Managing medically unexplained symptoms through screening, training and tailored psychological treatment 2gether NHS Foundation Trust

Medically unexplained symptoms (MUS) refers to the experience of physical symptoms which are distressing, but for which no medical cause can be found. An estimated 15–30% of all primary care consultations are for MUS. Those affected by MUS use significantly more health service resources, but do so without resolving either their symptoms or the associated psychological factors.

This initiative supports GPs in detecting MUS and in providing evidence-based treatments for patients. The intervention uses a new cognitive behavioural therapy (CBT) approach, which has been shown to be effective for MUS. The project aims to reduce unnecessary GP consultations and secondary care referrals, while empowering the primary care team to work more effectively with patients.

A screening tool for routine GP use was introduced into five GP practices across Gloucestershire to detect and facilitate early intervention for MUS patients. A treatment protocol and manual were also developed. Primary care and IAPT (Improving Access to Psychological Therapies) staff were trained to offer the MUS psychological intervention.

The screening tool has been used with more than 1,000 patients across five GP surgeries. Of those screened to date, 35 were eligible to be referred for the psychological intervention. 

The data collated so far during this project demonstrate that there are patients attending GP surgeries who meet the criteria for MUS, show psychological distress in relation to their symptoms, and want to be referred for psychological treatment.

The project team will continue to screen and identify patients eligible for referral, and will broaden access to therapist and supervisor training, in order to overcome challenges around therapist attrition rates. 

Contact information

For more information about this project, please contact Alex Burrage, IAPT Clinical Lead, Let’s Talk Gloucestershire and Herefordshire, 2Gether NHS Foundation Trust.