Agenda item

To receive a report from Chief Inspector Gavin Wong and Chief Inspector Dave Gilbert seeking the Health and Wellbeing Board’s support for the introduction of a Mental Health Street Triage Service across East Berkshire.

Chief Inspector Gavin Wong and Chief Inspector Dave Gilbert attended the meeting to present a report proposing the introduction of a Mental Health Street Triage Pilot in the Berkshire East area.

It was reported that under the current arrangements patients suffering from mental health disorders in public and in need of immediate care or control could, under Section 136 of the Mental Health Act, be detained by the Police and taken to a place of safety for up to 72 hours in order for a mental health assessment to be carried out.  Currently the nearest designated place of safety was Prospect Park Hospital in Reading however if no space was available at the Hospital then a police cell may be used.  Between 2013/14 and 2014/15 there was a 33% rise (from 265 cases to 352cases) in the number of Section 136 detentions in Berkshire and in 2014/15 135 of the detentions occurred in the east Berkshire area.  This has placed a significant strain on the service and analysis of those detained in the police custody suites across the Thames Valley Policing area has found that the average length of time that a patient waited before receiving a mental health assessment  was 10 hours. A situation that could exacerbate and cause a deterioration in a patient’s condition.

In order to improve the experience and outcomes of service users it was proposed that a Mental Health Street Triage Pilot be launched across east Berkshire on 1 April 2016.  The pilot would involve teaming up a Police officer with a Mental Health Professional who would provide a rapid response between the hours of 5pm and 1am.  Outside these times dedicated telephone support would be available.  The Street Triage Team would be able to assess a patient at the scene and quickly identify an appropriate treatment route thus negating the need to spend time waiting for a mental health professional to arrive and reduce the number of patients having to be detailed.

Evidence showed that in areas running a Mental Health Street Triage system were experiencing a lower number of Section 136 detentions, fewer referrals made to inappropriate places of safety  and patients were experiencing much better outcomes as a result of the immediate medical attention they had received. 

Arising from the Board’s questions and comments the following points were noted:

·         Analysis of a pilot in Cleveland had found that two thirds of those assessed by the Triage Team were not known to services at the time of the assessment and that 55% of those assessed did not have a mental health condition.

·         Out of hours emergency care centres were able to access primary care records and this information sharing was expected to be expanded more widely

·         The Emergency Duty Service had out of hours access to the local authority systems for the six Berkshire local authorities

·         Bracknell Forest Council currently provided the out of hours Emergency Duty Service for the six Berkshire local authorities.  This service had recently been reviewed in advance of a relaunch in April 2016 and care would be needed to ensure that duplication did not occur

·         The Mental Health Professional in the Street Triage Team would be a new additional role and it was expected that the demand on the Emergency Duty Team would reduce as a consequence of the pilot’s introduction

·         It was agreed that the Chief Officer: Older People and Long Term Conditions would work with Thames Valley Police to ensure that the Emergency Duty Service and the Street Triage Pilot worked in a cohesive and complimentary fashion

·         The times that the Mental Health Professional would be available on the ground had been determined by local evidence.

·         Clear and measurable indicators of success would need to identified

·         A decision would be taken on whether to continue the one year pilot towards the end of 2016

·         It was requested that an full update, including measures of success, on the work of the pilot be given at a future meeting

RESOLVED that;

      i.        The Health and Wellbeing Board support the introduction of the Mental Health Street Triage Pilot

    ii.        A full report on the work of the pilot would be brought to the Health and Wellbeing Board’s meeting in December 2016