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National Psychosis Service - Outpatients

How our service can help you

We provide a national, specialist outpatient assessment, treatment and rehabilitation service for people, aged over 18, who have complex psychosis, including schizo-affective disorder. A psychotic illness involves distorted perceptions of reality thinking, feeling, hearing and seeing often with symptoms of hallucinations and delusions.

National services are for people who live throughout the United Kingdom.

We treat people's physical and mental health. Our aim is to help people maintain their health and to reduce the risk of hospital readmission.

We encourage people, and their carers, to be actively involved in all decisions made about their treatment and care.

Due to Covid the out-patient service is accepting referrals and undertaking virtual assessments.

  • Service Type: Adult Mental Health Services (National) Service Borough Covers: National (Adult services) Treatment type: Outpatient
  • Contact the service

    Site Location: Maudsley Hospital Email: Enquiries: nps@slam.nhs.uk /Referrals: slm-tr.nps@nhs.net Phone Number: 020 3228 4312 Fax Number: 020 3228 4418
  • Disabled Access:

    Yes

  • Address: Maudsley Hospital
    Denmark Hill,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours:

    24 hour inpatient unit

  • Other essential information

  • Conditions: schizo-affective disorder, schizoaffective disorder, Addictions, Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Body dysmorphic disorder (BDD), Childhood degenerative disorders, Conduct disorder, Dementia, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Neuropsychiatry, Obsessive compulsive disorder (OCD), Perinatal disorders, Persistent physical symptoms, Personality disorders, Post-traumatic stress disorder (PTSD), Psychosexual, Psychosis, Self-harm

Interventions

Outpatient service

  • An evidence-based assessment in the Maudsley Outpatients Department, by teleconference, video-link or on site at the patient’s local hospital, followed by in-depth discussion at our multidisciplinary expert panel to inform recommendations for further investigation and management
  • Report with clearly defined treatment recommendations for local service providers, aiming to reduce disabling symptoms and improve daily functioning and quality of life
  • Joint assessments with children’s services for adolescents with treatment resistant psychosis
  • Family work

Eligibility criteria

Outpatients

  • 18 years and older
  • Male or female
  • A diagnosis, or suspected diagnosis of psychosis or refractory mania
  • Engagement and support from the local CMHT and responsible clinician

There are no exclusion criteria for our outpatient or outreach service. However, if the psychiatrist receiving the referral believes that another team may better meet the patient’s needs, this will be discussed with the referring clinician.

Outcomes

Our published outcomes are world class, demonstrating clinical excellence:

  • Reduction in psychosis
  • Improved quality of life
  • Reduced overall care costs
  • Expanded discharge destination options
  • Less frequent episodes of illness
  • Improved social functioning
  • Improved engagement with treatment plans
  • Improved understanding of illness by the patient and carers
  • Better physical healthcare leading to reduced morbidity
  • Fewer mental health admissions and bed days
  • Fewer in-patient days in physical health hospitals
  • Reduction in the total number of in-patient days
  • Reduction in level of support required

Read more in these research articles:

Krivoy et al, 2019
Sarkar et al, 2014 
Tracy et al, 2015 
Casetta et al, 2020


https://pubmed.ncbi.nlm.nih.gov/34676067/
https://pubmed.ncbi.nlm.nih.gov/33543755/
https://pubmed.ncbi.nlm.nih.gov/32744200/
https://pubmed.ncbi.nlm.nih.gov/32605667/
https://pubmed.ncbi.nlm.nih.gov/32542111/
https://pubmed.ncbi.nlm.nih.gov/32297722/

While almost all out inpatients come from acute inpatient or PICU settings, they are predominantly discharged to the community or to rehabilitation settings (Casetta et al 2020, in press: real-world-effectiveness-of-admissions-study.pdf).

Care Options

Outpatient

Care option: Psychosis – Outpatient Assess (A) 
Code: 40301 

Care option: SF Psychosis – Outpatient Assess (A) 
Code: 92807 

Outreach

Care option: Psychosis – outreach assess local (A)
Code: 53991 

 

Referrals

Enquiries and referrals 

  • By phone and to discuss possible referrals: Please contact our Administration Office on 020 3228 4322 or 020 3228 4276. We will be pleased to guide you through the process or to discuss your referral
  • By email: slm-tr.nps@nhs.net

Referral guidance

The assessment options we offer are:

Outpatient Assessment – online

Assessments are done remotely by telephone conference call via Microsoft Teams. This will usually involve the patient, the multidisciplinary team and sometimes family members. The patient will be seen by one of our consultants or a junior doctor supervised by a consultant. The assessment lasts approximately 1.5 to 2 hours. 

Outpatient Clinic Assessment (face to face)

In some cases, we can offer an Outpatient assessment at our Outpatients clinic at the Maudsley Hospital at Denmark Hill.  This would be attended by the patient accompanied by a family member and/or their care co-ordinator. 

Outreach Assessment (face to face)

Where necessary, one of our doctors can travel to see the patient on their current ward and meet with the treating consultant/clinical team members.

If you wish to pursue either the Outpatient Clinic or Outreach options, please state clearly in your referral letter why you consider this would be helpful. Please note that demand for Outpatient Clinic and Outreach assessments can be high, leading to a longer waiting period.  We consider all requests, and try to accommodate them, but allocation of an Outpatient Clinic or Outreach assessment cannot be guaranteed.

Our Outpatient and Outreach assessments take place on Mondays which is our allocated clinic day.  

What we need from you 

Our referral guidance letter sets out the information we require and provides advice on applying for funding.  The referral cover form also needs to be completed and submitted with referral documents.  Please email the administration team to request our referral guidance letter and cover form.

National Psychosis Service Administration Team

Tel: 0203 228 4322/4276
Email: slm-tr.nps@nhs.net

Training

Our clinicians offer education and training in the assessment and management of difficult to treat psychosis. This is available for individuals or small groups of professionals or may be extended as an outreach package for team-based training of larger groups. In addition, for those wishing to develop refractory psychosis services, consultations are provided to clinicians, managers and commissioners. The programme delivers the following outcomes:
 

  • Develops an understanding of the theoretical principles that underpin the effective assessment and management of resistant psychosis
  • Increases clinicians’ competence and confidence in the assessment and management of resistant psychosis
  • Explores ways in which psychopharmacological and psychotherapeutic skills can be combined with knowledge of emerging treatment strategies in resistant psychosis, including how to optimise clozapine treatment and reduce the medical risk associated with persistent psychosis 

Our experts

Our experts include some of the most highly cited in our field worldwide. Our focus on treatment resistant psychosis over three decades has enabled us to become a world class centre of excellence in this field. For instance, our research group on the antipsychotic drug clozapine is the most highly cited worldwide.

Prof Fiona Gaughran: Read more

Prof James MacCabe: Read more

Prof Sir Robin Murray: Read more

Prof David Taylor: Read more

Eromona Whiskey: Read more

Dr Maria Antonietta Nettis: Read more

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