Healthcare Transitions and Avoiding Attendances and Admissions Theme

The NIHR CLAHRC AvoidingAttendances and Admissions in Long Term Conditions Theme has linked routine patient data across different urgent and emergency care (UEC) settings. This includes data from ambulance providers and acute hospital trusts.  This linked data has identified patient groups, such as those with mental health problems, who may benefit from alternative care outside hospital.  Emergency and urgent care services provide important care for people experiencing an acute mental health crisis and continue to be focus of national UKpolicy.  

Preliminary analysis from our linked dataset has identified that there were missed opportunities for instigating care earlier in the UEC pathway.  This work was followed up with qualitative work with stakeholders in the ambulance service which identified a potential role for mental health triage nurses working in the call room of the ambulance service. The Avoiding Attendances and Admissions Theme has carried out an initial evaluation of the mental health triage nurse role and included an initial report of findings.  Staff interviewed felt the mental health triage nurse role had advantages over traditional responses on scene in that they had more experience and knowledge of the mental health services available to manage the transition of the patient across these care pathways.  Challenges were also recognised in the transition of patients with mental health problems across pathways of care, particularly integrating effectively with other healthcare and emergency providers.  Further evaluation and research is now planned at the national level, to further examine the range of initiatives in place across different ambulance service providers to manage this key patient group.