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Audit of primary care of people with schizophrenia (in general practice in Lothian)

Joan Rodgers

Aim To audit the management of patients with chronic schizophrenia within primary care in Lothian.Design The Clinical Governance Support Team in Lothian NHS Primary Care Trust developed an audit package to collect data about the quality of care of patients with chronic schizophrenia over the previous year. The package provided guidance on audit methodology, identiŽ cation of patients, and a standardised data collection sheet with explanatory notes.Setting All Lothian Local Healthcare Co-operatives (LHCCs) were invited to participate on an LHCC basis (with aggregated results being fed back to each LHCC). Where LHCCs did not wish to participate, individual practices within the LHCCwere invited to participate.Results Altogether 55 practices returned data on a total of 822 patients. The percentage of patients with schizophrenia in the participating practices was 0.17%. In the previous year 86.3% of patients had been reviewed and of those, 69.4% had beenseen by a consultant psychiatrist, 71.8% of patients had had involvement with the mental health team and 18.9% of patients were only seen by their general practitioner; 21.3% of patients had had a hospital admission; 90.4% of patients were recorded as being on antipsychotic medication.Conclusions For the 86.3% of patients who had a review, 69.4% were seen by a consultant psychiatrist. This falls short of the Clinical Standards Board’s recommendation that 100% of patients with a diagnosis of schizophrenia should be reviewed by a consultant psychiatrist at least once a year. It may be impossible to achieve the 100% standard and therefore it would be helpful to have a standardised template for an annual schizophrenia review. It is hoped that such a template will be developed across Lothian