The NHS England transformation funding supports the national ambition that by 2020/21 all acute hospitals will have liaison teams in place in emergency departments and in-patient wards, with at least half providing this on a 24/7 basis in line with the ‘Core 24’ standard.

The core 24 requires A&E’s to have on-site liaison psychiatry service commissioned to provide a 1 hour response to emergency referrals and 24 hour response to urgent inpatient ward referrals.

By 2019 nearly half of acute hospitals nationally will meet this standard, including 70% of London’s A&E’s.  There will be another opportunity for hospitals to bid for funding when Wave 2 opens in autumn 2018 where a further £90m available for 2019/20 and 2020/21.

Healthy London Partnership supported local areas to develop their bids. Further work is continuing over the summer to ensure A&E’s are aware of their roles and responsibilities with mental health crisis patients – specifically in relation to London’s new section 136 pathway.

The pan-London section 136 pathway was developed by the crisis care system last year and launched by the Mayor of London, Sadiq Khan in December 2016. The Mayor of London, Sadiq Khan, said:

“Improving mental health services in London was in my manifesto and now I’ve made it one of my top priorities in my Health Inequality Strategy.  I want every Londoner to know that should they or a loved one face a mental health crisis, they will receive the best possible care across all our emergency and healthcare services.

“Real improvements only come from listening to and respecting those suffering from mental health problems and from the experts – those who have been in crisis and experienced the service, and those who work tirelessly to support them – be they NHS workers, social workers, police or volunteers. These new guidelines bring together every agency involved in crisis care, with a shared goal of truly putting the interests of our most vulnerable Londoners first.”

Improving liaison psychiatry services will help improve the care for mental health patients in A&E but a new report recommends significant further work is needed to address the serious disadvantage mental health patient’s face when being treated for physical disorders.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reviewed mental health care provided to patients who are receiving treatment for physical health problems in UK general hospitals. The NCEOP’s ‘Treat as One: Bridging the gap between mental and physical healthcare in general hospitals’ report highlights that opportunities to identify patients with dual pathology were regularly missed despite clear evidence of a mental health disorder, and in many cases the mental health disorder was integral to the physical problem and neither could be treated optimally in isolation.

The report makes a number of recommendations to address to improve mental health support in general hospitals and bring together mental and physical health care. It includes a set of principle recommendations that the authors of the report believe can be undertaken immediately by the healthcare system.

Please read our summary of ‘Treat as One: Bridging the gap between mental and physical healthcare in general hospitals’ report.