NHS-police partnership reduces officers’ potential A&E attendance by 80%

A collaboration between police and the NHS to provide “optimum care” to mental health patients has cut officers’ potential A&E attendance by around 80%.

Since 2018, NHS Lanarkshire and Police Scotland have worked together to provide appropriate psychiatric care for mental health calls, while the demand on policing has increased by 250% since 2019.

In May, Chief Constable Jo Farrell said the demands of mental health calls – one around every three or four minutes – was consuming time equivalent to 600 police officers per year, out of a service of around 16,000 officers, and pledged to tackle it.

The clinically led project in Lanarkshire, known as the Community Triage Service (CTS), is focused on supporting the most vulnerable people, although it is estimated that 20,000 officer hours have been freed up since it was launched on June 1 2023.

It was hailed by the Scottish Police Authority (SPA) as an example for other regions to consider as it reduced “potential” A&E attendance by around 80%.

Superintendent Andrew Thomson, from the Lanarkshire division, said mental health calls had increased due to the pandemic and the cost-of-living crisis.

Previously, two police officers would accompany a person in distress to A&E, and could spend around 16 hours there, with the patient potentially being deprioritised as more serious casualties were brought in, sometimes causing the person to vent their anger and frustration at NHS workers.

But under the CTS, the patient would be referred to a psychiatric liaison nurse (PLN) and given a mental health appointment within the hour if appropriate, as long as they were aged over 16, not significantly intoxicated or suffering from other illness or injury, and had not been sectioned.

In 2023, around 2,000 people were assisted by the CTS in Lanarkshire, with 95% triaged over the phone, 2% taken to A&E and 3% given a mental health appointment, with police officers taking them to the location, waiting, and then returning them home.

Of the hospital admittances, 17% were kept in, 45% were discharged with no further action, and 38% were discharged with further support.

Feedback from professionals was said to be “excellent”, with a sergeant describing the collaboration as “one of the best tools police have got”.

The primary benefit was described as “optimum care for patients”, as well as reduced demand on A&E and frontline police, while around half of Lanarkshire police officers have received formal “distress” training to help people at low risk of suicide.

Since 2018 “incremental” changes have been introduced, and in January 2021 it became a 24 hours-a-day service, focused on “compassion and support” while allowing police to focus on crime rather than waiting for hours in A&E.

It was discussed at an SPA meeting at Motherwell Police Station, North Lanarkshire, on Tuesday, with stakeholders including Suzie Cochrane, NHS Lanarkshire’s service manager for mental health and learning disabilities.

Ms Cochrane said between 35% and 45% of mental health patients who miss appointments need “unscheduled care”, and added: “One of the pathways we know is increasing is Police Scotland, whether due to distress or mental health crisis.”

PC Tracey Nell said mental health demands had increased by 250% between 2019 and 2023, and added: “Every health board is independent.

“What we have done is look at organisational limitations and say ‘how can we come up with a model that works for everyone?’.”

Martyn Evans, chairman of the SPA, said: “This is clinically led and patient-focused. I hope it is not long before this is the norm. People are being seen within an hour, rather than waiting at emergency departments for hours. The pressure of mental health in society is going up.

He said officers could be “risk averse” in dealing with mental health due to the potential for a death-in-custody probe by the Police Investigations and Review Commissioner (PIRC) as well as by professional standards if a death occurred in custody or after contact with officers.

Mr Evans described the Lanarkshire project as “advanced”, and noted the “increasing” demand on officers, which he said was a concern to the SPA.

He added: “I hope the principles can continue to grow and be embedded in other areas.”

Superintendent Andrew Thomson said: “We don’t have a Jaffa Cake jury trying to replicate decisions made in the rain at 3am – we try to put ourselves in the shoes of the person in that situation.

“Our potential attendance at emergency departments has reduced in the region of 80% which is phenomenal.”