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Recognition in Primary Care

The pathways below only document the experience and expections for one PCT. It is not required that your particular environment shares their experience and Patient demands. Therefore, all of these pathways are variable to reflect local needs/expectations.

The vast majority of common mental health problems are dealt with in Primary Care, but many suffers go unrecognised. So, we start our process with Recognition in Primary Care and the "screen shot" below illustrates that 40% of Patients who do present to their GP will probably benefit best by being supported with Self-help materials or Social Prescribing activities.

When looking at this diagram, please bear in mind that the Activities (the green boxes) specify what is to be done, the Resources (GPs or Personal Advisors) specify who will do it. The connectors (e.g. Connecting a GP to Initial Assessment) specify when this work will be input and how long it's expected to take. A double click on any icon will present the appropriate dialog for that shape so that the detailed information can be entered to the model and stored behind the icon.

A significant minority of Patients need to enter the process at high-intensity Steps 4 or 5 but we expect Personal Advisors to assess the needs of more than half (55%) of GP referrals via Telephone Triage. Many of these (35%) will then become classified as Did Not Respond / No Further Action.

Each of the icons in this PatientFlow drawing can be used to store important information, like the expected duration of this activity or the time profile for when this person is available. One additional feature is the free format Notes which enable advice to be entered or links to important documents to be inserted. These 'important documents' can either be convenience references (i.e. immediately giving the GP the ability to print out a PHQ9) or they can be standard web references. For example, a GP can double-click the GP Initial Assessment box to see the following dialog box. A click on the PHQ9 or the Zung(A) link will raise the appropriate document.

After Telephone Triage, some of the Patients might be guided towards Supported Self-help with a Graduate Worker or they may need Face-to-Face Assessment by their Personal Advisor. In any event, as shown above, we can expect many Patients to move through to Step2 from only some of these initial activities.

The benefits of process mapping (patient flow planning) are widely understood throughout the NHS, but many NHS Trusts are failing to exploit the extra User benefits of visually powerful computerised techniques: