Improving access to A&E care for people with mental health conditions

Evolving Communities worked with Gloucestershire County Council and Healthwatch Gloucestershire to evaluate the experience of people who had accessed mental health support through the A&E departments at Gloucestershire Royal Hospital and Cheltenham General Hospital.

Parity of esteem for mental health and physical health services

As part of NHS England’s Five Year Forward View, the 2018 budget announced a commitment to achieving parity of esteem between mental health and physical health services. Funding for NHS mental health services is set to grow over five years, with a £250 million a year investment focusing on providing 24/7 crisis services, including comprehensive mental health support in every A&E department.

Several emergency departments now have a mental health liaison team for at least part of the day, and many have introduced additional training for staff to ensure that patients with mental health issues/conditions receive the best care.

A patient presenting to Emergency Department with either a physical or mental health need should have access to Emergency Department staff that understand and can address their condition, and access to appropriate specialist services, regardless of their postcode, GP or time of arrival. (The Core Principle of Mental Health in the Emergency Department, The Royal College of Emergency Medicine).

Mental health A&E care in Gloucestershire

Gloucestershire County Council asked Healthwatch Gloucestershire to find out more about the experiences of those who access mental health support through the A&E departments at Gloucestershire Royal Hospital and Cheltenham General Hospital.  Healthwatch Gloucestershire asked Evolving Communities Consultancy to carry out a short exploratory evaluation to gain an initial picture of how well the needs of those accessing mental health support through A&E were being served.

Our work

We looked at the experience of those who had accessed the hospital emergency departments with or for a mental health issue over the past year.  Over a three-month period, we spoke with patients and their families and carers. Due to the sensitive nature of the evaluation, we mainly used one-to-one interviews (face-to-face and telephone) and an online survey. We also spoke with emergency department staff and relevant external stakeholders such as, service providers within the voluntary and community sector.

Our findings were presented with recommendations for development and improvement, to help Gloucestershire Health and Care NHS Foundation Trust and Gloucestershire Hospitals NHS Foundation Trust respond to the issues raised. We also shared our report with other organisations and services that are involved in crisis mental health care in Gloucestershire.

Read more

Full report (updated November 2020): Experiences of urgent mental health care in accident & emergency: A Gloucestershire perspective.