Gillett George, Westwood Sophie, Thomson Alex B, Lee William
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
BJPsych Bull. 2024 Jun;48(3):151-158. doi: 10.1192/bjb.2023.43.
The prevalence of delaying psychiatric care until the patient has received 'medical clearance', and the definitions and understanding of 'medical clearance' terminology by relevant clinicians, are largely unknown. In a service evaluation of adult liaison psychiatry services across England, we explore the prevalence, definitions and understanding of 'medical clearance' terminology in three parallel studies: (a) an analysis of trust policies, (b) a survey of liaison psychiatry services and (c) a survey of referring junior doctors. Content and thematic analyses were performed.
Medical clearance' terminology was used in the majority of trust policies, reported as a referral criterion by many liaison psychiatry services and had been encountered by most referring doctors. 'Medical clearance' was identified as a common barrier to liaison psychiatry referral. Terms were inconsistently used and poorly defined.
Many liaison psychiatry services seem not to comply with guidance promoting parallel assessment. This may affect parity of physical and mental healthcare provision.
在患者获得“医疗许可”之前延迟精神科护理的发生率，以及相关临床医生对“医疗许可”术语的定义和理解，目前很大程度上尚不清楚。在一项对英格兰各地成人联络精神科服务的服务评估中，我们在三项平行研究中探讨了“医疗许可”术语的发生率、定义和理解：（a）对信托政策的分析，（b）对联络精神科服务的调查，以及（c）对转诊初级医生的调查。进行了内容分析和主题分析。
大多数信托政策中使用了“医疗许可”术语，许多联络精神科服务将其报告为转诊标准，并且大多数转诊医生都遇到过该术语。“医疗许可”被确定为联络精神科转诊的常见障碍。术语使用不一致且定义不明确。
许多联络精神科服务似乎未遵循促进平行评估的指南。这可能会影响身心医疗保健服务的平等性。
