The First Response Service (FRS) provides 24/7 direct access for service users in need of urgent mental health support.
Staffed by trained professionals FRS can assess, risk assess and offer crisis de-escalation over the phone and can arrange face to face assessments in the community within an hour. Nurses, Social Workers and Advanced Nurse Practitioners can make face to face assessments and signpost service users to the right service.
Co-Production
From start: Yes
During process: Yes
In evaluation: Yes
Evaluation
Peer: Yes
Academic: No
PP Collaborative: Yes
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Debra Gilderdale - Bradford District Care NHS Foundation Trust
The First Response Service (FRS) provides 24/7 direct access for service users in need of urgent mental health support.
Staffed by trained professionals FRS can assess, risk assess and offer crisis de-escalation over the phone and can arrange face to face assessments in the community within an hour. Nurses, Social Workers and Advanced Nurse Practitioners can make face to face assessments and signpost service users to the right service.
They work closely with Police who have direct access to FRS and have FRS staff within the DCR to help frontline officers make decisions and help them access services for people in crisis. FRS also work closely with the Voluntary Care Services including Mind and the Cellar Trust who both offer diversions from crisis and A&E these are called safe spaces they provide non clinical support to deescalate from crisis.
Approved Mental Health Professionals are also collocated with FRS providing timely access to Mental Health Act assessments.
Wider Active Support
We are proud of our Police partnerships, Local Authority Partnerships and work with the Voluntary Care Services.
Police have a direct line into FRS and have mental health staff located in their district control room to support and advice calls, they can identify and divert potential 136 detentions and bring in FRS staff to avoid use of the MHA.
The safe spaces were developed with Voluntary Care Services to provide both day and night provisional for those needing support and also a safe space for children has been developed as a place for children in crisis to stay over night.
The local authority have worked with us integrating their social workers within the acute care pathway and have placed AMPHs with FRS. They have provided access to respite, flexibility with budgets to avoid use of hospital beds and also provided a housing worker to support with accommodation.
Co-Production
Service users and carers were involved in the design of FRS and also the recruitment, they were involved with work on redesigning the acute care pathway.
In acute services we invite carers to come and talk to managers and staff about the experiences and we look at how we can develop the service. We commissioned a service user evaluation to collate further feedback to help shape the service.
Looking Back/Challenges Faced
We committed to ensuring that all calls into FRS would be answered within 2 minutes we have provided further training to tele coaches, streamlined their documentation processes, provided supervision feedback based on calls recordings and increased our capacity by recruiting more tele coaches and have staffed to the peak demands.
Sustainability
The service is managed within the acute services and is integrated within the Intensive Home Treatment Teams the governance is monitored through Quality and Safety. The Standard Operating Procedure outlines how the service should function and is the responsibility of the service manager. All systems, processes and documentation used is stored on a shared electronic share point, diaries are all electronic and shared with the team who use agile technology.
Data reporting is sent into Q&S and calls are recorded and managed by an electronic system.
Evaluation (Peer or Academic)
We commissioned a service user evaluation from our local advocacy service and internal service evaluation and also a mental health strategies evaluation.
Sharing
We have had several trusts visits since 2014 we have been very keen to share our model with others and have shared job descriptions, SOPs, pathways and assessment documentation to reduce time for other trusts developing their own.
Outcomes
A&E attendances reduced from approx. 900 per year to 500 per year as service users had direct self referral access into support for crisis.
136 detentions reduced
Demand on Police time reduced and service users stopped being sent to cells in 2014 when FRS went live.
Staff were freed up to care and see people face to face through use of agile and reducing the documentation time required
We have not used an out of area bed in Bradford since FRS went live as we have committed to caring for people closer to home.
