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Fedster

'Fine NHS trusts who keep officers attending mental health calls' says PCC

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Fedster

Officers are still waiting hours at a time for ambulances to pick up mental health patients despite new rules APCC mental health lead says.

Kent Police and Crime Commissioner Matthew Scott

Kent Police and Crime Commissioner Matthew Scott

 

The APCC lead for mental health is calling for the NHS to be fined if a trust experiences regular delays picking up mental health patients.

Kent Police and Crime Commissioner Matthew Scott told Police Oracle he wants a change in law to allow the police to penalise trusts which frequently keep officers waiting with patients.

In December new regulations were introduced significantly restricting use of police cells as a place of safety.

Earlier this week shadow Policing Minister Louise Haigh said 83 per cent of calls to police command centres are non mental-health related and one in five calls to the Met on average are mental health related.

And last month a report published by the Police Foundation, which followed two cohorts of new officers over the first four years of their careers, warned that participants became increasingly frustrated by the sheer volume of “Jeremy Kyle” social work which they were expected to do at the expense of proactive crime-fighting.

Mr Scott said although he has seen some improvement in his force area, officers are still left waiting sometimes up to an hour.

“I have heard horror stories in some areas of the country of police officers waiting for the ambulance for several hours at a time,” he said.

Currently there is no provision in legislation for police forces to fine the NHS but health trusts can in some circumstances fine each other.

Mr Scott said he is going to submit his idea to the mental health review and has received some positive support for the proposal but could not reveal more details.

“I want to see clinical commissioning groups prioritising the issue and putting more money into ambulances to meet the demand.

“There are only exceptional circumstances in which police cells can be used as a place of safety but still officers are waiting for hours for a patient to be conveyed to an A&E unit because the calls aren’t being prioritised as urgent.

“It is unreasonable to ask officers to spend their time in this manner.”

He added his proposal is for fines to be imposed “only as a last resort” and that his aim is to foster positive, collaborative relationships with NHS workers.  

“It would be for trusts who are unable to demonstrate waiting times have improved after a year, clinical commissioning groups who are not making sure the ambulance service can meet demand.”

He admitted that he expects some resistance to the idea of “one stretched service penalising another stretched service” but maintained something must be done to address the issue.

Mr Scott said he did yet have a specific figure in mind but said the fine would need to be large enough to act as a “deterrent” and an “incentive” for clinical commissioning groups to clean up their act.

Like the police service, the NHS has experienced government cuts - particularly in this area. Last year funding was cut by £4.5m in five mental health regions in the UK.

In September, Clinical Commissioning Groups (CCGs) in England said they would reduce the proportion of their budgets spent on offering mental health support in 2017/18 due to funding cuts.

The BBC reported that figures showed 50 per cent of CCGs would see their mental health budgets squeezed this year.

Despite this, NHS guidelines say all CCGs must increase their spending on mental health in line with any overall budget increase.

A Department of Health and Social Care spokesperson said: "The police work tirelessly to keep people safe, including people in mental health crisis.

"This government has established over 90 local crisis care concordat groups, where police and health staff plan local services responses.

“We have reduced the instances of police cells being used as places of safety by nearly 90 per cent, and are making £30 million available for health based places of safety to provide more appropriate support for people experiencing a mental health crisis, so that they do not have to be placed in police cells.”

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Mac7

And Fines will achieve what?

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Zulu 22

Has the PCC really thought this one out. Fine the NHS and take money out of one pocket to place into another pocket. The only loser all round would be the public who, ultimately, would end up paying more for nothing.

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obsidian_eclipse
Has the PCC really thought this one out. Fine the NHS and take money out of one pocket to place into another pocket. The only loser all round would be the public who, ultimately, would end up paying more for nothing.
Exactly. One public service fining another. When you factor in the associated costs for administrating the fine it lose lose all around. Public services need to be able to work closely together and form a good working relationship and not be ostracized.

The reasons why services such as the NHS can't perform their role is because there aren't the finances available and they aren't commanded to undertake it on the required scale.

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SD

Sorry, but I agree with him. We’ve try discussions with the NHS only to be ignored so hitting them in the pocket might make them wake up. The funds could be passed onto forces to recover the lost pay.

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Mac7
Sorry, but I agree with him. We’ve try discussions with the NHS only to be ignored so hitting them in the pocket might make them wake up. The funds could be passed onto forces to recover the lost pay.



I strongly don’t. For reasons as Zulu explains plus what next? Charge the fire service for putting cordons on for large fires? Charging the ambulance service when helping with a troublesome patient? Charge the MOD when helping with unexplored ordnance? Perhaps we could fine the NHS when a patient goes missing from hospital.

This does nothing to solve any problems. Emergency services and public services should work together.
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Fedster

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ParochialYokal

His comments show how little he understands the NHS.

You cannot reasonably fine mental health Trusts if they lack the funding to provide provision.

If he said ‘fine Commissioners if you do not commission appropriate mental health provision’ then that is a discussion to be had. Nonetheless, I don’t agree that it is the correct route.


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jamieMET

Who really waits for ambulances anymore anyway?

we seem to have gone back to days of old where the duty Inspector is appraised and more often than not approves police transportation instead of waiting an undisclosed time.

 

It is however the disgusting behaviour of hospital staff upon arrival that grates me, delaying booking in, MH practitioners refusing to make a decision on the patients diagnosis. All attempts to keep the police waiting in A&E unnecessarily so they do not have care of the patient and the responsibility that comes with them, such as observations and security.

And dont even get me started n the tactics the MH unit now employ to bat the patients off before we can even try and book them in, in many cases making up reasons for us to have to take the patient over to A&E as they suddenly have ‘no space.’

 

The NHS is dead beat and the sooner we lose it, the better imo.

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Growley

One underfunded public service fining another underfunded public service :wacko:

There does need to be some accountability for the nonsense some of these services pull, but fining them isn't it.

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PC Wannabe

How about funding NHS MH (and other) services correctly, instead. I'm sick of hearing Mrs May's denials of problems in the NHS, its exactly the same story as it is with the police.

My uncle's partner is a nurse and some of the things she's told me have been very eye opening. The NHS and ambulance services are struggling just as the police and many other services are, and that's the fault of this so called 'government' of ours. 

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SD
On 12/02/2018 at 18:51, Mac7 said:

 

 


I strongly don’t. For reasons as Zulu explains plus what next? Charge the fire service for putting cordons on for large fires? Charging the ambulance service when helping with a troublesome patient? Charge the MOD when helping with unexplored ordnance? Perhaps we could fine the NHS when a patient goes missing from hospital.

This does nothing to solve any problems. Emergency services and public services should work together.

 

 

Agree that many of your ‘what nexts’ should be billed. Fire brigade can do their own cordons so why use police? Most troublesome patients aren’t troublesome. And MFHs from hospital are potential neglect cases anyway.

Yes, we should work together but at the moment there’s a lot of take and very little give.

If cops are called due to a lack of staff, a repeat failing of a local system or out an out lethargy to the law and what’s morally right then they should be billed. Otherwise patients will continue to get a poor service and police resources will continue to be abused.

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SD
3 hours ago, Growley said:

One underfunded public service fining another underfunded public service :wacko:

There does need to be some accountability for the nonsense some of these services pull, but fining them isn't it.

Except NHS funding has increased while Police funding has been reduced. So they should be taking even more of the responsibility. 

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Growley
Except NHS funding has increased while Police funding has been reduced. So they should be taking even more of the responsibility. 
And what does fining them solve? It just becomes a peeing contest.

The notion of one service billing another for things that should be within the other's area of responsibility has some merit, but that's not a fine, that's charging for the value of work done; and it would presumably work both ways, such as when some cops call an ambulance for a grazed knee.

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MerseyLLB
4 hours ago, Growley said:

And what does fining them solve? It just becomes a peeing contest.

The notion of one service billing another for things that should be within the other's area of responsibility has some merit, but that's not a fine, that's charging for the value of work done; and it would presumably work both ways, such as when some cops call an ambulance for a grazed knee.

Well it's slightly different because we usually call an ambulance for people in lieu of them calling an ambulance or because the NHS has agreed that they are the appropriate service to deal in the circumstances.

Every single ambulance request we have had over the last four nights in Kent aside from cardiac arrest calls jointly attended we were told 'at least 4 hours'. Several of those calls we received were from the ambulance service itself telling us of medical issues or mental health issues which as per policy require ambulance attendance.

*** 

The topic here is mental health. Persons in The street suffering a mental health episode who require immediate care and control is a police issue as we are issued the powers and we then require ambulance assistance as a policy decision for transportation.

However, mental health/suicidal calls of people in their own homes (in the absence of a serious risk of violence etc) is a medical issue. Why are a large majority of these routed to the police? We are not medically trained even to the lowest level of ambulance staff, we are not mental health trained to even the lowest NHS mental health grade and we are (after research and consultation showing it to be the case) the appropriate service to be conveying people voluntarily to place a of safety or A&E departments.

We are despatched because it means the NHS don't have to go. I regularly drop crime investigations, victim visits, arrest attempts, non-emergency domestic violence calls, burglary calls and the like to attend calls routed in by ambulance control. 9/10 of those calls don't even have an ambulance deployed let alone at scene. The ambulance service then simply say 'sorry we are busy. Ring us if they haemorrhage  blood or go into cardiac arrest'.

In the police we simply don't do that to the ambulance service. We don't request the ambulance service and then wait for them to attend before telling them we aren't going and to call us if they are being assaulted. 

I don't see why there can't be a billing process. If the NHS have to commission a mental health transport team to convey a patient this can cosy anything from a couple of hundred pounds into thousands. If the police do it, it costs nothing. But it's not out role or remit and the NHS receive funding (however inadequate) to fulfil this function. 

If the NHS cannot meet their service level agreement and the police are required to transport a patient there should be a billing process - I think it works out as around £35 per hour per PC. So a doubly crewed car doing a 3 hour round trip is going to cost the NHS £210.

That's not punitive - that's recouping the cost of doing another agencies job for them. It also happens to be cheaper and quicker than waiting for a private contractor. 

The reason alot of the time we oblige with such requests is it will waste considerably more officer time sitting there arguing than doing it ourselves.

*****

I dealt with a female last week - head injury and wanted to speak to the mental health team. She was in the street so ambulance passed it to police.

I met the female and very quickly established she was going to voluntarily attend a&e to speak with the psych liaison and have her head injury assessed.

Ambulance had cancelled their job when police had accepted the log. I rere-reauested them and about 45 minutes later an RRV attended. Checked her out, said she was recommended to attend A&E but that they court convey in their RRV and they would request an ambulance. Ambulance ETA 4 hours. Now i could have waited 4 hours to make the point but instead I took the risk and drove her to hospital myself - with an ambulance handover sheet in hand. On booking in I made the point to the receptionist - this woman is not 'brought in by police' she has been conveyed on behalf of the ambulance service and here is the paperwork for handover. I then waited until I was able to hand over verbally to the triage and left. I was asked 'aren't you waiting with her?'.

I wasn't. Because I never needed to go to the job in the first place. And had the ambulance service have resources the call, I wouldn't have even attended A&E once the female was on the ambulance.

Because all throughout that incident I didn't provide any premium- I was a taxi and a 'just in case' asset.

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