Patients who can be treated in Primary care should receive their treatment in Primary Care.

We aim to identify depression treatments used by Bedford East Community Psychiatric Team (BECMHT) and hence identify those patients who could be appropriately managed in Primary care.

We identified 299 patients from the BECMHT database with depression (F32,F33, F41.2 and uncoded). Potential patient groups to discharge were identified by analysing these patients’ data; their medications were compared to NICE guidelines and other evidence-based-treatments.

Many patients were on different combinations of medications but there were 153 (51.2%) on one antidepressant only. Half of the patients’ medication was in accordance with NICE guidelines (157/52.5%), 11 patients were on medication with a different evidence-base and 101 patients were on medication without either of these. However, 36.5% of patients had an inter-current psychiatric diagnosis.

Prescribing patterns within BECMHT demonstrate groups of patients who are more likely to need Secondary care, including those with inter-current psychiatric diagnosis and patients on medications that are not backed by NICE or a known evidence-base. Provided adequate symptom control, the patients who could be discharged include those on one antidepressant and patients on medications in conformity with NICE guidelines who do not need monitoring in secondary care. The patient's notes should be reviewed before discharge to ensure adequate future treatment. There should be good communication with Primary care, with joint protocols and the possibility for patients to easily access services appropriate to their needs.