To whom it may concern,

I trust this email finds you well. I am Dr Roberto Galea, currently a BST in my third year of training in psychiatry. In part fulfilment of our training requirements, we undertook an audit looking at the quality and documentation practices of the tickets of referral received at Child and Adolescent Mental Health services (CAMHS). It would be much appreciated if the below correspondence could be disseminated amongst the GP community.

CAMHS hold a pivotal role in delivering mental health support to young people. The effectiveness and timeliness of psychiatric care are heavily reliant on the quality of the referrals received. The core objective of this audit was to evaluate the quality of referrals received requiring Multi-Disciplinary Team (MDT) discussion. Ensuring that referrals are not only comprehensive but also accurate, facilitating informed decision-making and robust care planning processes.

This audit adheres to the gold standard set by the NICE guidelines and aligns with the CAMHS referral guidelines established by the NHS, in the UK. Externally received tickets of referral requiring MDT discussion were systematically assessed against a number of parameters, including; demographics, clarity of presenting complaint, completeness and documentation of past psychiatric history, mental state examination, risk assessment, treatment history and investigations.

50 referrals have been identified. 62% males and 38% females. Only 28% (n= 14) were completely filled. Demographics were completed in 46% (n=23). 52% (n= 26) had no clear reason for referral documented. Despite crucial for treatment planning and risk stratification, 92% (n=46)  failed to document a mental state examination, 98% (n=49)  had no risk assessment and 48% (n=24)  did not clearly state the young person’s drug history.

The absence of crucial details documented in many referral tickets, pose significant risks to the safety and reliability of care planning.  Our imperative is to institute an improved referral system for CAMHS, underscoring the need for safe and comprehensive communication by disseminating respective guidelines to principally associated medical professionals and NHS at large.

Thank you in advance for your collaboration.

Regards,

Dr Roberto Galea

BST Psychiatry

Med. Reg. 4971