Published: 24/03/2005, Volume II5, No. 5947 Page 13

At the time of writing Justin Grayer and Rebecca Rudge were assistant psychologists at Camden PCT and Royal Free Hampstead trust respectively.

Against the backdrop of the target for 1,000 new primary care mental health workers by the end of 2004, Camden and Islington primary care trusts and the Centre for Outcomes Research and Effectiveness set up pilot studies to assess the feasibility of potential roles in referral facilitation and guided-self help.

Here are some key points.

Service clarification

Select a simple name for the service that reflects its aims. When meeting with staff have succinct answers and written materials ready when asked questions such as what the service is and who it is for. Make referral forms as simple as possible, with the eligibility criteria on the reverse.

Clearly present the service to patients. Print posters and leaflets that direct patients to someone who can explain the service to them.

Contact all referrals to arrange appointments, clarify issues and give an idea of what will happen in the first session. Realistic expectations will improve attendance.


If you are taking over from an existing worker, arrange to visit the practice with them so you can be introduced to staff. Develop a good relationship with the practice manager. You also need to know simple 'house-keeping' such as surgery hours and door codes. If you are not replacing someone, contact other sites running similar projects.


You may constantly be on the move between practices. Consider the time and cost of travelling and resources you need to take with you. It is easier to plan ahead if you have defined times at practices and you have space to keep essential materials. Some of us worked in a 'hub-and-spoke' model, seeing patients from one surgery while based at another. Extra effort is required when communicating with spoke practices and it is worth visiting weekly. It is also useful if you can find someone in spoke practices to 'champion' the service.


The GP retains overall responsibility for the patient, so it is important they are aware of your work. The easiest way is by documenting patient contacts on an electronic management system. Have an external e-mail address if you are based at more than one practice; '@nhs. net' is ideal. It is important to engage, and to be accessible to, primary care staff to allow for conversations about existing and potential referrals - lunchtimes are often a good opportunity. Another method is to regularly attend practice meetings.

Supervision and support

We had weekly supervision with a clinical psychologist, which informed both clinical and managerial aspects of our work.

Supervision tended to be one-toone, with the occasional session by telephone. Additionally, regular meetings with other mental health workers enabled us to share problems and support each other.