MP welcomes move towards better mental health services

Briefing from NHS England: Specialist mental health crisis teams now in every major A&E

Thousands more people who go to a major A&E experiencing mental health crisis are now able to access specialist care quickly with progress set to be accelerated as part of the NHS Long Term Plan. 

The fourth national Survey of Liaison Psychiatry Services has confirmed that:

  • Every consultant-led 24-hour accident and emergency department in England now has a specialist psychiatric liaison service to treat patients with mental health needs.
  •  More than 60% of those teams are now on duty 24/7, compared to around 40% in 2016, with nearly all remaining services reporting extended operating hours.

This is further proof that the NHS is already delivering on its pledge to improve care and offer comprehensive mental health support to patients, but this is just the start of the journey, and the Long Term Plan will see sustained investment and improvement in services for years to come.

With psychiatric liaison services now in every hospital, the ambition is for half of those to operate at what is known as ‘Core24’ level – with the right number of skilled staff to be able to provide rapid response at any time of day or night - by March 2021.

The NHS Long Term Plan, published in January, set out the intention for this to rise to 70% by March 2024, working towards 100% coverage in the following years.

NHS England has already invested £45m in 71 sites since 2017, and the further roll-out is backed by £48m of new funding over the next 2 years.

This will be alongside investment to ensure that 24/7 community-based mental health crisis response teams are available in every part of the country, accessible through NHS 111 and with ambitious waiting time standards.

More sanctuaries, safe havens and crisis cafes in convenient areas will also provide a more suitable alternative to A&Es for those in need of urgent assistance without physical injuries or health concerns.

 “Millions of families across our country know first-hand that emergencies aren’t just heart attacks, stroke and other physical problems, but mental health emergencies too. Liaison can bridge the gap between physical and mental healthcare, often when people need support the most, while at the same time relieving significant pressure on other front-line services."

Claire Murdoch, national director for mental health at NHS England

A&E should not be the first port of call for someone with urgent mental health needs, with community crisis teams available in every area, accessible through the free NHS 111 phone and online service. However, many people do go to A&E in times of crisis, in many cases with physical injuries or conditions linked to their mental health which also require treatment.

  • Liaison teams work alongside emergency department doctors and nurses to provide immediate care, assess an individual’s needs and arrange ongoing support, whether in hospital or the community.
  • The teams are usually made up of mental health clinicians, specialist doctors, nurses, and sometimes other professionals such as psychologists and social workers who can assess the patient’s mental health needs.
  • Most people receiving care from these teams can be safely discharged the same day, but where necessary they can also arrange access to other mental health services where care and treatment can continue
  • While they work most closely with Emergency Department colleagues, liaison teams can also help to address the significant mental health needs that are found in general hospital wards.
  • Older people, many with a long-term physical condition, might also have undetected dementia, delirium or depression.
  • Professionals from liaison teams can help diagnose and advise on treatment for these issues, putting in place appropriate care plans and reducing the length of stay on inpatient wards.

The news has been welcomes by the top doctors in both mental health and emergency medicine.

“We have seen an expansion in liaison services since 2016 and warmly welcome the additional investment in order to try to achieve the goal of as broad a coverage as possible of these services in acute hospitals. We know that patients benefit from having these services, not just patients in A&E but those of all ages across the acute hospital including children and older people. There is evidence that liaison services save money and research is ongoing to look at this in more depth."

Dr. Annabel Price, vice-chair of the Royal College of Psychiatrists' liaison faculty

 “We welcome the investment in providing more mental health resources to support patients who present to Emergency Departments in mental health crisis. This extra resource can’t come soon enough for patients. Our Members and Fellows know there is a 24 hour a day, seven day a week need across the country.” 

Dr. Katherine Henderson, President Elect, the Royal College of Emergency Medicine