Safety recommendation
It is recommended that NHS England ensures there is a sustainable funding model to support 24/7 urgent and emergency mental health liaison services in acute general hospitals with emergency departments.
Response:
Thank you for sharing the report with NHS England, and to the investigation team for their engagement throughout the investigation.
We were sorry to read the reference case about Diane who tragically took her own life. Please do pass on our condolences and gratitude to Diane’s family, with whom we know you have been working closely with during this investigation.
NHS England is happy to accept the recommendation made in the report. We are pleased that the recommendation supports our policy to expand provision of liaison mental health services across England. In particular, we welcome the emphasis your report places on patient safety and quality as the primary benefit of liaison mental health services in emergency departments.
As you will be aware, a national policy position on liaison mental health was set for the first time in 2016. Implementing the Five Year Forward View for Mental Health set an initial target that by 2021, all hospitals with type 1 A&E departments should have a liaison mental health service that can meet the needs of all ages, and that for adults and older adults 50% of these will achieve the ‘core 24’* service level by 2021. We intend to set out ambitions beyond 2021 as part of the NHS long term plan, due to be published shortly.
Since 2016, NHS England has invested £30m in over 70 hospital sites to achieve the core 24 service level. The 2018 survey of liaison psychiatry should be complete by the end of the year, and we expect it to show positive progress. While the data hasn’t yet been fully processed, preliminary findings suggest that there is now no A&E in England without a liaison mental health service, the number of services operating 24/7 has increased from 39% to 66% over the past 2 years (with many of the others having extended their opening hours), and staffing in the teams has increased significantly. We hope that your report will help local commissioners to make the case as expansion continues across the country.
With regard to the recommendations made to NICE, RCPsych, RCEM and CQC, NHS England also supports these, and we look forward to working with those organisations as they develop and implement the recommendations.
*Core 24 refers to: (i) 24/7 hours of operation; (ii) providing 1 hour response to referrals from emergency departments, 24 hour response to referrals to inpatient wards (iii) staffed in line with recommended levels.
Update received 16 July 2019:
The NHS Long Term Plan, published in January, set out the intention for this [the number of liaison mental health services operating 24/7] 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 rollout is backed by £48m of new funding over the next 2 years.
Response received on 23 November 2018.