Developing a new post in a hospital where no previous liaison service existed

Many district hospitals have no existing liaison service and a new post and team may have to be developed from scratch.

Trainees who are interested in liaison psychiatry may find themselves having to take a major role in the development of the post.

In these circumstances it is helpful to have a good grasp of background information. This would include:

• The NHS Plan
• NSF for Mental Health and Coronary Heart Disease
• The Cancer Plan
• Pain Guidelines from CSAG
• Guidelines from Regional Advisors on Liaison Psychiatry Consultant Posts
• College publications on liaison psychiatry: Joint Working Parties with the RCP and RCS.
• Seminars in Liaison Psychiatry (Guthrie and Creed)
• Liaison Psychiatry: Planning Services for Specialist Settings. Peveler, Feldman & Friedman Gaskell Press 2001.

Another useful initiative is to arrange to be invited to a forum within the general hospital to make the case for liaison psychiatry: e.g. the Trust Management Board. Your presentation should be tailored around how it will meet the requirements of the NHS Plan, NSFs etc, and improve the quality of care for patients, and has the potential to reduce costs and waiting times.

It is also helpful to consider putting in a bid to the health authority or primary care group for the development of a liaison service. If you have general support, even it if not successful, the trust may fund your service from within existing resources.

Visit other liaison services and speak to other liaison consultants to ask how they managed to set up their services. Do not be afraid to ask for advice or support. Consultants in established liaison psychiatry posts have often experienced problems identical to those which you may be facing. There is a growing pool of knowledge and experience which we are all keen to share.