The Integrating Mental & Physical healthcare: Research, Training & Services (IMPARTS) package for physical healthcare settings is designed to support clinical teams in providing timely, tailored, evidence-based care to patients presenting at King’s Health Partner’s acute trusts.
(IMPARTS) is an initiative funded by King’s Health Partners to integrate mental and physical healthcare in research, training and clinical services at Guy’s and St Thomas’, King’s College Hospital, and South London and Maudsley NHS Foundation Trusts.
We are looking to scale up use of IMPARTS beyond outpatient settings to inpatient and community teams, as well as scoping the potential for use in primary and social care.
Fiona Squire describes how the King's Health Partners IMPARTS service helped her recover mentally and physically after her limb reconstruction at King's College Hospital NHS Foundation Trust.
The IMPARTS package has five components:
Patients are traditionally asked to complete an IMPARTS screening in an outpatient clinic, usually in the waiting room before their consultation. The IMPARTS screening tool is a web based informatics platform collecting patient reported outcomes as part of routine clinical care. The outcome measures cover a variety of themes such as emotional wellbeing and how patients are managing their physical condition, including quality of life, pain, and disability, as well as condition-specific symptoms. The information is uploaded to an electronic health record in real time, allowing the patient’s healthcare professional to review and discuss the information during the patient’s consultation.
Since June 2020, we put the “e” in “e-IMPARTS” by making the screening available to patients outside clinics, and in their homes, using their personal mobile devices.
To ensure identified need is met, the patient reported information is supplemented with guidance to the healthcare professional on possible referral pathways. These are based on existing resources available to the clinical team and the pathways are strengthened and streamlined with this system. A range of care pathways may be available which include some or all of primary care, clinical psychology and liaison psychiatry, ensuring the needs of the patient are met appropriately.
All members of staff who use IMPARTS are offered training by a Consultant Clinical Psychologist prior to starting the work. This is to ensure everyone feels confident and competent in addressing mental health needs with their patients, as well as being able to use the IMPARTS tool. The sessions are flexible and built around the availability of the clinical team, and may be offered in one or more sessions depending on the needs and wishes of the team. Training can also be given on more condition specific areas, for example the dermatology team received a session on addressing social anxiety relating to a patient’s visible skin conditions. More extensive training is also offered to all KHP staff in a 5 day teaching course, which can also form an MSc level 7 15 credit module. This is targeted at healthcare professionals working in the general hospital setting and aims to equip them with the skills and knowledge to recognise and manage mental health issues commonly presented in this environment.
A portfolio of written self-help materials has been developed and continues to grow. They cover a range of issues related to physical and psychological health, and functioning. They are tailored to specific patient groups so that psychological needs are considered within the context of the physical health problem. They are free to use and are available here.
The routine collection of information on a range of psychological, physical and behavioural outcomes allows for valuable research questions to be answered. Data can be analysed to look at the prevalence of mental health problems in different conditions, the associations with physical outcomes, or to look at the course of these problems over time, and the impact on wellbeing. There is general ethical approval to conduct research on any data collected via the IMPARTS platform.