The Association of Ambulance Chief Executives (AACE) has played a key role in the development of new national arrangements for the faster treatment of patients experiencing mental health crisis.
Some 26 organisations, as well as patient groups, have been involved in the drafting of a new Concordat that describes the shared vision for improving care for people in mental health crisis. As a first step AACE has developed a new national NHS Ambulance Service protocol for the management of ‘Section 136 patients [1]’.
This has involved introducing clearer systems for NHS Ambulance Trusts when working with the Police and Mental Health professionals and will result in a much quicker clinical response for this vulnerable group of patients. Ambulance staff will be able to make an early assessment of their condition and to make quicker, better decisions about their care and transportation needs.
The new protocol – drafted by the NHS Ambulance Mental Health Leads Group – outlines how NHS Ambulance Trusts will aim to respond to Section 136 incidents within 30 minutes to conduct an initial clinical assessment and to arrange transport to a place of safety or emergency department. It also outlines how patients who are being actively restrained will receive an immediate, high priority response whilst red flag criteria have been identified as triggers for conditions requiring treatment or assessment in an emergency room. The protocol will be implemented from 1st April 2014.
AACE Managing Director Martin Flaherty OBE says:
Ambulance Trusts adopting a wider role in the field of mental health could deliver real improvements in patient care – an approach that is entirely consistent with the emerging findings of Sir Bruce Keogh’s review of urgent and emergency care.
AACE has had significant input into this new Concordat and we now look forward to working with the Department of Health, commissioners and other agencies to turn the aspirations of the Concordat into real improvements for patients.”
The new Concordat is built around four key principles: Access to support before crisis point; Urgent and emergency access to crisis care; Quality of treatment and care when in crisis; Recovery and staying well/preventing future crises.
Other key themes within the document include achieving parity of esteem for patients in mental health crisis (putting mental health on a par with physical health); improving commissioning arrangements to achieve “a shared local understanding of the mental health need; delivering a whole system approach with detailed coordination arrangements in place between all the agencies that are regularly contacted by people in mental distress; the removal of intoxication as a reason for exclusion from places of safety and stopping inappropriate use of police, police cells and police vehicles.
[1] These vulnerable people are often referred to as ‘Section 136 patients’ by the emergency services due to Section 136 of the Mental Health Act, which outlines the powers the Police have if they believe that someone is suffering from a mental illness and is in need of immediate treatment or care. This gives the Police authority to take a person from a public place to a ‘Place of Safety’, either for their own protection or for the protection of others, so that their immediate needs can be properly assessed by a clinician. (A Place of Safety could be a hospital, police station or some other designated place).
