mental health



Bringing together physical and mental health

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Appendix I: Physical health liaison service in Highgate mental health unit


Whereas mental health liaison services in physical health settings are increasingly

widespread, it is rarer to have physical health liaison services in mental health

settings. In Highgate, north London, a physical health liaison service has been

established whereby consultants from a range of specialties from Whittington

Health NHS Trust provide weekly physical health clinics within the secure mental

health unit at Highgate hospital, which is part of Camden and Islington NHS

Foundation Trust. This service allows patients to receive regular, specialist care for

physical health conditions within the boundaries of the mental health hospital,

saving time and distress that can occur in a formal transfer from one provider to

the other.

Service description

Patients at the secure mental health site in Highgate have a range of severe mental

illnesses and 70 per cent of them are detained under the Mental Health Act. Data

from the service suggests that many patients have long-term physical conditions

affecting their health and wellbeing; for some, the specialist treatment they receive

through the physical liaison clinic is the first specialist treatment they will have

received for their physical condition(s).

Because a large number of patients at the Highgate site are there for extended

periods, they can receive regular check-ups for their physical conditions through a

weekly physical health clinic held on-site. The clinics rotate by specialty each week

(specialties include diabetes, respiratory, cardiology and general old age) and are

delivered by five consultants (one each week) from the Whittington Hospital. At

the clinics, the consultant meets with the patient and there is a request that junior

mental health doctors and specialist mental health nurses also attend. This enables

the physical and mental health practitioners to educate and learn from one another.

Another service that Camden and Islington commissions from the Whittington is a

telephone advice line. The junior mental health doctors at Highgate have a telephone

number with direct access to the hospital’s consultant general physicians. This allows

staff to call to get advice on physical health conditions from a specialist instead of

calling for an ambulance or immediately referring the patients to an outpatient

Appendices: case study site profiles 97

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