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Oxford Health NHS Foundation Trust

Ketamine service for depression

KetamineKetamine is a new  treatment for depression which has not responded to other treatments. Ketamine has a brief rapid antidepressant effect demonstrated in several clinical trials over the last 15 years.

We provide a paid-for service for patients who have been referred by their GP or psychiatrist. Before treatment, patients are assessed by a psychiatrist to confirm their suitability. Initial treatment consists of three ketamine infusions over three weeks. You can find out more about the cost of treatment in the relevant section.

Oxford Health NHS Foundation Trust’s ketamine service is based at Warneford Hospital, Oxford.

 

Assessment for treatment

Before treatment you will be assessed in an outpatient appointment on a Friday afternoon to confirm your suitability for treatment. You will be assessed by Dr Rupert McShane MD FRCPsych, a consultant psychiatrist who works at Oxford Health NHS FT and undertakes clinical research at the University of Oxford’s Department of Psychiatry. Initial treatment consists of three ketamine infusions over three weeks delivered on a Monday.

What happens before an assessment appointment?

Once we receive a referral we will check to see that we have the information from your GP that we require. If not, we will contact you or your GP for further information.

We like patients to start monitoring their mood using the True Colours service before they come to the clinic. We will email you to set this up.

We will also send you a form to complete. It is essential that you complete this and bring it with you to your appointment.

What happens at the assessment appointment?

At the appointment, which will be held at Warneford Hospital, Headington, Oxford, OX3 7JX, we will:

  • check your contact details, including telephone numbers, email, GP and mental health team
  • talk to you in detail about your depression
  • assess and help you to manage your expectations of treatment
  • ask whether you are happy to be contacted about future research
  • ask you to sign a consent form (you can always change your mind at any time without giving a reason)
  • do a brief physical examination, including taking your blood pressure
  • weigh you
  • take a blood test
  • check your True Colours set-up

What happens after the assessment appointment?

If there are no problems identified on physical examination or blood tests we will schedule three infusions of ketamine.

This is sufficient to ascertain whether you are a “responder”. If you have not responded to the first two infusions and the dissociative effects are acceptable then we may increase the dose for the third infusion.

What treatment involves

  • On the day of your ketamine treatments please do not have anything to eat at least two hours before treatment.
  • During the appointment a consultant anaesthetist gradually infuses a low dose of ketamine through a drip over 40 minutes. Setting up the drip involves putting a needle into a vein on the back of your hand.
  • During the infusion you can lie down or sit in a chair. A nurse will be present in the clinic at all times. Before, during and after the infusion we will check how you are feeling and ask you to describe and record any symptoms or side effects you may be experiencing.
  • We ask patients to complete a daily mood assessment via email or SMS text which will only take a few minutes.

What happens at the end of treatment?

After the initial three treatments a telephone follow-up appointment will be arranged for you to discuss further treatment options.

Precautions after treatment

  • If accompanied home by a responsible adult, you will stay on the unit for an hour after treatment. If it is not possible for you to be accompanied, you should plan to stay on the unit for at least two hours after the end of the infusion.
  • You must not drive, drink alcohol, sign any legal documents or be responsible for looking after dependents for 24 hours after receiving your ketamine infusion.

Post-Treatment Care

Once the course of three infusions have been completed, your ongoing care will return to your GP / Psychiatrist.

We will provide them with a summary of your treatment and suggestions for your ongoing care.

The ketamine service is not yet available for NHS funding. Oxford Health NHS FT has been providing the treatment as part of its clinical innovation strategy and now offers the commercial service on the following basis.

These prices include the cost of all professional staff including doctors, nurses and healthcare assistants and the costs of all drugs, dressings and other items used in the delivery of the treatment.

Initial assessment appointment with consultant psychiatrist

£150

Initial treatment of three infusions, per infusion

£215 per infusion
£645 for three infusions

Further treatments

£195 per infusion

  • You will receive an itemised, personal quotation for any services offered.
  • On confirmation of your treatment date and type the clinical team will ensure that you are fit for treatment for your own safety.
  • Payments can be made by credit card (subject to an additional 2% surcharge), debit card or electronic bank transfer.
  • Payment for the quoted amounts must be made in advance of your appointment or treatment, or first thing on the day of your appointment.

All of the income from this service is used to fund NHS care within Warneford Hospital and other NHS sites across Oxfordshire, Buckinghamshire, Wiltshire, Swindon, Bath and North East Somerset where Oxford Health NHS Foundation Trust operates.

You can read more about this service in our leaflet.

 

 

Adult services

Last updated: 16 August, 2017

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