Care options

Care option Description Code Unit
Inpatient
Assessment and treatment, standard This care option is for people who have a neuropsychiatric presentation.

• Neuropsychiatric assessment is conducted by the
multidisciplinary team
• Imaging, to investigate a diagnosis or extent of organicity and its role in the person’s problems
• Monitoring and providing ongoing treatment of presenting symptoms
• Medication review
• Ongoing risk assessment and risk management
• Assessing the pattern of behaviour and formulating a cognitive behavioural programme
• A neuropsychological assessment to determine the nature, extent and impact of any cognitive impairments
• Speech and language therapy assessment of communication and swallowing difficulties, where appropriate
• Occupational therapy assessment of daily living activities
• Physiotherapy assessment
• Specialist nursing assessment and treatment
• Recommendations for follow-up, ongoing rehabilitation or assistance in providing adequate after-care arrangements
OBD
Treatment, intensive As per the standard assessment and treatment option, however the person also receives intensive nursing, psychology, physiotherapy, occupational therapy and other intensive therapy input where clinically indicated e.g. speech and language therapy. This care option is often used due to the complexity of physical dependency issues related to the person’s illness, resulting in a greater need for intensive nursing. The majority of people enter the service on this care option and this is reviewed regularly. OBD
Care option Description Code Unit
Outpatient
Assessment, Neuropsychiatry NHS England This assessment includes a thorough history, a physical exam and a formal assessment of the person’s mental state. Further investigations may include blood tests, a detailed neuropsychological examination, neuroimaging and neurophysiology. If needed, the person can return for a second session once the results are available. The initial diagnostic opinion is given directly to the person, along with a discussion about investigations and treatment options. The referrer and GP are sent a report. . Per assessment
Assessment, Neuropsychology and Memory Disorders A neuropsychiatry and/or neuropsychological assessment is undertaken by a team comprising of neuropsychiatrists, neuropsychologists and neurologists as required. Neuropsychological and blood tests are undertaken at the appointment and further investigations such as neuro-imaging and EEG are organised. Suitability for cognitive behavioural therapy and cognitive rehabilitation is assessed where appropriate.

In most cases, a follow-up session will be organised to review test results with the person and to continue assessment where the diagnosis is unclear. An initial diagnostic opinion is given to the person and the carer and a report is sent to the GP. The assessment takes up to four hours.
. Per assessment
Telemedicine assessment A telemedicine assessment by a consultant is available for people who are not able to be assessed in hospital and for whom outreach is impracticle. . Per assessment
Deep brain stimulation (DBS), assessment We provide a deep brain stimulation pre-operative assessment for the DBS surgery program. The purpose of the assessment is to screen for the psychiatric disorders commonly seen in the DBS cohort such as depression, psychosis and impulse control disorders. In addition we assess for the presence of cognitive impairment and the capacity to give consent for the procedure . Per assessment
CBT assessment and treatment, Neuropsychiatry People are referred via a consultant neuropsychiatrist* to the neuropsychiatry CBT team, who offer two-hour assessments for people with medically unexplained, non-organic or organic conditions, where psychological, emotional, behavioural or psychosocial aspects are an issue.

Treatment sessions are with a CBT therapist for one hour. The normal course of treatment for this group consists of 12 treatment sessions and three follow-up sessions, that are arranged weekly or longer depending on the clinical presentation.
(*Direct referral to this service is not available – it is only available with the outpatient assessment above.)
. Per assessment
. Per session
Treatment, Memory Disorders Treatment is delivered in up to 30 sessions. Treatment strategies are tailored to individual service users, but can include the following elements:

• Pharmacological treatment and assessment of response
• Medical assessment of response to cognitive behavioural therapy (CBT)
• Specialist investigations (such as neuroimaging and telemetry) for diagnostic clarification
• Transcranial magnetic stimulation
• Feedback of investigation results
• Cognitive Behavioural Therapy
• Cognitive rehabilitation (Memory Aids)
• Speech and Language communication skills
• Physical therapy
• Strategies for returning to employment, education or activities
• Support and education for families and carers
• Liaison with referrers and commissioners for ongoing local management
. Per session
Telemedicine treatment Telemedicine treatment by a consultant is available for people who are not able to be assessed in hospital and for whom outreach in impracticle. . Per session
Deep brain stimulation (DBS), treatment Following DBS assessment, up to three pre-surgical, psychiatric treatment and psychiatric follow-up, post-surgery sessions with psychotherapist or clinical psychologist, will be offered if indicated. . Per session
Telemedicine assessment As per the standard outpatient assessment, but for when the person is unable to be assessed at the hospital and outreach is impractical. Can be completed via phone or internet link. . Per assessment
Care option Description Code Unit
Outreach
Outreach assessment As per the standard outpatient assessment, but an option for when the person is unable to be assessed at the hospital. Per assessment