Northumberland Partnership Project for Early Intervention in Psychosis

This project was originally a pilot instituted by Northumberland Mental Health NHS Trust (now part of Newcastle, North Tyneside and Northumberland Mental Health NHS Trust), working with nine GP practices in Northumberland. The partnership also included mental health service users, Northumberland Health Authority and Northumberland Social Services. Financial support for the project was provided by Janssen-Cilag and Eli Lilly.

The aim of the project was to develop, implement and evaluate systems to promote evidence-based good practice in the recognition and treatment of early schizophrenia at primary and secondary care levels. The challenge was to achieve this within everyday practice and existing resources, in a largely rural area, where access to services may be difficult and specialist facilities difficult to organise.

The process was as follows:

• Firstly a literature review and synthesis of the evidence was carried out to establish good practice principles and standards
  
  
• This was used to create guidelines for primary arid secondary care supported by specialised materials - a "patient pack" that could be used for each individual patient giving information about early intervention and about the project, checklists of symptoms, referral algorithms and contact details of consultants so that GPs would have ready access to specialist advice.
  
  
• Data on current practice were collected from partnership GPs. consultant psychiatrists, care managers and integrated mental health teams via guided interview
  
  
• Education and training events in early detection and project protocols were organised for partnership GPs and primary care workers
  
  
• During the pilot maintenance was provided for training initiatives, including a regular newsletter about the project, and satisfaction data collected from new clients and carers
  
  
• Post intervention practice data were collection from participants via guided interview. Referral data were collected from partnership and non-partnership GPs.
  
  
• Data were analysed and reported.

This was a pilot study, with small participant numbers, but the findings were encouraging, suggesting raised awareness of the importance of early intervention in both primary and secondary care staff, and changes in practice towards earlier and more flexible responding. The project methods were found helpful by all the staff groups involved, but there is a need to shorten some of the guidance and data collection materials.

The project is now being rolled out throughout Northumberland. This will involve time dedicated to the project within the Northumberland Department of Psychological Services and Research, continuing training and raising awareness among GPs and their primary care teams and ensuring that there are professionals with specialist skills within the existing integrated teams who can form a specialist network across the county.

Discussions are taking place across the new Trust (Newcastle, North Tyneside and Northumberland) to develop a shared approach to early intervention, with local variations according to needs in the diverse communities within the Trust area. The project's emphasis on supporting primary care teams in early detection is widely applicable, and has attracted a good deal of interest.

Enquiries about the service should be addressed to:

Dr Roger Paxton

Head of Northumberland Psychological Therapies and Services
Newcastle, North Tyneside and Northumberland Mental Health NHS Trust
St George's Hospital
Morpeth
NE6 12NU