Signpost appointments in an adult psychological therapies team
| DOI | https://doi.org/10.1108/MHRJ-08-2017-0033 |
| Pages | 1-11 |
| Published date | 12 March 2018 |
| Date | 12 March 2018 |
| Author | Katie Phillips,Lucy N. Macintyre,Alison McMullan |
| Subject Matter | Health & social care,Mental health |
Signpost appointments in an adult
psychological therapies team
Katie Phillips, Lucy N. Macintyre and Alison McMullan
Abstract
Purpose –In Scotland, individuals referred for NHS psychological therapies are expected to commence
“treatment”within 18 weeks of receipt of referral. With high demand, high non-attendance rates and limited
capacity, this can be a challenging goal. The service discussed here was keen to develop a way of seeing
individuals referred sooner and improving the efficiency of the assessment process. The purpose of this
paper is to look at the impact of introducing assessment (“Signpost”) appointments on waiting times,
attendance, and treatment planning.
Design/methodology/approach –Signpost appointments were offered to all existing, and any new
referrals, to an adult psychological therapies team (PTT) in NHS Lanarkshire. Clinicians kept a record of the
outcomes of these appointments over a six month period. Waiting times and attendance figures were
compared before and after the introduction of the Signpost system.
Findings –Following the introduction of Signpost appointments, individuals were seen sooner for both
assessment and therapy. Attendance at first appointments improved and Signpost appointments helped
inform treatment planning. Although alternatives were discussed, the majority of clients were still offered
individual therapy. Service user and staff satisfaction was high.
Practical implications –The results from this study led to assessment (“Signpost”) appointments being
rolled out across other adult PTTs in NHS Lanarkshire.
Originality/value –There is little research looking at the impact of assessment/signpost appointments
on adult mental health services in the UK. In the current climate of public service cuts, this study provides
an innovative way of reducing waiting times and maintaining service user satisfaction, without requiring
more resources.
Keywords Triage, Psychological therapies, Adult mental health, Assessment appointments,
Scotland, UK
Paper type Research paper
Introduction
The Scottish Government’s“Health, Efficiency, Access, Treatment (HEAT)”, target sets out the
goal of seeing individuals referred for psychological therapy within 18 weeks from referral to
treatment (The Scottish Government, 2010). This came into effect from December 2014 and has
increased the need for psychological services to think more innovatively about how high
demand can be met in a timely and efficient manner. Assessment and triage appointments, also
known as advice or screening appointments have been used across a range of clinical services
as a way of meeting demand (e.g. Hayes and Caygill, 2004). Existing research suggests that
incorporating assessment and triage appointments within psychological services may have a
number of advantages.
Waiting times
There is evidence that the use of assessment and triage appointments can enable clients to be
seen quicker. Jones et al. (2000) implemented an assessment and triage system in a Child and
Adolescent Mental Health Service and found that this reduced the waiting time to first treatment
appointment, with this improvement maintained at follow up.
Received 24 August 2017
Revised 1 December 2017
Accepted 5 December 2017
The authors acknowledge the
commitment, hard work, and
dedication of the staff from the
Bellshill and Motherwell
Psychological Therapies Teams,
and the support provided by
NHS Lanarkshire’s Clinical
Quality Team.
Katie Phillipsis a Clinical
Associatein Applied Psychology
and Lucy N. Macintyreis a
Clinical Psychologist, both at the
BellshillPsychological Therapies
Team, NHS Lanarkshire,
Bellshill,UK.
Alison McMullan is based at
Bellshill Psychological
Therapies Team, NHS
Lanarkshire, Bellshill, UK.
DOI 10.1108/MHRJ-08-2017-0033 VOL. 23 NO. 1 2018, pp. 1-11, © Emerald Publishing Limited, ISSN 1361-9322
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MENTALHEALTH REVIEW JOURNAL
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