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The Royal College of Psychiatrists Improving the lives of people with mental illness

The Way Ahead for Adult Acute Mental Healthcare Provision

Embargoed until 09 February 2016

                      The Way Ahead for Adult Acute Mental Healthcare Provision

 

Faster access to acute care and an end to sending severely-ill mental health patients long distances are among the recommendations made in a new report launched today by an Independent Commission led by Lord Nigel Crisp and supported by the Royal College of Psychiatrists.

 

The Commission was set up in 2015 to address the issues facing patients in England needing acute care for mental health problems; patients who currently have no guarantee that they will be treated swiftly or even that the care they receive will be of an expected standard.

 

In 2014/15, 1.8 million people in England used mental health services, with 103,840 being admitted to hospital.

 

Current estimates suggest that around 500 mentally ill people have to travel over 50km to be admitted into hospital every month. These long distance admissions are mainly due to difficulties in finding acute inpatient beds or suitable alternative services in their home area, and are a symptom of far more widespread problems in the functioning of the whole mental health system.

 

With system-wide problems including variable quality of care in inpatient units, inadequate availability of inpatient care or alternatives to inpatient admission when needed, and patients remaining in hospital for longer than necessary due to inadequate residential provision, the acute psychiatric care system was well overdue for a review.

 

The Commission’s report consequently recommends significant changes to how mental health services are commissioned, organised and monitored across the whole mental health system.

 

The report clearly lays out exactly what is required to address the problems in accessing acute inpatient care for adults, with twelve recommendations that will help to close the gap that currently exists between access to acute mental and physical healthcare provision.

 

These include:

·         The introduction by October 2017 of a maximum waiting time of four hours for admission to an acute psychiatric ward for adults or acceptance for home based treatment following assessment.

·         Phasing out nationally the practice of sending acutely ill patients long distances for non-specialist treatment by October 2017.

·         More investment in home-based treatment, information systems and staff.

·         That patients and carers are enabled to play an even greater role in their own care as well as in service design, provision, monitoring and governance.

·         The piloting of a Patients and Carers Race Equality Standard in mental health alongside other efforts to improve the experience of care for people from Black and Minority Ethnic communities.

·         Better access to a mix of types of housing – and greater flexibility in its use – to provide for short-term use in crises, reduce delayed discharges from inpatient services, and to offer long-term accommodation.

·         That service providers, commissioners and Health and Wellbeing Boards work together to improve the way the mental health system works locally – sharing information, simplifying structures where appropriate, and finding innovative ways to share resources and deliver services.

Chair of the Commission, and formerly Chief Executive of the NHS in England and Permanent Secretary of the Department of Health from 2000 to 2006, Lord Nigel Crisp said:

“It is time to end the difference in standards between mental and physical illnesses. People with severe mental illnesses need to be able to find care just as quickly as people suffering from physical illnesses - and they shouldn’t have to travel long distances to do so.

 

“Most of what is needed is already being done somewhere in the country with committed and innovative people - patients and carers as well as professionals - working hard to improve services. This report’s recommendations are designed to get behind their efforts and help them to share their learning and achieve their ambitions.”

 

President of the Royal College of Psychiatrists, Professor Sir Simon Wessely said:

 

“Everyone agrees that it is a scandal that patients with serious mental disorders who need admission can end up being sent anywhere from Cornwall to Cumbria in a search for a bed.  And yet it continues.

 

“When I became President of the Royal College of Psychiatrists I asked Lord Crisp to chair an independent commission into the state of acute psychiatric care.  He and his team have travelled the length and breadth of the land looking at inpatient services, finding much to like, but still not enough being done. 

 

“The answers lie not in just providing more beds, although there are definitely places where that might help in the short term, but assessing the entire system.  In particular we stand alongside Lord Crisp in asking that there is a new pledge for a maximum four hour wait for admission or home treatment by 2017, and that the unacceptable practice of sending seriously sick patients around the country is ended by the same date.  If we were talking strokes, heart attacks or cancer, we wouldn’t even have to ask.”

 

                                                                                                                                                  

Ends

Notes to Editors

 

·         The independent Commission on Acute Adult Psychiatric Care was set up by the Royal College of Psychiatrists in January 2015 in response to widespread concerns about the provision of acute inpatient psychiatric beds in many parts of England and Northern Ireland. It is chaired by Lord Nigel Crisp, former Chief Executive of the NHS in England and former Permanent Secretary of the Department of Health with support from 14 Commissioners, with a diverse range of expertise in mental health and related sectors.

·         More information is available on the Commission’s website: www.caapc.info

·         This report sets out the findings of the Commission on Acute Adult Psychiatric Care’s work in England. The Commission’s findings for Northern Ireland will be published separately in the spring.

·         The Commission’s work has been funded and supported by the Royal College of Psychiatrists from its own resources. However, the Commission and its work remain wholly independent of the College.

·         All 12 recommendations are below:

1.       A new waiting time pledge is included in the NHS Constitution from October 2017 of a maximum four-hour wait for admission to an acute psychiatric ward for adults or acceptance for home- based treatment following assessment.

2.       The practice of sending acutely ill patients long distances for non-specialist treatment is phased out by October 2017.

3.       Commissioners, providers and clinical networks in each area together undertake a service capacity assessment and improvement programme to ensure that they have an appropriate number of beds as well as sufficient resources in their Crisis Resolution/Home Treatment teams to meet the need for rapid access to high quality care by October 2017.

4.       Service providers, commissioners and Health and Wellbeing Boards work together to improve the way the mental health system works locally – sharing information, simplifying structures where appropriate, and finding innovative ways to share resources and deliver services.

5.       There is better access to a mix of types of housing – and greater flexibility in its use – to provide for short-term use in crises, reduce delayed discharges from inpatient services and offer long-term accommodation.

6.       A single set of easy to understand and measurable quality standards for acute psychiatric wards is developed nationally with the involvement of patients and carers and widely promoted and communicated.

7.       The growing awareness and use of quality improvement methodologies in mental health is nurtured and accelerated.

8.       Patients and carers are enabled to play an even greater role in their own care as well as in service design, provision, monitoring and governance.

9.       A Patients and Carers Race Equality Standard is piloted in mental health alongside other efforts to improve the experience of care for people from black and minority ethnic communities.

10.   The collection, quality and use of data is radically improved so it can be used to improve services and efficiency, ensure evidence-based care is delivered and improve accountability.

11.   All organisations promote leadership development and an open and compassionate culture with particular reference to better ward management, values-based recruitment, and staff training and development.

12.   Greater financial transparency, removal of perverse incentives and the reduction of waste is coupled with investment in the priority areas identified here – acute care capacity, housing, information systems and staff – and guarantees about financial parity with physical health.

 


For further information, please contact:
 
Hannah Perlin
Press Officer
Telephone: 020 3701 2738
 
Leila Harris-Ryberg
Media & Communications Manager 
Telephone: 020 3701 2544
 
 
Out-of-hours contact number: 07860 755896

 

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