Thousands of people in mental health crisis in northeast England have been able to access the urgent care they need quickly and directly thanks to a flagship £1 million crisis helpline.
People with mental health issues, who might previously have attended A&E, have been able to use a single telephone number set up by Northumberland, Tyne and Wear NHS Foundation Trust (NTW).
The project was set up two years ago after patients told NTW that their care was good “once they accessed it”. The Trust introduced a single new telephone number for all calls including routine appointments, general enquiries and crisis care in the Sunderland area.
The 24-hour line is linked to a hub of specially-trained call handlers supported by senior nurses. Patients have fed back that thanks to the new line, instead of calling A&E when they have a mental health crisis, they receive the help they need directly and quickly through the helpline. More than 10,000 people are calling the line for support every month.
Dr Carole Kaplan, transformation programme director at NTW, said: “We’re pleased with the feedback we’ve received and hope that by making changes like this we are improving greatly the care of those with mental health issues while at the same time freeing other parts of the NHS, such as A&E, to focus on those who most need their care.
“Patients and carers are saying access is much better. They are put on the road to recovery right from the beginning and they say it works efficiently.”
Calls received are triaged allowing people who need urgent care to get the right treatment quickly, those who need community care to avoid admission where ever possible and those who need an appointment or referral to be seen quickly.
Sunderland Clinical Commissioning Group (CCG) funded an initial £500,000 set-up cost. A further £500,000 to fund staffing changes was obtained from a variety of sources, including a Commissioning for Quality and Innovation (CQUIN) scheme. The new helpline was based on patient experiences and was set up in consultation with service user groups at every stage.
Dr Geraldine Strathdee, NHS England’s national clinical director for Mental Health, said: “This is the type of innovation we want to see tackling some of the underlying issues in commissioning and service delivery in mental health.
“Mental health has led the way in providing crisis care in the community, by multidisciplinary teams, as a safe alternate to admission to hospital. This service shows the benefits of a single number to ring, skilled tele-triage staff who have in depth knowledge of the local services and can refer people onto the right service without referral back to the GP. This then frees up the home treatment teams to provide care seven days a week.
“We want our patients to get the same level of service that patients with a physical illness receive and that means being able to easily get through to someone who can help 24 hours a day. If every area had a similar system it would really help make a step change in the provision of safer services, would transform patient experiences, reduce suicides and ultimately could change lives.”
Ian Holliday, head of service reform and commissioning at Sunderland CCG, said that this shows what can be achieved when commissioners and providers work collaboratively to deliver an agreed vision. “The success is down to a transparent collaborative relationship, effective clinical leadership, and an innovative approach to outcome commissioning – service reform being the outcome.”
A number of other schemes have been established to complement the helpline and improve patient access to services. For instance, community psychiatric nurses (CPNs) are able to go from patient to patient on home visits dictating notes after each visit and sending them securely to a central digital dictation team. This avoids clinicians having to update patient records manually at the end of the day and unnecessarily increasing working hours.
CPNs also now have mobile kits that allow them to access up-to-date patient mental health records online.
Dr Kaplan added: “Many of the staff are working new shifts and although it took time to make the cultural change many are now pleased they get time off to spend with their children and families at other times.
“We are very happy that other trusts can learn from our experience over the last two years and we have been delighted to welcome visitors from across the UK and elsewhere to look at our model.
“Across the system we need to work more flexibly so that we can meet the needs of patients.”