05 Jul 2017

In its third episode last night, series two of the BBC documentary ‘Hospital’ shed light on individuals who present with mental health issues at A&E for the first time.

‘Hospital’ was first broadcast in January 2017 in partnership with Imperial College Healthcare NHS Trust and documents the pressures faced by the NHS across all departments.

Although WLMHT’s Liaison Psychiatry team were approached to take part in ‘Hospital’ earlier this year, we did not feature in the episode or the series, in the end, due to editorial decisions beyond our control.

However, many of the issues we deal with, including patient waiting times, pressures to find beds for acutely unwell mental health patients to meet their needs and people presenting in crisis at A&E, were at the heart of the episode.

As the episode aired last night, Imperial College Healthcare NHS Trust published a blog post on their trust blog which references both our partnership with them and explains how we are trying to improve patient care.

The blog is called ‘Why A&E is struggling to be a ‘place of safety’ for mental health patients in crisis.’

Claire Braithwaite, Imperial’s director of operations for the division of medicine and integrated care, explains why A&E departments struggle to be a ‘place of safety’ for mental health patients in crisis and how a ‘whole system’ approach is the only long-term solution.

We wholeheartedly agree with the need for a joined up approach advocated in Claire’s blog.

We would like to reiterate the ways in which we are working to improve our mental health provision in a much more integrated way.

Together with Imperial College Healthcare NHS Trust, Chelsea and Westminster Hospital NHS Foundation Trust and London North West Healthcare NHS Trust, we will be investing an additional £500,000 to improve the quality of liaison psychiatry at Charing Cross Hospital, West Middlesex University Hospital and Ealing Hospital. In partnership with commissioners, we will provide a full 24/7, consultant-led, liaison psychiatry service by investing in additional staff and developing skills within existing teams.

Also, as part of NHS England’s New Models of Care programme, we have launched a programme to provide better integrated care and treatment for children and young people living in North West London and experiencing a mental health crisis. This is in partnership with Central and North West London NHS Foundation Trust. Care coordination will focus on reducing the number of patients placed hundreds of miles from home for mental health care, decreasing the time young people spend in inpatient units, preventing avoidable admissions and improving access to community support.

We are also diverting more patients from A&E as a result of our crisis teams in Hounslow, Hammersmith and Fulham and Ealing, plus via the 24/7 Single Point of Access helpline on 0300 1234 244.

Last year, the Trust, along with partners, launched a new Community Independence Service (CIS). The service helps people in Hammersmith and Fulham regain their independence and remain in their own homes following illness and/or injury, avoiding unnecessary hospital admissions.

The three-borough service provides the best care for vulnerable patients when needed, without having to book an appointment.

The 8am – 8pm service delivers care through CIS Liaison too– working at A&E departments and pre-admission units to determine if people can be better supported at home or by other non- emergency services, rather than through hospital admission.

West London Mental Health Trust is working with partners in Hammersmith and Fulham, Ealing and Hounslow to provide a more joined up approach to care and avoid crisis admission in A&E for increased numbers of unwell mental health patients.

No-one watching ‘Hospital’ can doubt how hard staff in the NHS work, under mounting pressure, but some of the work we are doing longer term in redesigning services is about working smarter, too.

We aim to help people in their communities, much earlier, and give them the help they need with accessing other services and support, such as mental health recovery steps, practical help with daily living and other therapies.