The service is a tertiary service and therefore does not usually provide acute admissions or accept referrals from general practitioners.
When a referral is received from an external source, responsibility for commissioning is rapidly established before the referral is processed. This is usually done via the postcode of the last known address if they do not have a registered GP or last known GP.
The service does not routinely accept emergency admissions that have not been assessed. Assessment, where appropriate, will be carried out within two to four weeks of the referral being received. Where the assessment is urgent due to high risk or severe disturbance every effort is made to facilitate assessment as soon as possible.
Referrals are received by consultant psychiatrists as per the geographical area they cover. Based on the information provided by the referrer, suitability for care in a medium secure environment will be discussed within the clinical team. If a service user is not deemed suitable for potential admission this will be discussed with the referrer and followed up in writing, offering advice where appropriate.
Appropriate referrals will be assessed by a multidisciplinary team going and assessing the service user in their current location. As a minimum this will include medical and nursing opinion with other disciplines as deemed appropriate.
Based on the assessment a decision will be made at the clinical team meeting and discussed at the bed management meeting.
The clinical team will maintain appropriate contact with the current provider of care to gain information on the service user’s current needs, to establish improvement/ deterioration and to offer support and advice where appropriate.
Once an admission date is established a member of theclinical team, often the ward manager of the admitting ward, will make further contact with the current provider for an update of the current needs of the service user. A care plan will be drawn up by the nursing staff based on clinical team assessment of the current situation to include leave, observation, pharmacological interventions, physical and mental state assessment.