9 December 2021

CNWL has received extra investment from North West London ICS to provide more services for the additional demand the cold weather and holiday season can bring; demand from people in crisis is increasing.

CNWL’s Northwick Park (Harrow) Psychiatric Liaison service saw 19% increase compared to 2019; that’s a 6% increase at A&E and a 50% increase from referrals from the hospital wards. St Mary’s (Paddington) Psychiatric Liaison Service increased by 13% (10% at A&E and a 30% increase in ward referrals) since 2019.

So there will be an additional four Psychiatric Liaison staff at Northwick Park and St Mary’s.

St Mary’s will also have a ‘twilight’ Emergency Duty Team worker (this helps with the administration of the Mental Health Act), jointly with West London NHS Trust, to cover St Mary’s and Charing Cross.

We’re also adding two staff to First Response (1 daytime and 1 night time) who can be based at any A&Es where required, particularly overnight. Two extra qualified staff will work in our Single Point of Access for crisis calls (1 in day and 1 at night) too.

Other initiatives we’re developing include a ‘Divert to Admit’ model at St Marys and additional lounge capacity at Northwick Park.  

The Divert to Admit is a repurposing of 4 existing beds at St Charles offering a space to safely divert patients detained on section 2 of the Mental Health Act whilst they wait their final bed allocation, instead of waiting in A&E. This will allow timely assessment as patients move through the system, Home Treatment or a Step Down bed. This is now operational with the additional lounge capacity coming soon     

We’re planning to open a ‘Step Up 5-bed House’ for Westminster, Kensington & Chelsea. This is for patients who can’t be managed with just Home Treatment but do not need an admission to a ward. These people often attend A&E for lack of an alternative.

We’re working to identify a supported housing provider to start in January. A high proportion of short stay admissions (three and seven days) are often in social crisis, perhaps housing or a deteriorating social situation. This scheme has the support of many patients and families.

We’re also looking at a block purchase of up to 10 acute beds with other providers, mainly for people with no connection to the local area (like foreign nationals). This will provide some flexibility to our resources over Winter.

Ann Sheridan, Managing Director of Jameson, said, “As more people go into mental health crisis, many for the first time, they often go to A&E, so this investment means we can see people more quickly and not take up A&E space. But we’re also working on earlier treatment and better alternatives to a mental health ward. Every patient is different and their needs are too, so we need a more flexible system that can provide a good service for them.”