The Lived Experience: it’s all in your head
Tim Kent, Service Lead Primary Care, Consultant Psychotherapist and Social Worker, Tavistock and Portman NHS Foundation Trust
Tim is the Primary Care Service Lead and Consultant Psychotherapist and Social Worker at the Tavistock and Portman NHS Foundation Trust. He undertook a first degree in Psycho-Social studies at UEL leading to Social Work at London Met and MA at Essex with clinical training in Psychoanalytic Psychotherapy (TQAP – M1) at the Tavistock Centre. He has worked for 20 years in East London , initially in Child Protection and later as a Consultant and service manager in both Child / Adolescent and Adult Mental health services. For the last 7 years he has been immersed in the Tavistock / Hackney CCG Primary Care Psychotherapy Consultation Service ( PCPCS) and is now also leading the Camden primary care based Team Around the Practice (TAP) since 2015. Tim has a special interest in the application on Tavistock traditions to external settings, translating theory into everyday language (to help train and educate anyone with a core interest in understanding the human condition) and bringing psychoanalytic work to people who might never have access to it outside of a GP surgery.
Improving the Primary Care Response to Medically Unexplained Symptoms
Dr Thanos Tsapas, Consultant Psychiatrist in Psychotherapy, Complex Psychological Interventions Service, Avon and Wiltshire Mental Health Partnership NHS Trust (AWP), with Dr David Porteous, GP, Fishponds Family Practice
The speakers Drs Porteous and Tsapas have worked together over the past years and with people with complex difficulties who have attracted the label of medically unexplained symptoms. In their presentation they will share what they have found helpful and also the obstacles in their work, including poverty related distress. They will also present some findings from the Primary Care Assessment and Consultation service (PCACS), which operated in Bristol from March 2014 to October 2016, and the proposal for the evolution of this service in the context of Liaison Psychiatry.
"With MUS the patient doesn’t know what’s the matter and neither does the Doctor. 15 – 30 percent of all primary care consultations are medically unexplained Patients don’t like scans and blood tests. The main reason GP’s send for further investigation is because they run out of time as they only have 10 minutes for each patient Its our job as a GP to ask the right questions and to manage risk The medical model we were all trained to follow is Symptoms, Diagnosis, Treatment – This model does not work with medically unexplained symptoms. It doesn’t help to focus on diagnosis – focus on the symptoms and their effect’ Treat the treatable bits – eg anxiety and depression and Empathise GP’s having psychological training is crucial as it means the patients do not have to keep coming back, they can be referred to a psychological liason service if available"
Working in partnership to develop an effective care pathway
Dr Catherine Parker, Consultant Clinical Psychologist, Clinical Lead for Familiar Faces, Physical Health and Rehabilitation Psychology, Cumbria Partnership NHS Foundation Trust
Catherine is a Clinical Psychologist and Clinical Lead for Familiar Faces in Cumbria. The Familiar Faces team is part of the Cumbria Physical Health Psychology Service and is commissioned to work with people whose complex physical, psychological and social needs bring them into frequent contact with the health care system.
Catherine trained as a Clinical Psychologist at Lancaster University and qualified in 2010. She worked for seven years in the Clinical Health Psychology Department at the Queen Elizabeth Hospital in Kings Lynn, where she took a lead in developing and delivering the psychological trauma, stroke and neuropsychology pathways. She joined the Cumbria Health Psychology Service in January 2018.
"A patient suffering with MUS usually has Persistent physical symptoms with a wide variation in symptoms. In Cumbria we have set up Familiar Faces - this is for frequent attenders who are presenting MUS. We have living well coaches as well as a full time Clinical Psychologist to help treat these patients. Our findings so far show a 50 percent reduction in GP visits and 27 percent reduction of visiting A and E"