Rebecca Lawrence
Dr Rebecca Lawrence studied medicine at Edinburgh University, graduating MBChB in 1988. She then undertook General Practice training (MRCGP 1996) before commencing training in General Psychiatry in South East Scotland (MRCPsych 2000, CCST with endorsement in addictions 2005). She has an interest in the history of psychiatry and her MPhil thesis was entitled The Roxburgh, Berwick, and Selkirk District Asylum. A study of patients admitted from 1887 to 1897. She has worked as a consultant psychiatrist in addictions since 2005, firstly in the Scottish Borders, and in Edinburgh and the Lothians since 2006. She is the lead consultant for the specialist in-patient addictions unit in Edinburgh, and works with LEAP (Lothians and Edinburgh Abstinence Programme), as well as having a special interest in pain management through her outpatient work in the Lothian Pain and Dependency Clinic. She is currently undertaking an MSc in Clinical Management of Pain (University of Edinburgh), and is a co-investigator in a multi-site observational study of the side effects of opioids (SEOS). She is active in teaching and training, and is the local teaching lead for addictions for medical students. She is a medical examiner and supervisor for the GMC, and has a particular interest, both personally and professionally, in doctors’ health and supporting doctors in difficulties.
Ritson Outreach – an addictions liaison service for psychiatric in-patients
Aims: To set up and evaluate a liaison service to psychiatric in-patients with comorbid drug or alcohol problems. This is supported by several NICE guidelines (CG120, 52 and 115; nice.org.uk), and was a response to the rise in drug deaths in Scotland.
Design: Referrals were made by phone to the specialist addictions ward, or to a designated email. The team consisted of the consultant, trainees, charge nurse and pharmacist, and was possible due to reduced beds in the pandemic. Same-day telephone advice was offered during working hours, and face-to-face patient reviews within 24-48 hours. There was a focus on ensuring rapid and safe prescribing (including the provision of take-home Naloxone).
Setting: The Royal Edinburgh Hospital, a general psychiatric hospital with in-patient beds for the usual range of specialties.
Participants: All in-patients
Intervention: To evaluate this novel service
Measurements: Referrals were entered into a database between September 2020 and June 2021 (ongoing). Information recorded included ward, diagnosis, drugs/ alcohol, advice or intervention. A satisfaction survey of in-patient doctors was also conducted.
Findings and conclusions:60 referrals between September and June (at time of writing), majority (47) from general adult psychiatry, 1 from forensic, 3 from old age and 9 from rehabilitation. 37 were male, 23 female. 17 were for alcohol advice, 40 were for drugs. 10 in-patient doctors responded to the survey, which was described as ‘hugely important’ and ‘excellent’. In conclusion, our findings suggest that this service provides excellent patient care, and is also a highly useful training experience.