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NHS needs funding model for 24/7 A&E mental health support, report says


By Valeria Fiore
Reporter
28 November 2018

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NHS England should develop a sustainable funding model for 24/7 mental health support in emergency departments, a report has said.

Investigation into the provision of mental health care to patients presenting at emergency departments, published last week by the Healthcare Safety Investigation Branch (HSIB), found variation in the provision of mental health care in A&Es across England.

HSIB chief investigator Keith Conradi said: ‘In publishing this report, we’ve highlighted the systemic issues in funding and integrating mental health liaison services into the emergency department.

‘The investigation also showed that there is a lack of clear guidance and process for staff already working in a pressured environment.’

Last month, Chancellor Philip Hammond set out an extra £2bn a year by 2023/24 in mental health spending as part of the budget.

He specified that the NHS long-term plan will focus on measures such as offering a new mental health crisis service with comprehensive mental health support in every major A&E.

Four recommendations

HSIB set out four recommendations for NHS England and arm’s length bodies to follow to improve mental health assistance at A&Es. These are:

  1. For NHS England to develop a sustainable funding model for 24/7 mental health support in acute general hospitals with emergency departments
  2. For the Royal College of Emergency Medicine and the Royal College of Psychiatrists to issue guidance for emergency department practitioners to standardise the initial assessment of patients presenting to A&E
  3. For NICE to amend the guidance for the management of self-harm management in A&E
  4. For the CQC to update its inspection criteria to make sure equal weight is given to patients’ physical and mental health needs

In response to the report, The Royal College of Psychiatrists said it is already working with NHS Improvement to issue a clearer guidance for A&E staff to help them better assist patients who present with mental health crises.

24/7 mental health liaison services

Although most trusts already have 24/7 mental health liaison services, the HSIB report found that there is variation across England and no consensus on commissioning models.

An NHS England spokesperson said: ‘Since 2016, NHS England has invested £30m in over 70 hospital sites and now two thirds of A&E departments offer 24/7 mental health services. The NHS long term plan will consider appropriate next steps.’

NHS Providers deputy chief executive Saffron Cordery said: ‘As the report signals access to [liaison mental health] services is not available across all emergency departments and local commissioners are not compelled to fund these services.

‘Better access to mental health care will be a focus of the long-term plan for the NHS. To achieve this, we need a sustainable funding model for these services which ensures that the money reaches the frontline. It is also vital that we have the plans in place to recruit, train and retain the mental health workforce that we need.’

In the summer, Prime Minister Theresa May made achieving parity between mental and physical health one of the Government’s priorities when she announced that the NHS will receive £20.5bn in real terms by 2023/24.

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