Devon Street Triage Pilot - NHS Networks
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Devon Street Triage Pilot Tim Francis – Mental Health Commissioning Manager, NEW Devon CCG Karla Wilson-Palmer – Devon Partnership NHS Trust Rob Curtis – Devon and Cornwall Police
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Transcript of Devon Street Triage Pilot - NHS Networks
Devon Street Triage Pilot
Tim Francis – Mental Health Commissioning Manager, NEW Devon CCG
Karla Wilson-Palmer – Devon Partnership NHS Trust
Rob Curtis – Devon and Cornwall Police
The Bradley report (DH, 2009)
•82 Recommendations for improving treatment of people with mental health problems and people with learning disabilities in the criminal justice system in England and Wales
The Bradley Commission An independent review set up by the Centre for Mental Health to examine progress five years on. The benefits include:
•Evidence of benefit of early Intervention •Prevention mitigates future offending •Intervening as part of neighbourhood schemes and/or emergency call outs (MH Act)
Criminal Justice & Mental Health Solutions
Police Custody •Liaison and Diversion schemes – early identifying, assessment, signposting/referring, offering training, integration and collaboration
Courts •Liaison and Diversion – early identifying, assessment, informing sentencing, offering training, integration and collaboration
Devon Street Triage Pilot
‘Working in partnership with people in crisis to help keep them safe and find the support they need – whatever the
circumstances ’
What are the aims of Street Triage:
•To reduce the number of detentions made under s136 of the Mental Health Act 1983 •To reduce the amount of time Police Officers spend dealing with incidents involving people with suspected mental health issues •To ensure that people with mental health issues are referred to appropriate services to meet their presenting needs
Background: •Devon and Cornwall Police were one of the initial four national forces selected to pilot Street Triage. There are now ten national Force Street Triage Pilot sites. •Devon Partnership Trust in partnership with Plymouth Community Healthcare were successful in a bid to provide this pilot service to Devon and Cornwall Police. •Operational from March 2014
Unique Challenges •Significantly high use of s.136 •Large rural area/Geographic isolation •Pockets of extreme deprivation •Ageing demographic •Large ex-military population •Transient population •Logistics
Service Configuration • Police response units across all of Devon will be able to access a
Street Triage Mental Health Practitioner by phone for information and advice.
• Mental Health experts in police Control Room working together for joint solutions
• Police response units in Plymouth and Exeter will be able to ask
Street Triage Mental Health Practitioner to attend incidents for face to face assessment/ advice and information.
• Hours of operation: Thurs, Fri, Sat, Sun (20:00-06:00)
Innovative Solutions
Unique Outcomes
•Information sharing to prevent harm and manage crisis at first point of Police contact • Working together to divert s.136 detentions from Police custody at the earliest opportunity • Providing continuity for service users through inter-agency/dept referrals (not just managing the immediate crisis) • Increasing trust between partners to deliver a better service to the public
One Team Working Together
What are we learning? Average monthly referral rates: 100 pm
Referrals relating to potential risk: 74% of referrals received presented as a risk of harm to self
Previous contact with Mental Health services: 64% of referrals relate to people currently open or previously known to Mental Health Services
Street Triage Example:
April 2014
•Street Triage Nurse receives urban call out to support officers with a female thought to be experiencing mental health problems and presenting with potential risk of harm to self •Clinical record accessed by Street Triage Nurse - confirms that the female was well known to services and had experienced previous psychotic episodes- with relapse indicators identified in most recent care plan. •Street Triage Nurse attended incident to assess female and support Police Officers. Post assessment of mental health presentation and risk - Street Triage Nurse recognised relapse indicators were present. Street Triage Nurse liaised with Mental Health Services and female was offered and agreed to an informal admission to the psychiatric inpatient unit. •Street Triage Nurse accompanied officers and escorted female to hospital and handed care over to inpatient staff.
Is Street Triage Making a Difference?
6th March- April 28th 2014: 73 persons detained s136 Police Custody 38 detained s136 and taken to NHS Place Of Safety 11% of s136’s averted by Street Triage 6th March-April 28th 2014: (During Street Triage Operational Hours): 14 persons detained s136 Police Custody 5 detained s136 and taken to NHS Place Of Safety 14 persons had s136 averted as a result of Street Triage Intervention
42% of s136’s averted by Street Triage (during hours of operation)
How is Street Triage Making a Difference?
•Identifying people not previously known to services
•Enabling people to access services
•Intervening earlier than ever before
•Preventing full relapse
•Promoting joint planning and risk management
•Reducing risk and self-harm
•Promoting engagement through collaborative intervention
•Closing the gap between front line services
•Enhancing experiences and promoting recovery
Efficiency and Cost Effectiveness Initial data points to savings in the following areas:
•Police time •Approved social worker time •Medical time •Recovery time to the individual
•Since the service became operational, Devon Street triage has averted a total of 31 s.136’s. Based on the Oxford formulae, this equates to a financial saving across the public sector community of: £42,750 (Financial testing currently under way to reflect Devon’s operational configuration) •Potential for significantly more savings as service utilised more often
Next Steps: •Encourage greater use off service •Engage those with lived experience •Further refinement to cost/benefit analysis (DoH/HO) •Pilot evaluation - developing a robust business case to secure future investment •Detailed analysis of the outcomes and experiences of those using the service •Seeking evidence of sustained recovery outcomes for those signposted to MH services
Thank You
•Questions?
