#7161 Tertiary specialist neuropsychiatry pilot: a service evaluation

<h3>Aim and Method</h3> Neuropsychiatry remains an under-recognised and underdeveloped discipline. The role of neuropsychiatry service is to assess and treat patients with neurological diseases and associated severe psychiatric symptoms; or with severe and disabling neurological symptoms without identified neurological cause (NHS England, 2019). We set out to complete a service evaluation following the successful one-year operation of a pilot neuropsychiatry tertiary service in Derbyshire, U.K. We completed retrospective scrutiny of the collected responses from patients and referrers (clinicians) as well as scrutiny of the assessment letters and case records following weekly Neuropsychiatry OPC assessments. Data extraction and quantitative analysis were carried out using MS Excel and Thematic analysis was completed to analyse the qualitative data. <h3>Results</h3> The pilot service received 88 referrals between Jan 2022 and Dec 2022, of which 70 were included following data cleansing. The majority(67%) of referral sources were from neurology (n=47), followed by 7% from community mental health teams (n=5), 6% from rehabilitation medicine (n=4), and Liaison Psychiatry (n=4). Functional neurological symptoms (FND) constituted 35% of neurological comorbidities (n+25), followed by epilepsy at 20% (n=14), neurodegenerative disorders at 15.7% (n=11), brain Injury at 14.29% (n=10), migraine at 14.29%(n=10) and other symptoms at 14.29% (n=10). A wide range of neuropsychiatric symptoms were noted among the referrals, the majority being anxiety (n=27) 39%, depression (n=23) 33%, subjective cognitive impairment (n=20) 29% and neurodevelopmental disorders (n=16) 23%. Out of 86, 49% of patients received medication interventions, 31% received a referral for psychological therapy and 5% received new diagnoses in addition to person-centred formulations. 16 patients and 10 referrers completed feedback questionnaires. Five themes were identified by patient and referrer feedback. Patients had a positive experience of the clinic. Staff were friendly and knowledgeable. The service was accessible and responsive. There is a gap in current service provision that the clinic fills. The clinic should continue and increase offer of provision. <h3>Discussion</h3> This service evaluation provides evidence for setting up a neuropsychiatry service within the local integrated care system. Gaps in service provision were evident from the responses; thus emphasising the importance of having neuropsychiatry service available within the system to deliver effective interdisciplinary care for vulnerable groups of patients. This service evaluation adds valuable evidence towards collaborative working among different disciplines even under economic challenges and pressure on resources. We intend to repeat the service evaluation after two years of completion with a view to disseminating the results nationally and in peer-reviewed journals. Responses collected from patients point to improved quality of life, reduced disease burden and instillation of hope among this vulnerable and often neglected cohort of patients such as the ones diagnosed with FND.