Calls for improved mental health care in Norfolk A&E departments

Norman Lamb. Picture: MARK BULLIMORE

Norman Lamb. Picture: MARK BULLIMORE - Credit: Archant

Former health minister Norman Lamb is today calling for action over the disparity of mental health provision at Norfolk's three A&E departments.

It was crucial to ensure robust support for people presenting at A&E in crisis having self-harmed or even tried to take their own life, a meeting of Norfolk County Council's health overview and scrutiny committee (HOSC) heard.

A round-the-clock service was introduced at the Norfolk and Norwich University Hospital (N&N) last year, but there is still no on-site cover at night at the James Paget University Hospital (JPH) in Gorleston or the Queen Elizabeth Hospital (QEH) in King's Lynn.

The QEH has on-site cover from 8am to 8pm daily and at the JPH it is from 9.30am to midnight daily.

Bert Bremner, a member of the HOSC committee, asked yesterday's meeting: 'How can it be that Great Yarmouth and King's Lynn don't have the same level of support and what can we do to change that?'

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Michael Scott, chief executive, at Norfolk and Suffolk NHS Foundation Trust (NSFT) said this 'reflects how healthcare is commissioned across Norfolk'.

Mr Lamb said: 'To have no cover after 8pm is not acceptable.

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'A lot of A&E admissions where there may be a suicide attempt or someone in psychiatric crisis may be after that time.

'It's quite common for that to take place late at night when people are isolated and alone, so the [HOSC] committee is right to be concerned about it and I would want Norfolk to be leading on this. This comes down to the need for a greater priority for mental health and equal provision.

'There are too many cases of people who have been to A&E and subsequently taken their own lives, so getting them access to help quickly at that point is critical.'

The N&N has a single member of staff, a registered mental health nurse, covering at night.

Jon Higgins, whose son Christopher Higgins died at a mental health unit on the site of the QEH in 2013, stressed the importance of having trained mental health staff on hand.

'There should be provision in A&E to understand that these patients can be highly volatile,' he added.

The N&N has 24/7 mental health nurse cover, and is getting pilot funding for a full-time, on-site consultant psychiatrist and additional nurses in 2016-17.

At the JPH there is a commissioned service from 9.30am to midnight, and the off-site crisis team is relied upon outside of these hours.

Rebecca Driver, director of commissioning and engagement with NHS Great Yarmouth and Waveney Clinical Commissioning Group, said: 'Every CCG has a duty to commission the services which will meet the specific needs of the population they serve, which is why provision may differ between different areas.

'We commission a psychiatric liaison service within the A&E at the JPH from Norfolk and Suffolk NHS Foundation Trust and Mind.

'This has had a positive impact by making sure patients can be assessed quickly while reducing their length of stay in hospital.

'In some cases, the service has helped prevent hospital admissions by referring patients to more appropriate sources of help within the community.'

'We are now working with both NSFT and Mind to further enhance the service over the next 12 months while looking specifically at steps which can be taken to help patients who attend A&E frequently with acute mental health issues.'

The QEH has a commissioned service 8am to 8pm and uses the crisis team out of hours.

A spokesman for the West Norfolk Clinical Commissioning Group said the CCG had commissioned services to allow cover around the clock, although this cover was only provided at the QEH site during the day.

'During 2015 the deployment of staff was reviewed by NSFT to provide additional staff to the Crisis Resolution Home Treatment team, with the aim of keeping patients at home and reducing A&E attendances,' the spokesman added. 'During the hours of 8pm to 8am, urgent mental health assessment is accessed through this local team.

'The hospital trust and NSFT are in discussion about how to get the best out of this service to ensure that staff can respond rapidly at the most appropriate times of the day to meet the needs of patients.

'The CCG will be facilitating this discussion and has confirmed continued funding for the service in 2016-17.'

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