QI Project story: Introducing genetic testing into routine psychiatric practice

Dr Ian Hall

In the Q&A below, you can learn more about the project and access Dr Ian Hall’s presentation

Dr Ian Hall, Consultant Psychiatrist, East London NHS Foundation Trust and Associate Dean, RCPsych, presented some results of the QI project on Introducing genetic testing into routine psychiatric practice during the RCPsych International Congress in June 2018. In his presentation, he reviewed what recent developments in genetic testing can offer to psychiatric patients and explained how  the team used Quality Improvement methodology to introduce genetic testing into routine practice, in collaboration with the clinical genetic service at Great Ormond Street Hospital.

The project team is also composed of Dr James Smith (Specialty Registrar), Drs Faisal Faruque, George Bruce and Christopher Chung (Foundation Doctors), Dr Kate Adlington (Core Trainee), Niah Gaynair (Lead Speech and Language Therapist) and Vivienne Smith (Clinical Psychologist in training).

What motivated the creation of this QI project and who is involved in it?

We wanted to make sure that people with learning disability had access to the latest developments in genetic testing, as this can help explain why they have a disability, and also help with identifying any health screening they need, and also develop intervention strategies for any mental health problems they may have.

Which change ideas were tested?

We developed a screening tool for staff to use to identify people for genetic testing, and introduced a bespoke training for staff in the community learning disability service.  We developed and tested accessible materials to help explain genetic testing to people with learning disability.  We integrated the offer of genetic testing into our initial multidisciplinary assessment.

What were the main difficulties?

Staff were enthusiastic but had limited knowledge of genetic testing.  We hadn’t anticipated the complexities of explaining results to patients and their families, so have developed protocols to assist with this.

What were the main results/achievements so far?

We now routinely offer genetic testing at assessment for people with learning disability.  Results take time to come through, but patients and their families have found the results helpful, and it had helped us devise specific management plans in some cases.  We have developed excellent working relationships with the Clinical Genetics Service at Great Ormond Street Hospital.

How will this project ultimately improve the quality of life of the populations we serve?

Patients and their families will have a better understanding of their disability, and access bespoke health screening and interventions for their condition. Families can make better informed decisions about having children.

What is next?

We aim to roll out the genetic testing to other learning disability services in the Trust, and work further with people with learning disability and their families to refine the way we offer and explain genetic testing.

You can access his presentation slides in this page.

This project’s Life QI code is 108051.