Urgent & Emergency MH Care Pathway for Children & Young People – Southern Derbyshire – NCCMH

The Derby CAMHS Rapid Intervention, Support and Empowerment (RISE) team has been operating since October 2014, with the aim of providing a rapid response to children and young people presenting to the emergency department (ED) and children’s emergency department (CED) as well as responding to urgent and emergency referrals from the community, including self-referrals.

Co-Production

  • From start: No
  • During process: No
  • In evaluation: Yes

Evaluation

  • Peer: No
  • Academic: Yes
  • PP Collaborative: No

Find out more

  • Chris Kirk, Clinical Team Leader / Senior Nurse

Southern Derbyshire

The Derby CAMHS Rapid Intervention, Support and Empowerment (RISE) team has been operating since October 2014, with the aim of providing a rapid response to children and young people presenting to the emergency department (ED) and children’s emergency department (CED) as well as responding to urgent and emergency referrals from the community, including self-referrals. The service offers a seven-day extended hours response. Children and young people referred outside the RISE team’s operating hours – between the hours of 9pm and 8am – would normally be admitted for a full mental health review the following morning. However, if the child or young person does not want to stay overnight and the CED/ED can safely facilitate discharge, RISE will contact the family at the start of the next working day and arrange to see them on the same day. If the child or young person does not want admission and CED/ED cannot safely agree a discharge plan, the on-call psychiatric staff can be contacted.  The RISE team provides follow-up, either by a member of their own team or the generic children and young people’s mental health team.

The service reversed a previously increasing rate of admission of children and young people to paediatric beds for mental health related reasons (26% in 2014) to achieve a steady reduction in admissions of under 18 year olds. The initial impact of a seven-day service was further enhanced by the introduction of extended hours of operation. A 46% reduction in admissions and 48% reduction in bed days utilised was observed in the period ending August 2016 compared with the same period in the previous year, reflecting a reduction in admission rates from 75% to under 40%.  Admission avoidance generated paediatric bed cost reductions estimated at more than £350k over a 12-month period to August 2016.

The RISE team utilise the goal-based outcome measure and service users are also asked to complete the Experience of Service Questionnaire, achieving very positive responses with 95% saying they would recommend the service.

Operating hours08.00 – 23.00 (referrals accepted until 21.00)
Age rangeUp to 18 years
Geographical area coveredSouthern Derbyshire (Amber Valley, Erewash, South Derbyshire, Derby City)
Approximate size of 0-18 population132,000
Referrals received per year900
No. referrals seen per year870
% referrals 9am-5pmCED/ED* referrals 30%; Community referrals** 95%
% referrals 5pm-midnightCED/ED* referrals 65%: Community referrals** 5%
% referrals midnight-9amCED/ED* referrals 5%
Response time1.5 hours approximate average from referral to response
Workforce (approximate staff composition)1 WTE band 7 clinician

9 WTE band 6 clinician

0.5 WTE CAMHS consultant

Team contactChris Kirk, Clinical Team Leader / Senior Nurse

*CED/ED constitute 60% of total referrals

** Community GP, self-referrals, other professionals equate to 40%

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