Staff at Camden and Islington NHS Foundation Trust (C&I) are carrying out cutting edge research using a groundbreaking “super” database with access to millions of pieces of data.
The Clinical Record Interactive Search (CRIS) system contains anonymous information about thousands of patients, including from other mental health trusts, which can now be analysed on a mass scale for large research projects that would previously have been impossible.
It has the potential to show which treatments work best, to identify where things don’t go so well and to improve care for thousands of people with mental health problems.
The wide scope of the CRIS data, makes the information far more meaningful and evidence-based when it comes to clinicians and policy makers making decisions about the most effective, mental health services in the future.
C&I clinicians are working on several research projects in collaboration with other health trusts, including colleagues at King’s College London and South London and Maudsley NHS Foundation Trust (SLaM) who originally developed CRIS, with funding from the National Institute for Health Research (NIHR).
A first published piece of work with SLaM colleagues was to successfully identify the key factors that increase the likelihood of patients relapsing and being admitted to acute mental health services including hospital, enabling clinicians to avoid a recurrence in the future *.
Development of the CRIS database at C&I has been led by David Osborn, Professor of Psychiatric Epidemiology at UCL and C&I Clinical Consultant, supported by UCL research associate Nomi Werbeloff-Becker.
Professor Osborn said: “The CRIS database is a hugely exciting and significant step forward in helping us and partners undertake much larger mental health research projects to benefit patients.
“It also has the potential to be linked to other data held by GPs on mortality for example. This will expand the reach of projects and their impact and also encourage closer research involvement from our service users.”
Research and innovation is one of C&I’s three strategic priorities*. Other significant research being carried out by Trust staff using CRIS includes:
* Researchers from C&I and South London and Maudsley used the CRIS database jointly to assess patterns and likelihood of service users being admitted to acute mental health services within a year of previously being cared for by Crisis Resolution Teams (CRTs), with the findings published in the highly-respected Lancet Psychiatry.
CRTs are specialist NHS teams which respond to major mental health crises and provide rapid assessment, home treatment and support early discharge from hospital.
Using the CRIS database enabled researchers to analyse six years of clinical records, narrowing the data to a core pool of about 18,000 relevant but anonymous service users whose treatment in the following 12 months could then be traced.
Research showed that factors such as the severity of mental illness and the length of time illness had been experienced were likely to increase the risk of future relapse. Other relevant factors included their age and the type of mental health condition diagnosed.
Our three strategic priorities are:
We provide mental health and substance misuse services to people living in Camden and Islington, and a substance misuse and psychological therapies service to residents in Kingston.
We have two inpatient facilities, at Highgate Mental Health Centre and St Pancras Hospital, as well as community based services throughout the London boroughs of Camden and Islington. Our Trust is also a member of University College London Partners (UCLP), one of the world’s leading academic health science partnerships.
We provide services for adults of working age, adults with learning difficulties, and older people in the London area either in a community or inpatient setting.
Our income for 2015/16 was £138million and we have approximately 1,700 staff. Our staff work in multi-disciplinary teams providing a holistic approach to recovery. This means that we often work with partner agencies and the voluntary sector. Camden and Islington Mental Health and Social Care Trust was established in 2002. In March 2008 we became the first Care Trust to achieve Foundation Trust status and are licensed by NHS Improvement.
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.