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Working in partnership with the police to deliver effective crisis care

Clair Carson Acute Service Line Manager Pennine Care NHS Trust spoke at today’s Improving Mental Health Crisis Care conference giving a case study presentation on developing a street triage service including:

• developing a partnership approach
• developing a hospital based street triage service
• supporting people, keeping people out of custodial settings and reducing the demands on police time


The Oldham Mental Health Phone Street Triage Pilot and evaluation.

In response to both national and local conditions, GMP in Oldham and Pennine Care NHS Foundation Trust jointly developed the Oldham Phone Triage/RAID Pilot Project to provide a service available to local police officers who attend incidents where an individual appears to be experiencing mental health problems. For the pilot, police officers were able to contact a dedicated 24-hour telephone number for professional advice and assistance from RAID (Rapid Assessment Interface and Discharge), the Trust’s psychiatric liaison service. 
RAID is based in Royal Oldham Hospital, within its Accident & Emergency department. The RAID service consists of experienced trained mental health workers (working with hospital colleagues) who are available to support people with mental health and/or alcohol problems.

The pilot project was set up to improve police decision making and outcomes in circumstances where police officers attend incidents in the community and they believe a person requires professional mental health advice and assistance.

Aims of the evaluation
The purpose of the evaluation is to assess the impact of the Oldham Phone Street Triage Pilot Project in relation to:
1. Decision making, actions and outcomes from mental health referrals made by police officers to the Phone Street Triage Service.
2. Delivery of appropriate, timely and improved outcomes for individuals, families and communities.
3. Use and management of s.136 orders.
4. Broader learning from the pilot for the police service, in relation to improving complex and challenging decision making in the context of policing and mental health.

Findings and recommendations
The pilot has met its key objectives and demonstrated that there is extensive collective mental health expertise, skill and knowledge in Oldham to draw on and develop. 
The findings from the pilot should be shared in order to:
• build on the sound foundation of the pilot as a model for future police and mental health inter-agency working;
• widen future policing and mental health partnerships at a local level, incorporating other essential agencies into future projects (e.g. service user groups, carer groups, ambulance services, social care, specialist services, third sector organisations);
• inform future local service planning in order to respond effectively to the needs of vulnerable groups and communities.

The presentation today aims to explore the problems that existed in the Oldham Borough of Pennine Care NHS Foundation Trust and to give delegates an opportunity to relate these to their own locality. It will explore in depth how the service was developed and in particular the local integrated working partnership with the police. In the context of the Crisis Care Concordat the presentation will look at the evaluation processes and discuss two case studies of service users who have experienced the street triage process.

In conclusion the presentation will allow for questions to discuss the pitfalls of implementing such a service and offer an opportunity to identify how the service can, and recently has been, expanded to other emergency services such as local Ambulance Trusts and in doing so not only addressing principles within the Crisis Care Concordat but aiding in the achievement of A and E deflection targets.

Clair's full presentation is available for download at the end of this page.

Clair is an experienced, current PhD student, master’s degree educated, senior nurse and manager with effective leadership skills and a proven track record of achievement and change in a wide variety of settings and services. Currently working as the Assistant Director of Operations for Pennine Care NHS Foundation Trust she qualified as a Registered General Nurse in 1987 went on to complete her RMN in 1992. Her current Doctorate studies are focussed on the management of the mental health service user in a crisis and the use of a street triage approach. Clair is a strong advocate for service user centred services and a champion of the service user, carer and staff voice in equal measures. Clair has had a wide ranging career to date and is widely respected for the work undertaken in the development of mental health services, especially within the acute service line, acute adult wards, A and E liaison as well as Home Treatment Teams teams and Crisis Services such as RAID (Rapid Assessment Interface and Discharge) .

Clair is constantly accessing ways in which to personally develop including a recent trip to New Zealand on a research scholarship with the Florence Nightingale Foundation researching the management of the service user in a crisis via emergency services.

More recently Clair has worked with Greater Manchester Police and North West Ambulance Service in developing an innovative approach to Street Triage that is both hospitals based and uses telephone support designed to maximise capacity through the current RAID A and E provision.

Recently promoted within Pennine Care NHS Foundation Trust, Clair is now the Assistant Director for Operations.

Clair is also the mother of two teenage girls and also manages an under 15s Girls Rugby team known as the Pink Warriors. She is a clinical advisor to the State of Mind Rugby league Charity dedicated to the mental wellbeing of males in the sport of Rugby league and is a huge, season ticket holding, Wigan Warriors fan.

Future conferences of interest:

Smoking Cessation in Mental Health
Monday 11 May 2015 
Hallam Conference Centre, London

Information Governance in Mental Health: Implementing Caldicott2 & the New Code of Practice on Confidential Information
Monday 11 May 2015 
Hallam Conference Centre, London

Stronger Code: Better Care Implementing the Changes to the Mental Health Act Code of Practice
Tuesday 12 May 2015 
Hallam Conference Centre, London

Masterclass: The Mental Capacity Act and Advance Decisions
Wednesday 13 May 2015 
Hallam Conference Centre, London

Improving the Quality of Perinatal Mental Health Services
Tuesday 19 May 2015 
Hallam Conference Centre, London

Improving Physical Health for People with Mental Health Conditions
Wednesday 20 May 2015 
Colmore Gate Conference Centre, Birmingham

Psychosis & Schizophrenia in Adults
Monday 8 June 2015 
Hallam Conference Centre, London

Foundation Certificate in Dementia: 2 Day Interactive Training Course
Monday 15 June 2015 — Tuesday 16 June 
Hallam Conference Centre, London

Psychological Therapies for Severe Mental Illness
Wednesday 1 July 2015 
ICO Conference Centre, London

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 22 September 2015 
ICO Conference Centre, London


Download: Clair Carson full presentation

30 April 2015


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