Healthy London > Resources > Case study: London’s mental health handover form

Case study: London’s mental health handover form

Some of the things we do might be small and simple but have a massive impact on people’s lives. For example, we worked with London’s A&E departments and police forces to develop a handover form, which has resulted in 83 per cent fewer people going missing from A&E when having a mental health crisis, compared to the previous year. 

What was the challenge?

The Met Police accompany over 6,000 individuals to A&E every year for mental health issues. They dealt with close to 25,000 missing persons last year; around 2,000 were from A&Es where failure to understand an individual’s needs and risks played a significant role.

There is evidence to show that 1 in 10 patients with a mental health problem leave A&E before receiving an assessment and further treatment, putting them at risk of harm.

What did we do?

We developed a handover process with the Met Police, acute and mental health trust staff, and service users.

The aim of the process was to improve information sharing, partnership working and patient safety. The process was designed to be cost-effective and simple to implement, and involved handing over risks and care needs of voluntary mental health patients presenting in A&E departments.

What were the results?

The pilot started in April 2017 with the Met Police and four A&Es: Homerton, St Mary’s, Lewisham and King’s. By September 2017, there were 82 per cent fewer missing person reports, and police officers were spending less time in A&E departments, freeing them up for other duties.

In February 2018, we rolled the process out across the whole of London – 28 A&Es and three police forces. By April 2018 there were 83 per cent fewer missing person reports than the same period the year before.

There is now only 1 missing person per 39 patients in A&E compared to the previous figure of 1 in 6.

The handover process has been recommended for national roll-out given the success in London. There has been interest from police forces in Hampshire and Thames Valley and Bristol University Hospitals A&E.

The success of this initiative is due to the strong, collaborative relationship that has been built between police and healthcare professionals in London. 100 per cent of A&E staff with experience of the handover process agreed or strongly agreed that it changed practices and improved patient safety for this group.

Find out more

Contact Emily Treder, Programme Manager for Healthy London Partnership, at e.treder@nhs.net or visit www.healthylondon.org/resource/voluntary-mental-health-attendance-to-hospital-form

“This is remarkable. We have hit the sweet spot of positive acclamation from all stakeholders and a demonstrable patient benefit.” – Simon Eccles, Consultant in Emergency Medicine

“An innovative, but simple solution. A fantastic way forward for improving mental health services and hopefully the start of something big. It makes me feel more positive about the future.” – Service User, London

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