Two specialist services for people experiencing delirium have been shortlisted in prestigious national awards.
The ‘Reach out’ Delirium service in North Cumbria has been shortlisted for ‘Psychiatric Team of the Year: Older-age adults’ in the Royal College of Psychiatrists Awards, and the Delirium Liaison Pathway in South Tyneside has been shortlisted for ‘Mental Health Innovation of the Year’ at the Health Service Journal Awards. Both services are run by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW).
To be recognised on a national stage, shortlisted amongst tough competition from hundreds of other, is a phenomenal accomplishment for every staff member involved in these services – particularly during one of the most challenging periods the NHS has ever seen.
This upsetting condition affects about 2 in every 10 people admitted to hospital. Delirium is a temporary state of mental confusion that starts suddenly. It is actually caused by a physical condition of some sort, such as an infection – including COVID-19. Medical problems, surgery and medications can all cause delirium too.
Someone suffering from Delirium might not know where they are, what time it is, or what’s happening to them. In severe cases, the person may hear voices or see things that are not there, or believe that other people (such as hospital staff) are trying to harm them. Current research indicates that around three quarters of people remember their delirium, and all the distressing things that they experienced during it.
Delirium often leads to people staying in hospital longer than they might otherwise have needed to. This leads to worse health outcomes, and reduces the number of beds available – a particular concern during the COVID-19 pandemic and its pressures on the hospital system.
‘Reach out’ Delirium service, North Cumbria
The ‘Reach out’ delirium service was developed to proactively prevent, detect, and manage delirium in North Cumbrian hospitals. In recognition of the team’s significant positive impact on patient care, they have been shortlisted for ‘Psychiatric Team of the Year: Older-age adults’ in the Royal College of Psychiatrists Awards.
The service was launched to help identify patients with delirium early on, so they can be successfully treated as quickly as possible and recover at home, as well as preventing delirium in the first place wherever possible. Working seven days a week, the team proactively seek out and screen patients at risk of delirium who are admitted to hospital – they screen about 2,000 patients every month.
The team then ‘reach out’ to the patient, carers, and staff to offer support, with patients with suspected or confirmed delirium being seen twice a day by the team. They also help to coordinate discharge and coordinate follow-up to support the person once they are out of hospital.
The service’s impact on preventing delirium and reducing patients’ length of stay has seen it save the healthcare system over one million pounds each year. But most importantly, the service has increased the quality of care for people with delirium and their loved ones.
Since the team’s introduction in 2017 there has been a 20% reduction in delirium across the hospitals. The average length of stay for patients at risk of delirium has also decreased, and patient outcomes and quality of care have improved.
Throughout the pandemic, staff have gone above and beyond their role to ensure patients have maintained contact with loved ones – particularly important for people living with dementia, who have been struggling with isolation, low mood and distress during lockdowns.
David Storm, Associate Director for Access and Community services in North Cumbria at CNTW said: “The news that the ‘Reach Out’ delirium service has been shortlisted by the Royal College of Psychiatrists for Psychiatric Team of the Year is a fantastic boost after such a tough year.
“This small team has made a huge different, enabling a significant reduction in delirium across North Cumbria. The team have also played a significant role in supporting patients and their families throughout the pandemic, particularly where restrictions necessary due to COVID-19 have had such a negative impact on older people. The team have really shown innovation and flexibility, working in partnership with all disciplines across the hospitals, and we are very proud of their achievements.”
Delirium Liaison Pathway, South Tyneside
Launched in January 2021, the Delirium Liaison Pathway is part of the South Tyneside Psychiatric Liaison Team. It is a pioneering way of working – an outward-facing service which aims to raise awareness of delirium and combat its widespread impact in both hospital and community settings – and this has been recognised nationally, with the team being shortlisted for ‘Mental Health Innovation of the Year’ at the Health Service Journal Awards.
The team, which is the first of its kind, consists of medics, nurses, and a specialist occupational therapist. Patients suffering from delirium receive follow-up care at home from the team, which reduces the likelihood of the delirium reoccurring and the person needing to go back into hospital. The team help develop a care plan for each patient, and make onward referrals for more specialist support if needed. The team also provide resources, contact information and support to carers looking after an individual with delirium.
The Delirium Liaison Pathway team also work with primary care clinicians to provide training in how to identify and assess patients with delirium. The team also provide specialist support to care homes to help prevent and manage delirium.
Emma Hodgson, Community Clinical Manager at CNTW, said: “The successful development of this new pathway would not have been possible if it were not for the culture of innovation that exists within CNTW, nor without the involvement of carers who have engaged with us to shape the pathway.
“We hope that through being shortlisted in these nationally-recognised awards, we can help change how delirium is viewed, and continue to share this innovative pathway with other NHS trusts across the UK to help other patients, carers and staff elsewhere.”