Liaison psychiatry is a sub-specialty of general psychiatry. Liaison psychiatry teams provide the psychiatric service for general or acute hospitals (and occasionally other types of hospitals).
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
Liaison psychiatry is a young and developing sub-specialty.
Liaison psychiatrists work at the interface of physical health and mental health. They often treat people who are severely unwell, and must balance people’s need for psychiatric treatment against their need for physical treatment.
Most liaison psychiatrists treat ‘working age adults’ from 18 to 65 and many also treat older adults. Increasingly some new consultant posts have been developed for specialist older adult liaison psychiatrists, and there are a very small number of specialist child and adolescent liaison psychiatrist posts.
Liaison psychiatry is sometimes known as psychological medicine or consultation-liaison psychiatry.
If you specialise in liaison psychiatry, you are likely to be based in a general or acute hospital, rather than in a psychiatric hospital.
Compared to other psychiatric sub-specialties, liaison psychiatry has a relatively greater emphasis on assessment, and less emphasis on providing ongoing treatment. If you like a diagnostic challenge, you like working in a hospital, and you enjoy the more acute aspects of psychiatric practice, then liaison psychiatry may be a career for you.
Most liaison psychiatrists provide a service across three broad areas of the hospital:
- the emergency department
- hospital wards
- liaison psychiatry outpatient clinics
In the emergency department, liaison psychiatrists work closely with emergency medicine consultants and other clinicians to assess and treat people who have presented acutely with psychiatric disorders. This ranges from acute psychoses to deliberate self-harm and drug and alcohol disorders, and undiagnosed patients who appear to be suffering from an acute mental disorder.
On the hospital wards liaison psychiatrists treat a wide range of psychiatric disorders, some of which may have arisen as a result of a physical health problem. In other cases the psychiatric disorder may have led to the health problem, or the two problems may be coincidental. Most liaison psychiatrists will treat some older adults, where skills in assessing and managing confusional states and dementia are also important. They also find the right treatment for someone who may have multiple physical health problems and may be taking an array of medication. The person’s home setting, safety and independence must all be considered as well as decisions about medication and follow-up.
Liaison psychiatrists must be ready to offer assessment and treatment to people with any psychiatric disorder. Commonly encountered problems and disorders are deliberate self-harm, delirium, depression, anxiety, acute psychosis, addictions and dementia. They also see people with medically unexplained symptoms, neuropsychiatric disorders, eating disorders and almost any other psychiatric disorder.
The liaison psychiatry outpatient clinic reflects the patient group served by the hospital. Liaison psychiatrists usually offer treatment for patients with medically unexplained symptoms, as well as common mental disorders (anxiety and depression) that may arise from or worsen a person’s physical symptoms.
Want to learn more?
Find out more about:
- the working life of someone in liaison psychiatrist
- the entry requirements and training and development
- a first-hand account of life in liaison psychiatry
- Pay and conditions Expand / Collapse
This section provides useful information about the pay for junior doctors (doctors in training), SAS doctors (specialty doctors and associate specialists) and consultants.
NHS employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.
Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.
- Where the role can lead Expand / Collapse
Read about consultant and non-consultant roles in liaison psychiatry, flexible working and about wider opportunities.
Managerial opportunities for consultants include:
- clinical lead - lead NHS consultant for the team
- clinical director - lead NHS consultant for the department
- medical director - lead NHS consultant for the Trust
Most NHS consultants will be involved with clinical and educational supervision of junior doctors.
Here are some examples of education and training opportunities:
- director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
- training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the LETB/deanery
- associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery
SAS doctor roles
SAS doctors (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for SAS roles.
Further information on the SAS doctor role is on this site.
Other non-training grade roles
These roles include:
- trust grade
- clinical fellows
If you have trained on an academic psychiatry pathway or are interested in research there are opportunities in academic medicine. However, opportunities with psychiatry are fairly limited. Academic psychiatrists make up 7.6% of the total medical academic workforce. There has been a 33% decrease in the number of academic psychiatrists between 2000 and 2013. 11% of the total medical workforce are academics, meaning that psychiatry is under-represented. (CfWI 2014).
For those with a particular interest in research, you may wish to consider an academic career in psychiatry. Whilst not essential, some doctors start their career with an academic foundation post. Entry is highly competitive. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.
Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) at ST1-2 and may progress to a Clinical Lectureship (CL) at ST3 and beyond. Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
After completion of the academic foundation trainees can then apply for academic core training posts (instead of normal core training). A PhD is often taken, either during core or specialty training.
Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health
Research Trainees Coordinating Centre (NIHRTCC). Further information can be found on the National Institute for Health Research website.
There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.
The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.
Psychiatrists often undertake research, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting work at conferences. Research within this specialty, as is often the case, is subject to financial constraints. There is not always sufficient money to carry out all the necessary work.
There may also be opportunities to work in the private sector and overseas.
- Job market and vacancies Expand / Collapse
This section provides useful information about the availability of jobs, how to find vacancies and sources of further information.
Psychiatry is the fifth largest medical specialty in the UK. Consultant psychiatrists comprise 4.5% of the mental health workforce and 10.5% of the total NHS consultant workforce (Health and Social Care Information Centre, HSCIC 2014). Most areas of psychiatry have seen considerable growth in the consultant workforce in the last ten years, and general adult psychiatry (liaison psychiatry being a sub-specialty of this) is no exception. In 2003 there were 1604 general adult psychiatrists in post and by 2013 this had risen to 2204, showing a 37% growth. (CfWI analysis based on HSCIC, 2014).
52% of entrants to core psychiatry training in 2013 were women (HEE 2013). At present 41% of psychiatrists are women (HSCIC 2013).
54% of consultant psychiatrists specialise in adult general psychiatry (nb: there is currently no information available about numbers sub-specialising in liaison psychiatry).
At present there are 2314 full time equivalent consultant general adult psychiatrists in the UK (2015, HSCIC).
The competition ratio (CR) to Core Psychiatry Training in 2015 was 1.42 (NHS Specialty Training, 2015).
In 2014 there was an in-depth review of the whole psychiatric workforce by the Centre for Workforce Intelligence (CfWI).
On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.
Where to look for vacancies
Specialist medical psychotherapy training is open to those who may want to train flexibly on a less than full-time basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply. Link to our new article on LTFT
Recruitment into specialist psychiatry training (excluding Northern Ireland) is coordinated by the Health Education North West.
Registration and applications for psychiatry core and higher specialist training is online via Oriel.
Northern Ireland has its own recruitment process for psychiatry. For further details please visit the Northern Ireland Medical and Dental Training Agency website.
- Further information Expand / Collapse