
• Everybodys Business (2005) Older people to
  receive full range of services available to
  working age adults access to services
  specialising in later life where appropriate.

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Older Adults Primary Care Psychology service

• A dedicated primary care psychology service
  tailored to the needs of older people
• Uni-disciplinary psychology service - accepts
  referrals directly from primary care, social
  workers and therapy teams for people over 65
  years of age in Southwark
• staffing
• clinical psychologist (0.8 FTE)
• counselling psychologist (1.0 FTE)
• Clinical psychology trainees

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Service Development

• Frequent information reminders to GP practices
  regarding the service (letters, leaflets,
  posters, talks)
• Links to community groups (esp. BME groups)
• Public health promotion events (health social
  care)
• Choice flexibility of service (out-patients,
  practice based clinics, home visits)

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Service Uptake (I)
Predicted referrals for 2008 100
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Service Uptake (II)
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Service Uptake (III)
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Uptake of Psychological Therapy

• Service fits well within a stepped care model
• Average waiting time 14 days
• Uptake of the service 90
• DNA rate (3)
• 74 of clients seen no more than 6 sessions
• Publication of age appropriate self help
  literature
• Depression, anxiety, bereavement, retirement,
  sleep, etc
• Currently evaluating impact of screening and
  watchful waiting/self help literature for high
  risk population identified via general practice
  lists

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Clinical Outcomes (I)Brief interventions have
led to significant reductions in symptom severity
at end of treatment gains are maintained in 3-6
month follow-up (using CORE-OM)
P lt 0.001 ES (uncontrolled) 0.83 Norms for 65
popln. Clinical grp. Mean 1.49
s.d. 0.60 Healthy grp. Mean 0.63
s.d. 0.36
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Clinical Outcomes (II)
Service outcome (Subjective report)
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National interests

• Identified as an example of Innovative Ways of
  Working by the British Psychological Society.
• Informing Pathfinder sites which are targeting
  IAPT for older people

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Conclusions

• Even within relatively well resourced mental
  health services for older people there is huge
  unmet need, especially for psychological
  therapies.
• Where psychological therapies are made available
  they can have a significant impact on improving
  the wellbeing of older people.
• Contact details Dr Grace Wong, Maudsley
  Psychology Centre, Maudsley Hospital, Denmark
  Hill, London SE5 8AZ.Tel [phone] / 2194
  Fax [phone] Email - grace.wong_at_slam.nhs.uk