Care options

Care option Description Code Unit
Inpatient
Treatment, standard The first phase is a full assessment of current physical and mental state in the context of past history and treatment response. We then collaborate with physician colleagues if needed to assess risk and create evidence-based treatment packages. These include bespoke psychopharmacological and psychological interventions and assertive management of co-morbid physical and mental health conditions. We use our experience and ethos to start and maintain clozapine in patients where it has not been possible to do so before with excellent results. We have developed particular expertise in clozapine (re-)challenge in people with various medical complications including 'red lights' or cardiac problems. Where clozapine is not an option, we work with the Maudsley Pharmacy to apply the latest evidence in devising effective and tolerable medication strategies. 13540 OBD
Treatment, secure facility This option may be offered in one of our more secure facilities, when a higher level of security or physical health monitoring is required. The patient’s treatment and care will be managed by the Psychosis Service in conjunction with the team from the secure facility. The person will have the same level of psychopharmacological and psychological interventions as they would on the Psychosis Service. This option is reviewed regularly, and the person may be transferred back to the Psychosis Service when their condition is stabilised and they can be treated on an open unit. The price listed is for a low-secure challenging behaviour unit, however it may vary for other units. 92842 OBD
Treatment, one-to-one nursing This care option is used when a person’s mental state is disturbed to such an extent that one-to-one care is needed 24-hours a day. Clinical interventions are as per the standard treatment care option, however the person may present with problems that require additional care. They may have clear plans to self-harm or periods of aggressive behaviour, as detected by risk assessment, or increased physical dependence needs relating to current mental or physical conditions. This is not a long-term option, but it can be used during the acute time required. 91760 OBD
Treatment, two-to-one nursing Suitable when a person’s mental state is disturbed to such an extent that two-to-one nursing is required 24 hours a day. As per standard treatment, however the person may present with problems that require additional care. They may have clear plans to self-harm or periods of aggressive behaviour, as detected in the risk assessment, or increased physical dependence issues relating to their current mental or pre-existing physical illness. This is not a long-term option, but is used during the acute period required and reviewed frequently. 91440 OBD
Patient escort The required number of nurses to escort a patient from the Bethlem Royal Hospital inpatient unit to another hospital. 91732 Per trip
Care option Description Code Unit
Outpatient
Assessment An in depth assessment, including an interview with the person and their carers, and a discussion with our expert team, which includes consultant psychiatrists, academics specialising in psychosis research, and a pharmacist. A report is provided including recommendations for treatment. This option is also available via telephone or video-conferencing. 40301 Per assessment
Assessment, residential The person is admitted to our unit the night prior to their outpatient appointment. As per the standard assessment, but is enhanced by observation from clinicians on the unit. This option includes provision
of local accommodation for up to two accompanying staff or family members.
92530 Per assessment
Assessment and treatment, family work This option is suitable for families of people with psychosis. There are four assessment sessions which take place at different time points (at referral, prior to starting therapy, mid-therapy and at the end of therapy), using a range of standardised psychological outcome measures. Therapy sessions last approximately one hour, with patients and their families seen weekly or fortnightly for around six months. Therapy is delivered by family work therapists specialising in psychosis. This option is available at no extra charge for inpatients. 92531 Per assessment
92532 Per session
Improving Cognitive and Negative symptom Evaluation and Treatment in Schizophrenia (ICoNeTS) service Assessment includes a full psychiatric assessment, a brief cognitive assessment, scoring and interpretation of results and on occasion additional testing. The person is discussed within the ICoNeTS multidisciplinary panel, and a report is prepared detailing the results of the assessment and advising on how to reduce negative symptoms and optimise cognitive function. For people who can attend sessions at the Maudsley hospital, cognitive remediation therapy may be possible to arrange.
ICoNeTS is only suitable for people who have begun to successfully manage their psychosis and with the help of medication, no longer experience hallucinations or paranoia that significantly impact on their functioning. This option is research funding, therefore no cost.
No Cost Per session
Independent prescribing review An expert pharmacist provides an independent medication review service for referred patients. This includes a review of the complete drug history provided, with advice to referrers on potential future medication options. 11721 Per review
Bipolar clinic Assessment and treatment for those with bipolar disorder. The Psychosis Service will work in collaboration with the Affective Disorders Service where indicated. 62751 Per assessment
62752 Per session
Voices clinic An in depth assessment with a full report, including recommendations. Treatment sessions are for people experiencing persistent auditory hallucinations, particularly those who are difficult to evaluate or are resistant to conventional treatments. 50441 Per assessment
50442 Per session
Care option Description Code Unit
Outreach
Assessment Assessment by a psychiatrist at the person’s location. The assessment includes an interview with the person and their carers, where applicable and is presented to our distinguished expert panel which includes consultant psychiatrists, renowned senior academics specialising in psychosis research and an expert pharmacist. A detailed wide ranging report is provided including recommendations for treatment strategies. 53991 Per assessment