NHS Specialist Services are commissioned by Regional Specialist Commissioners in accordance with the Specialised Services National Definitions Set (SSNDS). This sets out general and specific criteria defining the nature of patients who are viewed as appropriate for referral.

The Regional Affective Disorder Service (RADS) in Newcastle is commissioned under such arrangements - SSNDS definition 22 (Mental Health), section 6 (complex and/or treatment refractory disorders). The aim of this audit is to assess the appropriateness of referrals to RADS based on SSNDS criteria. http://www.specialisedservices.nhs.uk/info/nhs-specialisedservices.

This is a retrospective study: The referral and initial assessment letters of patients referred into RADS between January 2011and July 2011 were reviewed and scored against the criteria. We collected data on whether patients definitely, partially or didn’t meet the criteria. We also collected data on whether patients were referred from primary or secondary care and if they were a health care professional.

67 referrals were audited. 25% definitely met criteria (15 of them with bipolar disorder), 18% partially met criteria (11 unipolar) and 57% did not meet criteria. The reason for only partially meeting criteria was due commonly to meeting the pharmacological, but not psychotherapy criteria or not meeting the pharmacological criteria in details. Of those not meeting criteria, 8 were health care professionals being seen out of area, 2 from GPs for diagnosis clarification, 6 have a non-affective disorder diagnosis and 17 meet the general criteria but it was less clear that they met specific criteria. 5 did not meet either general or specific criteria.