Dr Lisa Page says the way the trust uses mental health triage nurses is unique. Photograph: Sussex Partnership NHS Trust A year ago people with mental health problems turning up at A&E in Brighton often had to wait four hours to be seen. Around 12% of patients would get fed up waiting and leave; those who were prepared to sit it out frequently ended up being inappropriately admitted to the hospital's observation ward, where they stayed until being assessed by the specialist mental health team.
But today, the number of patients with mental health problems being admitted to the observation ward at the Royal Sussex county hospital through A&E has dropped by 50%. More than 85% of patients are seen and assessed by the mental health team within four hours. Anybody turning up and A&E with a mental health problem is automatically referred to a specialist mental health triage nurse within an hour – something which Dr Lisa Page, consultant in liaison psychiatry at Sussex partnership NHS trust, says is unique. "I don't know of any other hospital which uses the triage nurse in the way that we do, although others do have proactive teams in A&E."
The improvement in waiting times and the introduction of the mental health triage nurse is part of the Brighton Urgent Response Service (Burs), which was introduced in January to tackle the 30% year-on-year rise in unscheduled mental health attendances at the East Sussex seaside town's A&E.
Page says the reduction in observation ward admissions is good news for patients and A&E staff but also for the clinical commissioning group (CCG) because of the high tariff associated with this kind of admission. "That is where the savings are coming from as we are no longer having that large number of patients admitted," she says.
Burs, set up by Sussex partnership NHS trust in collaboration with Brighton CCG and the acute trust, also includes a 24-hour urgent phone line for GPs, mental health patients and carers who are new to the system. GPs can book a patient a next-day appointment at the mental health clinic – rather than the previous minimum five-day referral. Patients and carers are offered telephone advice from a Burs practitioner and are referred as necessary. A dedicated mental health nurse is also available in the community between 8am and 8pm Monday to Friday and from 8am to 6pm at weekends. A new waiting room for people with mental health problems, which provides a calm and quiet environment has also been established at the Royal Sussex as part of the scheme.
Page says her mental health team is busier than ever and that it is too soon to say whether the number of people turning up at A&E has pulled back from its 30% year-on-year rise. But she feels Burs is ensuring that people are seen more appropriately and more quickly. She says: "Referrals to our team have gone up by a third because we are now seeing people who in the past would have come to A&E and left. We haven't curtailed the 30% but we have made some inroads – it would have been even busier without Burs."
This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.
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