#7192 The value of liaison neurology within an NHS mental health trust: a service evaluation

<h3>Background</h3> Our mental health trust recently commissioned a liaison Consultant Neurologist. Given its novelty we sought to define the typical caseload in the first two years and its clinical impact. <h3>Methodology</h3> Using available records for 134 referrals seen by liaison neurology, we collected: reason, outcome, investigations and advice given. For a set of pre-specified conditions (dementia, psychosis, seizures, traumatic brain injury, functional neurological disorders, movement disorders) we also looked for whether there was a clear rationale and role for the neurologist in diagnosis or treatment (n=70). We also received subjective free text feedback from five referring clinicians. <h3>Findings</h3> The majority of referrals were from acute adult wards (n=78), and only (28/134, 21%) were previously known to neurology services. Consistent with a mean age of 55 years, the most common reason for referrals were cognitive decline (n=29, 22%), movement disorders (n=22,16%) and psychosis (n=20, 15%). Diagnosis was altered in 57/134 (43%) cases and management alterations were suggested in 40/134 (30%). In those with pre-specified conditions, 52/70 (74%) cases there was a clear rationale and role for the neurologist. This was largely due to diagnostic clarity through neurological examination, and improving access to timely specialist neurological assessment. In the other 18 cases the rationale was unclear and would be within typical psychiatric practice. Clinicians found the service most helpful for neuro-psychiatrically complex cases and praised communication and efficiency. <h3>Conclusion</h3> A liaison neurology service appears to be useful - rooted in clinical acumen. Beyond this, the liaison neurologist also brings clarity to interpreting investigations e.g. neuronal surface antibody testing. Akin to the growth of liaison psychiatry, further experience will delineate the best application of the liaison neurologist.