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The Neuropsychiatry is service based at St George's Hospital and is a regional specialist tertiary care mental health service commissioned by NHS England offering multidisciplinary outpatient assessment and time-limited treatment to adults suffering from psychiatric complications of neurological and neurosurgical disorders including epilepsy, Parkinson’s disease, memory disorders, brain tumours and functional neurological disorders (FND).
The service also provides specialised liaison neuropsychiatry input (assessment, advice and time-limited management) to inpatients admitted to neurological, neurosurgical and neurocritical care beds on neurosciences wards at St George's Hospital.
- Service Type: Specialist Services
- Service Contact: Neuropsychiatrysecretary@swlstg.nhs.uk
- Service Category: Community
- Disabled access: Yes
- Address: Neuropsychiatry Service, 2nd floor Grosvenor Wing, St George's Hospital, Blackshaw Road, London, SW17 0QT
- Reception hours: Monday to Friday, 9am-5pm
- Reception phone number: 0208 725 3786 For appointment queries, call 0208 767 5289
About our care
Treatment offered is evidence-based, patient-centred and collaborative. You will be seen for an initial assessment in a consultant-led clinic at St George's Hospital in Tooting.
Your treatment can consist of pharmacological and psychological therapies, psychoeducational workshops, self-help strategies, problem solving and rehabilitative approaches.
The team's clinicians will establish links for clients with community and voluntary agencies and liaise with other disciplines such as occupational therapy, physiotherapy and neuropsychology in community and inpatient neurorehabilitation services to make treatment outcomes better.
Who is this service for?
The service is for adults aged 18+ who have complex needs of a nature and degree requiring specialist assessment and treatment. The service is not commissioned to provide specialist assessment or management of neurodevelopmental disorders.
Inclusion criteria
The Neuropsychiatry Service provides non-urgent outpatient assessment and management advice for those with a range of neuropsychiatric conditions:
- A neurological disorder that is causing moderate to severe neuropsychiatric comorbidity (cognitive, emotional, behavioural, or other psychiatric symptoms).
- Functional neurological disorders (FND) such as dissociative seizures or conversion disorder that have failed to improve with primary or secondary care management and where symptom control is unsatisfactory/sub-optimal.
- A mental disorder with possible organic aetiology, e.g. psychosis related to as-yet-undiagnosed epilepsy or encephalitis.
- Other neuropsychiatric conditions may include specific conditions such as neuropsychiatric sleep disorders or complex neurobehavioral disorders associated with acquired brain injury or severe neurological disorders.
- Investigation for possible neuropsychiatric disorder including likely functional neurological disorder where there is diagnostic uncertainty and all relevant tests and scans have been completed by primary and secondary care.
Exclusion criteria
- Patients where the primary problem is a general somatoform/functional psychiatric disorder such as schizophrenia disorders, chronic fatigue or chronic pain.
- Dementia
- Psychiatric disorders co-morbid with unrelated neurological disorder (e.g. panic attack disorder or OCD in context of MS) unless specific medication advice is sought.
- Those with psychological difficulty adjusting to a neurological disorder.
- Those where a neurodevelopmental diagnosis or concern is the primary issue.
- Those with psychiatric symptoms resulting from a neurological and/or neurosurgical disorder that are part of an adjustment disorder or other pre-existing mental health conditions where patients are under primary and secondary services responsible for their ongoing care.
Presentation needs to be of sufficient severity/complexity or of a nature and degree warranting specialist assessment and treatment.
This list is not exhaustive.
Referrals and access
Outpatient referrals are accepted from professional registered clinicians working in the regional neurosciences centre, including neurologists and neurosurgeons.
In addition, outpatient referrals are received from various mental health professionals, including psychiatrists working within our Trust and Surrey and Borders Partnership NHS Trust.
Referrals are also accepted from GPs, as long as they are appropriate, and meet the criteria of a neurological or neuropsychiatric disorder severe or complex enough that warrants specialist neuropsychiatrist service.
We do not accept self-referrals or emergency referrals i.e. referrals that have not been assessed and require an urgent appointment.
How to refer:
Please attach a referral letter on your team headed paper with supporting clinical information including the clinical query/issue you would like the neuropsychiatry team to address.
Your referral must be made by or supported by a neurologist, neurosurgeon, psychiatrist or GP.
To avoid unnecessary delays in offering your patient an appointment and treatment, please ensure that all relevant clinical details are attached to your referral and patient demographic details are up to date.
Then please email the above to: neuropsychiatryreferrals@swlstg.nhs.uk
Patient information
Additional resources
About our care
Treatment offered is evidence-based, patient-centred and collaborative; it consists of pharmacological and psychological therapies and behavioural interventions including CBT, psychoeducational workshops, self-help strategies, problem-solving and rehabilitative approaches.
Patients are also signposted to appropriate allied services within the neurosciences centre, psychiatric and psychological services within the SWLSTG Trust or to local mental health services depending on their residence. This may include a referral to NHS Talking Therapies, Family Therapy, Traumatic Stress Disorder Service, OCD Service, Complex Needs Service, Personality Disorder services, Psychotherapy Services, Eating Disorders Services or other services.
The team also links in and liaises with other disciplines such as occupational therapy, physiotherapy and neuropsychology in community and inpatient neurorehabilitation services to optimise treatment outcomes.
Pharmacotherapy: Clinicians advise GPs or other treating clinicians about patients’ medication needs and recommend dosing schedules, titration and withdrawal plans.
Catchment areas
The service is closely allied to the Regional Neurosciences Centre based at the Atkinson Morley Wing of St George’s Hospital (AMRNC) and serves the population of southwest London including the boroughs of Wandsworth, Merton, Richmond, Sutton, Kingston, Surrey and some surrounding areas covered by the AMRNC*.
- *Croydon - referrals from our neurologists at Croydon University Hospital and May Day Hospital, all others are redirected to SLAM.
- *Streatham - referrals from our neurologists.
- *West Sussex – we accept referrals from a small part of West Sussex covered by East Surrey Hospital in Redhill provided that they are under one of our neurologists from the AMRNC alliance.
- *We do not cover Brighton and Crawley.
The service is managed by the Specialist Services Line within our Trust and is closely integrated within the Trust’s wider portfolio of services.
