A team in Southern Health NHS Foundation Trust found people presenting with mental health difficulties constitute up to 30% of all GP consultations. They recognised that many of the issues were social or emotional and did not require secondary care. However, GPs were not necessarily the most appropriate professionals to provide the advice and support required.
Support Treatment and Recovery (STAR) workers were employed to work within six Primary Care Hubs and used the primary care IT systems. They operate during the day and extended hours, offering 30 minute appointments with follow-up support telephone calls, for individuals highlighted by GPs as having a mental health difficulty. The STAR worker assesses and focuses on self-help, advice, guidance, signposting and liaison with other services.
The service used the well evidenced Collaborative Care Model to implement integrated pathways.
The project is being evaluated as follows:
Frequency of contacts with primary care (in and out of hours) and with the emergency department.
Number of patients seen by STAR workers
Needs identified and Quality of Life measured using DIALOG
Use of data from PHQ9 and GAD7
Number signposted to Improving Access to Psychological Therapies, Community Mental Health Teams and other agencies
In the first 6-8 months, 160 people with anxiety and depression were linked to a wide range of community and statutory resources. Outcome data is being gathered as part of the overall Primary Care Hubs project. Initial results for Hubs show a 10% reduction in emergency department and Medical Investigation Unit activity and associated cost savings.