Frequent attenders to the Accident & Emergency (A&E) can cause a huge burden on the services.

To screen this group of patients for any previous existing psychiatric background as well as to identify patients with Medically Unexplained Physical Symptoms (MUPS) in order to sign post them to the appropriate services and to create a joint management plan with the A&E department.

Not different from the objectives.

The list top 52 frequent attenders to two busy A&E departments in the North East of England for the period between Jan-Jun 2012, was obtained. Their records been verified on PARIS (the local Psychiatric Services Electronic Notes System) looking for at least one previous encounter with the services, if the patient was open to mental health and if the patient was care coordinated during that period. Diagnosis, history of substance misuse and significant alerts as well as housing were recorded. For the MUPS main reason for presentation was recorded. Joint care plan with A&E was also verified.

This group generated 851 attendance to A&E during this period. Mean attendance 16 (12-41). Nearly 80% of the sample had at least one encounter with the psychiatric services. 40% were actively open to the services. 18 patients were care cordinated. 30% had significant alert to harm others. 9 patients in total were classified as homeless.

Significant number of regular patients at the A&E department have psychiatric background. There was limitation in identifying MUPS due to anomalies in coding.