Nick Parkin – Senior Commissioning Manager, Mental Health and Learning Disabilities at NHS North East Hampshire and Farnham CCG – presents a case study of The Safe Haven at the Time Out Cafe, a pioneering out-of-hours mental health crisis service.
This presentation was recorded at The King’s Fund Annual Conference 2016 on 9 November 2016.
I want to move on now to talk about the Safe Haven at the Time Out café. Now, some of you may have heard of this. It’s had quite a bit of national attention. We’ve been on the One Show. When we started in April 14, there was nothing like it in the country. So, it’s an out-of-hours mental health crisis service which is open seven days a week, including bank holidays. So, 6.00 till 11.00 in the evenings and 12.00 until 11.00 at weekends. What’s great about this service is, it was co-designed with our people who use services. So, there was a piece of consultation work done with our colleagues who use services, who told us what they wanted when they’re experiencing a mental health crisis. And we took a gamble. We developed a partnership with the third sector, mental health secondary care provider, Surrey and Borders Partnership Foundation Trust and Hampshire county council. It is a system that is unique because it is open to anybody. You don’t have to have a GP referral. Anybody can go. It doesn’t matter where you live. It doesn’t matter where your GP is. If you have a mental health crisis, the service is available to you.
Since the service opened, in April 2014 it has had over 4,000 attendances. It has been widely praised by the Police and ambulance service, who also take people there as an alternative to A & E and people use it as an alternative to going to accident and emergency. In its first year of operation it reduced acute psychiatric admissions by 33 % and that was independently validated by mental health strategies. But, that in terms of cost, represents about a £500,000 saving across our footprint, in terms of those reduced admissions. It is an award-winning service. It won a health service journal award. And there’s just a little bit of an art-work, I’m on there somewhere, I think I’m the one at the end, it says Nick. And this was a piece of work that we did with our partners and our people who use services. Just further benefits. We noticed that A & E attendances for north-east Hants and Farnham where the diagnoses in a psychiatric category show a rising trend from April 2013 – February 2015. But since that point, since the Safe Haven opened, it appears to have plateaued. And a forecast of activity for that later period, based on previous trends indicates that the attendances that time, are less than would have been expected. The plateau in A & E attendance numbers coincides with a rapid increase in the number of attendance at the Safe Haven.
We have also done a comparison with other clinical commissioning groups, to support that figure and it clearly shows that A & E attendances for psychiatric diagnosis per thousand of the population are continuing to rise for Portsmouth city and Southampton city CCGs who don’t have safe havens currently. Most critically, the Safe Havens service users have increasingly reported that their attendance at the service is an alternative to A & E. We have some wonderful stories from people who use that service, who said it’s changed their lives, that it has helped them to manage their mental health crisis. They don’t feel that there is any pressure on them to attend their community services, it is a safe place to go. They get support there. There is secondary mental health specialist support there if they need it but also professional third sector mental professionals who can support them. We have noticed that, as more people have attended the Safe Haven, the people are saying that they are using that more as an alternative to going to accident and emergency. So, where they would perhaps end up in liaison psychiatry or self-harming or taking an overdose, they are going to the Safe Haven and they are able to manage their mental health crisis better without having to resort to other coping strategies. So, a whistle stop tour but I am sure there will be questions which I can answer.