Integrative care pathway for patients with medically unexplained symptoms

East London NHS Foundation Trust

  • Run by a team from East London NHS Foundation Trust. Project runs for a year from September 2014.
  • Piloting a service for people with medically unexplained symptoms (MUS), identified from four primary care practices in the London Borough of Newham.
  • Aims to improve health for people with MUS, and to reduce unnecessary attendances.
  • Establishing a care pathway that provides a holistic primary care service.

Medically unexplained symptoms (MUS) is the term used to refer to disorders where the patient’s physical symptoms have no medical explanation.

MUS patients often have unmet health needs, as a result of incorrect diagnosis, and consequently ineffective treatment, despite frequent presentation at primary and secondary care services. There is also an overlap between MUS and generic mental health, predominantly somatic depression and somatic anxiety.

Existing care pathways do not meet the complex needs of this group of patients. The complicated presentations, physical symptoms and distress mean that they require a care pathway and package that is both flexible and complex.

A team from East London NHS Foundation Trust is establishing an innovative care pathway that provides a holistic primary care service. It will offer identification, assessment, engagement and treatment to MUS patients. Patients will be identified from four of the largest primary care practices in the London Borough of Newham.

A specially trained doctor will hold patient health advice/psycho-education group sessions once a week with up to 15 patients per practice. In parallel, patients will be given the option to participate in a group programme tailored towards their complex health issues and needs. Under the umbrella term ‘Strategies for better living’, two alternative groups will deliver either body-oriented interventions or mindfulness training.

The main project aims are to see a reduction in unnecessary attendances at primary and secondary care, improved health and increased patient satisfaction.

The care pathway will be implemented from September 2014 to August 2015.

Supporting Dissemination

This project was given further support through a Spreading Improvement grant to help disseminate learning and maximise the impact of the approach across the health service.

Funding will be used to disseminate information, knowledge and skills that are needed to introduce evidence-based practice through lcoal primary care pathways for patients with Medically Unexplained Symptoms (MUS). This will be done through a variety of activities including: the development of educational materials, training of staff to deliver novel body-orientated interventions for MUS sufferers, and the development of an information and networking platform for clinical staff and service users.

Contact details

For more information about this project, please email Frank Röhricht at East London NHS Foundation Trust.

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