Supporting the Development of Responses to Mental Health Emergencies
In mid 2021 we secured a significant grant from the NHS Charities Together Covid-19 appeal fund that enabled us to fund a new role of Senior Mental Health Lead at the South Western Ambulance Service. Our Charity was able to fund the role for 2 years, so that the Trust could explore it's potential to develop dedicated mental health responses.
Matthew Truscott was appointed to the role and brought considerable knowledge as a Mental Health Nurse and experience of working with the police on their mental health responses.
One year later, our Head of Charity, Zoe Larter, caught up with Matthew to find out how the role had developed in the first year and where he thought it would go in the second year.
How is the team looking a year on?
When we spoke in May last year I joined a team of 6 people with a vision to improve Mental Health pathways for our patients in the South West. Twelve months on, we have secured funding for 60 members of staff. Our team consists of Management and Clinical Staff who operate on a rotational basis between remote telephone triage and on-scene assistance.
How has the Mental Health Triage model developed over the last year?
The aim of the Triage model was to provide a dedicated route for 999 calls to enable telephone assessment and advice for patients experiencing a Mental Health emergency. These calls are handled by Mental Health specialists to ensure the most appropriate response to the emergency.
In May last year we had just launched this model in the BNSSG (Bristol, North Somerset & South Glos.) and Somerset areas. The impact was very positive, with the number of patients being supported via telephone, without the need for an emergency Ambulance, increasing from 24% in February 2021 to 46% in February 2022.
For those incidents where an on-scene response is required, the Mental Health Triage desk also provides support to our front-line staff to ensure the best possible care pathway for our patients.
Since launch, the Trust has seen a reduction in conveyance to Emergency Department for Mental Health patients from 41% in April 2021 to 25% in February 2022. Patients who are not conveyed to an Emergency Department are treated at scene by the attending crew with remote support from the Mental Health specialists.
Over the course of the past year I have secured over £1.2million of funding to develop the telephone and remote support aspects of our service and in February 2022 the Triage model went Trust-wide, across all of the eight counties served by the South Western Ambulance Service.
I have also secured a further £200,000 to develop a blue light mental health Rapid Response Vehicle (RRV) covering the BNSSG area.
Matthew Trustcott with members of the SWASFT EOC Mental Health Team and the link officer from Avon & Somerset Constabulary
How would you like to see the Triage model develop?
Our model is most established in BNSSG which has the highest level of Mental Health acuity in the South West. In this area the Mental Health Triage desk can dispatch a rapid Mental Health on-scene response.
In addition, the BNSSG area has introduced a police link officer onto the Mental Health Triage desk to increase efficiencies where 999 calls require a multi-agency response. Devon and Cornwall Police are interested in this model and will pilot a similar approach from the Emergency Operations Centre (EOC) in Exeter.
With national capital funding agreed for Mental Health Response Vehicles we hope to be able to expand our on-scene response and police link initiatives across the South West.
We are also planning to replicate our Mental Health Triage desk, currently based in the Bristol EOC, in our Exeter EOC to provide resilience and additional coverage.
An important part of your role has been to provide guidance to our front-line staff, how has this developed over the past year?
During the course of the past 12 months I have developed a specific Mental Health risk assessment and associated training for our Clinical Support Desk paramedics and specialist nurses working in our 999 Emergency Operations Centres. I have also redesigned the Trust’s Decision Support tool on Mental Capacity which will provide our front-line staff with a more comprehensive set of evaluation criteria.
I have volunteered to be 2nd on call at all times to provide assistance and guidance to senior staff responding to a Mental Health emergency.
What do the next 12 months have in store?
I have recently been asked to assist with the development of a 111 Mental Health Triage model in the BNSSG area. This will involve the integration of the current 999 model with 111 in order to activate a Mental Health Triage response.
My role will continue to focus on vital partnership working within each Integrated Care Service (ICS) system as well as multi-agency collaboration across the 10,000 square miles served by the South Western Ambulance Service.
As the demand for emergency mental health response continues to increase (we have seen a 100% increase in face-to-face emergency contacts in March within BNSSG alone), the team will focus our efforts on providing the most effective care pathway for patients experiencing a mental health emergency, ensuring the most appropriate use of emergency services resources.
What does this role mean to you?
I am extremely grateful to the South Western Ambulance Charity and to everyone who supported the NHS Charities Together COVID-19 appeal. The money raised through this appeal is enabling huge positive enhancements in NHS Trusts across the UK.
The funding for my role has meant that we can build the foundations for a sustainable and truly exceptional Mental Health emergency response service in the South West.
(Matthew Truscott spoke to Zoe Larter in June 2022).