Psychiatric Liaison services provide mental health care to people being treated for physical health conditions in general hospitals. Given the common co-occurrence of mental and physical health problems in these patients, effective psychiatric liaison services offer potential cost savings as well as improved health outcomes.

How can my Trust gain the described benefits?

The case study is an economic evaluation of the Rapid Assessment Interface and Discharge (RAID) psychiatric liaison service operating in City Hospital, Birmingham. The service offers round-the-clock mental health support to all adult patients in the hospital.

Case study sources

Economic Evaluation of a Liaison Psychiatry Service – Michael Parsonage & Matt Fossey

Academy of Medical Royal Colleges – Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care, November 2014

Financial Calculations

Savings

The RAID service was launched in Birmingham City Hospital, with key features including a 24/7 support, emphasising a rapid response, with targets of one hour to assess referred A&E patients and 24 hours for referred patients on the wards.

Through an internal evaluation, estimates were made for savings resulting from reduced length of stay, avoidance of admissions to general wards and reduced frequency of re-admission after discharge. Total incremental savings from RAID were conservatively estimated at £3.55 million a year, or 14,500 bed-days saved at £245 per bed-day.

The savings per bed-day were scaled up to the NHS level using the total number of beds across the NHS acute hospitals.

Costs

The evaluation of the RAID service estimated that its cost was £0.8 million a year in addition to the equivalent cost of the previous service. This cost was also scaled proportionally by number of beds across acute hospitals in order to provide an estimate of the total cost if the service were rolled out across the NHS.

Carbon Calculations

Carbon savings were calculated using the established carbon intensity of bed-days multiplied by the number of saved bed-days and scaled to the national level proportionally according to the total number of beds.

Assumptions

In scaling up the intervention to the national level, it has been assumed that similar services would be applicable to other acute hospitals, with an uptake factor of 50% taken.

The analysis presented in the case study is taken from a wholly NHS perspective, whilst there are potential benefits to the wider public sector resulting from improved health outcomes. These are not included in the analysis