Background: The aim of the study was to evaluate Initial Assessment (IA), a new system for managing referrals. The system is designed to: reduce waiting times, reduce 'did not attend' (DNA) rates, and improve multidisciplinary team working and team morale, compared to the existing referral procedure. Method: A comparison was made between a child mental health service using IA and a second centre using the existing system over a 6-month period, based on administrative records, a child functioning measure, staff and user questionnaires. Results: The Initial Assessment system was associated with a significantly shorter average waiting time for the first appointment (9 weeks) and a lower DNA rate (10%) in the intervention centre. The populations seen under the new and existing systems were similar in terms of the severity of cases. Staff reported a positive impact overall on team working and team morale, despite a reported individual increase in time pressure; users reported acceptance of the system. Conclusions: Findings suggest that the increase in team morale and support from colleagues associated with the new system may have mediated against any negative impact of the increased time pressure. Substantial cost savings to the NHS are indicated.

The objective of this study was to provide what we believe to be the first report of the establishment of a clinical psychology service to provide accessible psychological assessment, intervention and crisis support, integrated within an existing East London sexual health clinical and outreach service for commercial sex workers (CSWs). Data are presented on referral patterns, demographics, presenting issues to clinical psychology, interventions and outcomes for the first year of the service. Women presented with a range of psychosocial needs. Psychological interventions included direct therapy, signposting to other services and consultation with staff. We concluded that this flexible model of service provision improves access to mental health services within the context of a specialist sexual health and outreach service for CSWs. The provision of a named, female clinical psychologist who provides both the clinical sessions and attends outreach has been an important factor in developing trust and familiarity, leading to better uptake of the clinical psychology service.

Background/Aims The need for holistic support to address the psychosocial impact of cancer has featured in NHS recommendations since 2004. This article describes the review, rewrite and evaluation of the North Central and North East London region ‘level 2’ psychological support skills training for oncology clinical nurse specialists. Methods The review was conducted in 2016–18; the new training package was then rolled out and evaluated in 2018–19. The re-written training includes models of individualised assessment based on psychological theory, including adjustment and adaptation. It also includes self-care exercises, providing experiential learning for the dual purpose of self-care and as potential material to teach to patients as level 2 interventions. The new training model requires follow-up attendance in clinical discussion groups to consolidate knowledge and skills development. In total, 135 clinical nurse specialists attended over an 18-month period. The evaluation involved pre- and post-training questionnaires. Results Evaluation suggests the new training is valued by clinical nurse specialists, is pitched at the right level and increases clinical nurse specialists' subjective ratings of confidence and identification of psychological need, onward referral and self-care. Conclusions The new package provides a useful development of the level 2 training model. Future plans are discussed.