Oxford clinic for people with first-episode psychosis believed to be first of its kind in UK
Oxford Health says the one-off assessment brings brain imaging and memory tests into a single visit
A new NHS clinic in Oxford for people experiencing psychosis for the first time is believed to be the first of its kind in the UK.
Oxford Health NHS Foundation Trust said the Baseline Biomarker Check (BBC) clinic is designed to improve the assessment of people with first-episode psychosis.
It is based at the trust's Warneford Hospital site.
The trust said first-episode psychosis is the term used when a person experiences psychosis for the first time.
It said people experiencing psychosis may see or hear things others do not, known as hallucinations, or develop unusual beliefs that can be difficult to change, known as delusions.
The trust said psychosis can be distressing and confusing for individuals and their families. It said symptoms often first develop in late adolescence or early adulthood, although people can be affected at any age.
Why the clinic has been set up
The trust said early assessment and treatment can significantly improve outcomes.
However, it said psychosis can have many different causes and people respond differently to treatment.
It said this means it can take time in routine clinical practice to establish the most appropriate diagnosis and treatment for an individual.
The trust said the clinic aims to address this by providing a more comprehensive and standardised assessment early in a person's care.
It said the clinic's development was informed by pilot work and feedback from people with lived experience of psychosis.
The clinic is supported by funding from the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC): Oxford Health and Wellcome.
What the clinic offers
The clinic provides a one-off enhanced assessment for people receiving care through Oxford Health's Early Intervention in Psychosis service.
During a single visit, patients are offered:
An MRI brain scan
Memory and thinking assessments
A physical health examination, including assessing neurological health
A detailed discussion about their symptoms, health, background and experiences
The trust said this means a more detailed assessment in one visit, as well as shorter waits for appointments and test results.
It said clinicians will have access to a richer set of information to support personalised care and treatment planning.
Research opportunities
The trust said patients can choose whether to take part in additional research activities.
It said taking part is voluntary and separate from their clinical care.
Optional research activities may include:
Advanced research-grade MRI brain imaging
Additional memory and thinking assessments delivered on an iPad
Providing biological samples, such as a blood sample
The trust said researchers hope the information gathered will improve understanding of why psychosis develops and why people respond differently to treatment.
It said the longer-term aim is to develop more personalised approaches, where assessment and treatment can increasingly be tailored to the individual.
The trust also said the clinic will create a resource for mental health research by linking research data with detailed clinical information from a representative group of patients.
Patient's experience of the pilot
A woman from Oxfordshire who has experienced psychosis went through the clinic process as part of the pilot.
Katie said: "The experience of trial-running the clinic was very informative, I learned a lot about the research process and what all aspects of the patient visit would be like."
She said: "I was made to feel very welcome by the research team. The BBC Clinic felt like a safe space to talk, I felt listened to and I was well guided throughout the different parts of the clinical assessments and optional research opportunities."
She added: "I feel that in taking part in this aspect of study design, that I can be part of a change that provides more options for people living with psychosis in the future."
What the clinic lead said
Dr Graham Blackman is a consultant psychiatrist at Oxford Health NHS Foundation Trust, a senior clinical researcher in the University of Oxford's Department of Psychiatry and the BBC clinic lead.
He said: "Experiencing psychosis for the first time can be overwhelming for patients and their families."
He also said: "The new BBC clinic allows us to bring together a range of assessments in one place and at an early stage in a person's care."
He added: "By gaining a more complete understanding of each individual's health and experiences, we hope to improve diagnosis, support more personalised treatment and ultimately achieve better outcomes for people affected by psychosis."
What the trust hopes will happen next
The trust said the clinic will generate evidence that could help shape future NHS services across the UK.
It said it hopes sharing the clinic's learning, results and research outputs will support collaboration with clinicians, researchers, NHS organisations and national partners interested in developing similar approaches.
It said the initiative could also help build the case for future investment in specialist psychosis services and wider use of enhanced assessment pathways.