The Fife Dementia Strategy: 2010 – 2020 - The Knowledge Network

4.11.3 All acute and community based hospitals work with a specialist
Older Age Psychiatry Liaison Service.
In the current hospital setting people with dementia or cognitive impairment
may be admitted to a number of different wards depending on their acute
medical needs. Amongst care staff and wards there is marked variation and
deficit in knowledge and skills in caring for people with dementia. This will be
addressed by improved training; however specialist support will be required.
The NHS Fife Mental Health Service provides an Old Age Psychiatry Liaison
Service which covers Victoria Hospital in Kirkcaldy. This service comprises a
specialist Mental Health Liaison Nurse (working office hours only) supported
by dedicated time from an Old Age Consultant Psychiatrist. The primary role
of this service is to improve the care of older people with mental health
problems in the hospital (see Good Practice Box below).
Liaison services of similar models have recently been advocated by the
National Institute for Clinical Excellence 72 due to their ability to provide rapid
and high-quality specialist assessments as well as input into care planning.
In order to ensure all people with dementia in Fife are receiving care from well
trained and knowledgeable staff while in hospital, the Liaison Psychiatry
Service should be expanded to include comprehensive coverage throughout
both acute and community hospitals across Fife. Such a liaison service should
ideally comprise a multidisciplinary team following guidelines provided by the
Royal College of Psychiatrists 73 , 74 .
Old Age Psychiatry Liaison Service
The primary objective of the Mental Health Liaison Nurse (MHLN) is to
improve the care of older people with mental disorders in the Victoria
Hospital. The nurse is supported by an Old Age Consultant Psychiatrist
with time dedicated to the service. The liaison model is proactive, focusing
on collaborative working to provide a timely response to referrals and
ongoing frequent review if necessary. The MHLN assesses new referrals
and, with the assistance of the Consultant Psychiatrist, provides advice
and support on a range of issues including diagnosis, medication and
potential discharge options. There is a clear referral protocol and
operational policy outlining service objectives. The service also offers
training and educational programmes on mental health issues. The most
common reason for referral is problems related to confusion and
dementia.
71 House of Commons - Public Accounts Committee (2008). Improving Services and Support for People
with Dementia.
72 National Institute of Clinical Excellence (2006). CG42 – Dementia: Supporting people with dementia
and their carers in health and social care. London.
73 Raising the Standard: specialist services for older people with mental illness. (2006). Report of the
Faculty of Old Age Psychiatry.
74 Who Cares Wins - Improving the outcome for older people admitted to the general hospital:
Guidelines for the development of liaison mental health services for older people (2005). Report of a
working group for the Faculty of Old Age Psychiatry, Royal College of Psychiatry.
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