Royal College of Psychiatrists in Northern Ireland Spring Meeting 2015
Thursday May 7th
Royal College of Psychiatrists President Professor Sir Simon Wessely opened the conference with a talk titled “If I knew then what I know now”. He reflected on some of his early experiences in Psychiatry in an entertaining and engaging manner, including a letter he received from a colleague saying “could you please see this man, there’s nothing wrong with him.” He highlighted the high prevalence of medically unexplained symptoms and the stigma faced by psychiatric patients.
Dr Carol Emerson, Consultant GUM and HIV in Belfast Trust, presented the changing demographics of HIV in Northern Ireland and highlighted in the benefits of early diagnosis. She recommended that Psychiatrists should strongly consider HIV testing in cases where it was even a low likelihood differential diagnosis. She described the association between self-harm, substance misuse and depression both pre- and post- HIV diagnosis.
Dr Catherine Taggart, Liaison Consultant Psychiatrist in Belfast Trust, and Dr David Coyle, ST4 General Adult Psychiatry, presented the development of an HIV Liaison Clinic in the Royal Victoria Hospital. The clinic runs on a fortnightly basis providing new patient assessments and limited review. The clinical profile included adjustment difficulties to diagnosis, exacerbation of personality traits, low mood, anxiety and alcohol and substance misuse. Ideas for development included interfacing with psychology and further staff training.
We returned after lunch to a presentation by Dr Anthony Lewis, Consultant in Diabetes, Endocrinology and Acute Medicine, titled “Recognising and treating the deteriorating patient”. Dr Lewis emphasised the importance of this skill in psychiatric patients by highlighting physical comorbidity and reduced life expectancy. He also described the National Early Warning System, the Systemic Inflammatory Response Syndrome, management of the ill patient, and Acute Kidney Injury.
Dr Stephen Bergin, Consultant in Public Health at the Public Health Agency, presented the Service Framework for Mental Health and Wellbeing. The Service Framework includes the development of Key Performance Indicators which will be used to measure Trust performance on Mental Health Services. The consultation will take place later this year and Psychiatrists were encouraged to air their views.
Dr Michael Mannion, Consultant Psychiatrist, presented developments in the field on Informatics in Mental Health. He began with an interesting review of changes in documentation including a look back to the time when there was one ledger for a whole hospital. He described some of the current difficulties with paper based information systems and some of the developments in informatics including the Northern Ireland Electronic Care Record. Future developments were described including paperless systems, teleconferencing and virtual clinics.
Friday May 8th
Dr Mark Harbinson, Consultant Cardiologist in Belfast Trust, opened Friday with a presentation on “The Cardiac Health of our Patients”. He presented the elevated cardiac risk in the mentally ill, risk factors for cardiac disease and tools for calculating and communicating cardiac risk. He then presented the detection and management of clozapine induced myocarditis and cardiomyopathy. He ended the presentation by highlighting the once rejected but now accepted association between stress and cardiac disease.
Dr Maria O’Kane, Consultant Psychiatrist in Self Harm Team and Associate Medical Director of Belfast Trust, set the context of Quality Improvement and Patient Safety. She set the context for Quality Improvement and Patient Safety projects including recent NHS reports including the Francis Report and the Berwick Report. The STEP programme for Higher Specialist Trainees to train in Quality Improvement methodology and undertake Quality Improvement projects was presented.
Quality Improvement Projects were presented by Dr Ruth Carville, CT2, Dr Chris Southwell, ST5 Psychiatry of Old Age, and Dr Lauren Edgar, ST6 Psychiatry of Old Age. Dr Carville presented the development of a Patient Management Plan leaflet for Emergency Department Mental Health Assessments. She outlined the context in which the project arose, the use of PDSA methodology, and feedback following implementation. Dr Chris Southwell presented a project to improve the recognition of delirium in care homes. Dr Lauren Edgar presented the development of a Psychiatry of Old Age Patient Information leaflet using the PDSA cycle and a Gantt timetable.
The meeting was concluded by a talk from Dr Fred Browne, Consultant Forensic Psychiatrist, which had the same title as the opening talk “if I knew then what I know now…..” Dr Browne gave insightful and personal reflections on his reasons for entering Psychiatry, changes throughout his career, and what he thought was important i.e. spending time with patients.
Dr Phil Campbell
ST5 Forensic Psychiatry