London Ambulance Service NHS Trust

Best Practice at London Ambulance Service NHS Trust

The LAS Mental Health Pioneer Service

Background to LAS pioneer services

As part of the London Ambulance Service’s organisational strategy (2018-2023), the Trust has launched five new ‘Pioneer Services’. They are bespoke services for specific patient cohorts who we think we can provide a different type of response to in order to better meet their individual needs.

To meet the challenges of increased demand for urgent and emergency care and improve outcomes for patients, we need to offer specialised responses for more patients. These ‘pioneer services’ will change how we respond to these groups when they call 999, significantly improving quality of care and patient experience, and reducing unnecessary trips to an emergency department.

Mental health pioneer service

Launched in November 2018, our mental health car was rolled out as a pilot, seeing a registered mental health nurse (RMN), paired with a paramedic, responding to patients identified as requiring a specialist mental health response. This service ensures we provide parity of care for patients with physical and mental health needs.

How does it work?
  1. The service provides a specialist mental health response consistently seven days a week.
  2. The Mental Health Nurse is able to deliver specialist care and support and navigate the appropriate mental health pathways, especially out of hours.
  3. The paramedic is able to assess and treat any physical health needs.
  4. The two clinicians have the skills and knowledge to discuss risk assessments, recommended management plans and presenting condition with approved medical practitioners and mental health units.
  5. Their specialist skills are able to reduce unnecessary conveyance to acute hospitals when that is not the best place to meet the patient’s needs.
  6. We continue to have mental health nurses based in the Clinical Hub within our Control Centre where 999 calls are received.

Positive outcomes

  • Benefits for patients

  • Provision of specialist care for mental health patients
  • Better referrals into specialist mental health care pathways
  • An improvement in patient care by providing the right response first time and avoiding unnecessary emergency department attendances.


  • Benefits for partners

Supporting hospitals by reducing ED conveyance rate from 55% to 24% equating to around 30,000 fewer patients a year.

  • Benefits for staff

It will provide our staff with opportunities to develop their clinical practice with skills transfer between mental health nurses and paramedics.

Next steps

Upon completion, the pilot will be evaluated and, if successful, we will look to work with commissioners and London’s mental health trusts to expand the mental health pioneer service across London.

Listening to service users

As part of our ongoing commitment to listening to service users and improving patient care, the London Ambulance Service recently held a mental health workshop to explore service user experience of LAS mental health care and the wider system. It was attended by patients, staff and stakeholders including MIND, Samaritans, the Metropolitan Police Service, NHS England and mental health trusts.

Two interesting messages that came across on the day:

  • Our mental health car has been well-received by the police
  • Our staff sometimes find mental health pathways difficult to navigate, especially out of hours






For further details, you can follow the conversation on twitter #LASMentalHealth and watch event highlights here.



For more details contact:

Carly Lynch
Consultant Nurse,
Mental Health,
London Ambulance Service NHS Trust

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