Bradford District Care NHS Foundation Trust (BDCT), in partnership with colleagues in Bradford Council, the voluntary sector and West Yorkshire Police, provides acute mental health services developed as part of the multi-agency Crisis Care Concordat partnership. They support people at home where possible, offering the least restrictive and most appropriate care through a single point of access across Bradford, Airedale, Wharfedale and Craven.
Bradford District Care NHS Foundation Trust (BDCT), in partnership with colleagues in Bradford Council, the voluntary sector and West Yorkshire Police, provides acute mental health services developed as part of the multi-agency Crisis Care Concordat partnership. They support people at home where possible, offering the least restrictive and most appropriate care through a single point of access across Bradford, Airedale, Wharfedale and Craven.
Previously, inpatient wards were at over 100% occupancy and people were placed out of area several times a day. Through careful analysis of the daily work and acute care procedures, the team improved the discharge processes to facilitate patient flow through the service. Because of this, and the development of the 10-point discharge tracker, BDCT has not placed anybody out of area since March 2015. There are vacant beds on a daily basis, and delayed transfers of care are reduced.
Acute mental health services provided include:
• The First Response Service (FRS), which offers 24/7 self-referral access and support to people of all ages who are experiencing a mental health crisis, including in the emergency department. When a person contacts the service for help, a ‘telecoach’ assesses the person’s needs over the phone. They can also provide crisis de-escalation and signposting advice. Calls made to the FRS are triaged using the UK Mental Health Triage Scale. People requiring a face-to-face response will be seen within an hour by a nurse, social worker or advanced nurse practitioner. The FRS can also respond quickly to requests from the police, who have a designated phone number.
• The IHTT, which sees people at home or in the community. By separating the gatekeeping and assessment function from home treatment, the IHTT has increased capacity to support service users intensively at home or on discharge through nursing or social work intervention.
• The Haven service, which is delivered by The Cellar Trust (a voluntary care service working in collaboration with BDCT and the local authority). The service offers a non-clinical environment to work with the person and their family to help to de-escalate their mental health distress and develop a wellness and safety plan. The service is open 365 days a year, from 10.00 a.m. to 6.00 p.m. Outside of these hours, the Sanctuary service at Bradford Mind is available from 6.00 p.m. to 1.00 a.m., via the FRS.
• The Police Hub, which provides NHS and social care expertise in the control room to advise the police on appropriate support for vulnerable people.
• The Approved Mental Health Professional service, which is operated by Bradford Council is located next to FRS and IHTT to support integrated, least restrictive working and a timely response when a Mental Health Act Assessment is required
• Acute inpatient wards, of which there are five for Bradford and Airedale. The wards hold a daily bed meeting to monitor care needs through discharge trackers. All service users are given a discharge date on admission and key milestones are identified. People with identified housing needs are seen and assessed by a dedicated housing social worker. The council has commissioned a specialist housing framework that is open to all care coordinators.
The person’s need for acute mental health care is reviewed within the first 24 hours and daily thereafter. The hospital works in collaboration with other mental health services to support the person’s recovery goals. Access to meaningful activities is provided through links with Haven and Sanctuary support workers and the IHTT. The role of the advanced nurse practitioner has facilitated early discharges from hospital using the nurse-led discharge approach.
