Collaboration across the primary and specialist care interface in Early Intervention in Psychosis services: a qualitative study
Rickett M., Kingstone T., Gupta V., Shiers D., French P., Lennox B., Crawford M., Penington E., Hedges A., Ward J., Williams R., Bateman PA., Chew-Graham CA.
Background People with new psychotic symptoms may be managed in an Early Intervention in Psychosis (EIP) service. They may be discharged back to primary care at the end of their time in an EIP service. Aim To explore the role of primary care in supporting people with psychosis in an EIP service. Design and setting Qualitative study, within a programme of work to explore the optimum duration of management in an EIP service in England. Method Semi-structured interviews were carried out with people in EIP services, carers, GPs, and EIP practitioners between September 2022 and September 2023. Data collection continued until information power was achieved. Data were thematically analysed using principles of constant comparison. Results While most service users and carers described their experiences of EIP services as positive, there are issues around access to and discharge from the services. GPs reported difficulties in referring people into EIP services, having little contact with people who are supported by EIP services, and not being included in planning discharge from EIP services to primary care. Service users and carers described challenges at the point of discharge from EIP services to primary care, associated with feelings of abandonment. Conclusion This study suggests that GPs should have a role in the support of people in EIP services (in particular, monitoring and managing physical health) and their carers. Inclusion of GPs in managing discharge from EIP services is vital. We suggest that a joint consultation with the service user, their carer (if they wish), along with the EIP care coordinator and GP would make this transition smoother.