Improving treatment for people living with psychosis
CPFT is running a pilot project to increase access to effective treatment for severe mental health conditions psychosis and schizophrenia, funded by the Cambridgeshire and Peterborough Integrated Care System.
Schizophrenia affects under one per cent of the population with 30% of people living with the condition likely to be resistant to standard treatments and suitable for clozapine treatment and monitoring, which can be provided by CPFT’s specialist Clozapine Clinic.
In Cambridge, the team led by consultant psychiatrist Dr Emilio Fernandez-Egea with independent prescriber and mental health practitioner Brian Kotelo have developed a process to safely start clozapine treatment for service users in the community.
However, access is not as easy for service users in Peterborough, Huntingdon and Fenland who need to be admitted to an inpatient ward first. Clinics in the north of the county need more support to offer clozapine treatment, new therapies and advice in these communities.
To address this clinical challenge, project manager Alex Mason worked with the Trust’s psychosis lead Dr Liliana Galindo Guarin (pictured centre above) and general manager Michelle Espley on a one-year pilot project to extend clozapine care in the north, linked with expert advice for treatment resistant or unusual cases, to test how well cognitive assessments work before discharging people from mental health wards.
Liliana said: “We are working closely with clinical services in Peterborough, Huntingdon, and Fenland to facilitate access to training, and increase our existing capacity. It has been a great pleasure to work with clozapine experts, clinical leaders from different services, carers and service users to implement innovative solutions that reduce the existing gap."
This project focuses on reducing health inequalities across CPFT, by increasing access to an evidence-based treatment for resistant psychosis in the community. To deliver this specialist service they have recruited senior transformation manager for psychosis Helena Paice (left) and advanced nurse practitioner Clare Saunders (right).
Alex said: “In November last year (2023), the Peterborough Clozapine Clinic achieved a significant project milestone and started their first community service user on clozapine in Peterborough, which prevented significant trauma and distress for this individual, who did not wish to be admitted to an inpatient ward. The multidisciplinary team effectively managed the risks and delivered suitable treatment in the community, saving 18 hospital bed days and improving the service user experience.”
The team aim to recruit more staff to provide the additional capacity required to help more people in the community safely access clozapine treatment, trialling the service model developed in Cambridge.
One service user shared their feedback: “Being able to re-start clozapine at home was really helpful for me. If I had been re-admitted, this almost certainly would have had a negative effect on my mental health. With the flexibility of clozapine clinic staff and the Crisis Resolution and Home Treatment Team (CRHTT), who were able to see me whenever and wherever was easiest, I was able to carry on going to work which is important to me. I could also carry on seeing my friends and family - they are my main support system so maintaining these relationships is crucial to my wellbeing. Overall I am very grateful the option to re-start clozapine in the community was available to me.”
If you are currently working with a service user living with psychosis, and they have not responded well to treatment with at least two antipsychotic drugs, please contact your local clozapine clinic service:
- Peterborough - pboroclozapine@cpft.nhs.uk
- Huntingdon – CPFTIandTHunts@cpft.nhs.uk
- Fenland – AgenoriaReferrals@cpft.nhs.uk
- Cambridge - ccphc@cpft.nhs.uk
If you would like to learn more about this project, please contact Helena Paice.
