The Practice-Based Mental Health (PBMH) Service is a team of consultants, nurses and psychologists that work alongside GPs and other primary care professionals within practices. It offers mental health expertise, advice, training and consultation to GPs and practice staff and sees patients for comprehensive mental health assessments.
Following a referral, a member of your local PBMH Service will be on triage (checking the email inbox) every day. Your referral will therefore usually be looked at either the same day or the next working day by a clinician.
Once reviewed, the clinician on triage will either allocate the referral to a member of the clinical team, or will get back in contact with you. Contact at this stage is likely to occur if there is a reason why the PBMH team should not be involved (e.g. already open to another mental health team), or if further clarification on the reason PBMH involvement is needed, or if the referral can be dealt with by immediate advice.
Once a referral has been allocated to a team member, the PBMH clinician will read the background information available on the patient, using EMIS, Carenotes and sometimes IAPTUS (iCope’s patient record). They may then get in contact with you to discuss what they have learned, or to provide advice on the basis of the diagnosis and formulation. This is not a rejection of your referral, but a clinically driven process.
The PBMH clinician may also offer the patient an appointment for a consultation. This may be a face-to-face individual consultation, an offer of a joint appointment with you the GP, or with other clinicians. Telephone and email consultations are also offered on occasion. If it is agreed a face-to-face consultation is offered, the PBMH team will aim to offer an appointment to the patient for a date within 21 days.
Allocated cases are discussed in the PBMH multidisciplinary team meetings, which occur at least once weekly for each locality team. Cases are thought about in terms of formulation, and recommendations are discussed at these meetings.
Following a consultation and team discussion, either advice will be provided to the patient and yourself at this stage, or if further appointments are required to complete the process then these can be offered by the PBMH clinician. Most patients are seen once or twice, but there is flexibility to see people for a few more appointments if indicated. This might happen if, for example, more time is needed to gauge how much the patient has been able to take on board of the conversation, and to see if they are able to respond to the initial comments and recommendations.
PBMH clinical records can be accessed by the GP at any time by clicking on “All Records” on EMIS. Once the assessment/consultation has been completed, GPs will be alerted to the outcome by email or a document being sent.
As well as direct referrals via email, the PBMH team is keen to meet GPs and practice staff to discuss clinical cases and provide training. The frequency of such meetings may be negotiated locally (our experience shows that every couple of months works well).
We would also like to meet practice staff to gain feedback about the service. To arrange a visit or discussion, please contact Durand Darougar, Senior Service Manager, Camden and Islington NHS Foundation Trust
People aged 17.5+ years at the time of referral (there is no upper age limit).
- with significant mental health problems affecting their functioning
- registered with an Islington GP practice
- an Islington resident without a GP or registered with an out-of-borough GP will be reviewed and accepted on case-by-case and needs basis
- children <17.5 years old
- people registered at a GP practice outside Islington
- referrals for crisis care
- patients whose primary problem is substance abuse (drug and alcohol issues) and there is no evidence of co-morbid mental illness
- patients under the care of secondary mental health services provided by the trust (make contact directly with appropriate trust service).
How to refer
The following clinicians can refer to this service:
Referral methods: Email
Where to find forms
Islington: ISL EMIS under ISL global documents > Mental Health > PBMH Referral Form
Email with any relevant supporting documents for the team to process.
To clarify referral routes: GPs can refer directly to the PBMH service, and may continue to refer directly to iCOPE, Crisis Services, EIS and the Memory Service. Referrals that may be suitable for the other secondary services (eg CDAT, PD service, R&R) should be directed to the PBMH team.
Islington Practice Based Mental Health Team