Evaluation of new investment in psychiatric liaison services at University Hospitals Bristol

What we did

We compared attendances at the emergency department during a three month period before the change in operating hours, to attendances during a similar three month period afterwards.

We looked at:

• whether patients received an assessment from the liaison psychiatric service
• the waiting time until the assessment
• whether patients were admitted to a hospital ward

We also estimated average costs per emergency department attendance and compared total costs between the before and after periods.

How we involved people

Staff from the liaison psychiatry service were central to the success of this project. They helped us with their expertise on the data, considering how to carry out the evaluation, and interpreting the results.

What we found and what this means

About 10 per cent more patients received a psychosocial assessment following the change to extended Psychiatric Liaison team operating hours. The waiting time for an assessment decreased by more than three hours. In 2015 with the new hours in place, patients were 20 per cent less likely to re-attend for self-harm within 90 days.

The findings also show that, over a three-month period, the initial investment in the extended service may lead to a saving of £36,150 in emergency department and hospital costs, for this specific group of patients. This equates to £144,600 annually.

However, because the study only covered a short three-month period and relatively small number of patients, these results are preliminary. A larger study is needed to provide stronger evidence on costs and re-attendance.

What next?

Our study will help commissioners across England judge whether further investment in liaison psychiatric services represents value for money.

This study only compared two short periods. It didn’t look at whether there were improvements in patients’ health, or how frequently patients used other services after involvement with the liaison psychiatry service.

The service extension is likely to benefit other patient groups, but we were only able to look at data for patients who had self-harmed.

We hope to do more analysis that includes health outcomes and follow-up care, and look at more patients over a longer period. This further work will allow us to provide a more complete picture and more robust results.