Four regions that successfully bid for dedicated ambulances for mental health patients are still without the specialist vehicles, despite growing concerns the NHS is unable to respond to people in crisis, according to HSJ research.
NHS England announced in winter 2022–23 that about 100 of the specialist ambulances would be introduced in coming years, and indicated “the majority… will be on the road by next winter”.
It comes amid a growing struggle to manage emergency care demand from people in mental health crisis or those with mental illness, and fears of an even greater problem as the police withdraw from responding to many cases.
The mental health response vehicles were meant to add to capacity to respond, as well as being better suited to the patients, as they have fewer fluorescent markings and a less clinical interior to help put patients at ease.
More than a year on from the NHSE announcement, HSJ has asked England’s 10 regional ambulance trusts based on how many they had in operation.
Four said they had none so far: London Ambulance Service said it was waiting for six to be delivered; North West is waiting for seven; South Central is waiting for five; and South West for 19, including eight expected in June.
East of England has said it is introducing three over the next four months and expecting nine more in the future.
The North East service said it did not bid for any, and South East did not respond.
The remaining three trusts appear to have received at least one specialist ambulance: East Midlands said it received one in March; West Midlands has received six; and Yorkshire is using six “on hire” and waiting for nine more.
Gemma Byrne, policy and campaign manager for the charity Mind, told HSJ any delay in delivering specialist mental health ambulances was a concern, but said it is “particularly worrying in the context of the national rollout of the ‘Right Care Right Person’ policy”.
Under RCRP, recently adopted by the police and NHS nationally, the police are refusing to attend mental health calls unless there is a risk to life or of serious harm.
Ambulance chief executives warned earlier this year they had bid “some time ago” for the vehicles and many were yet to arrive. They would not solve problems with additional demand from RCRP, the CEOs said, but would help.
Ms Byrne said she was also concerned about the lack of funding for additional staff to make use of the new specialist vehicles.
Most trusts told HSJ they did not have confirmation of plans to fund the extra staff needed to operate the ambulances. Only WMAS and YAS said funding had been agreed with commissioners; while SWAST said they would be “part funded”.
Ms Bryne said: “It is simply impossible to take a million hours of support out of the system [through RCRP] without replacing it with investment. Failing to properly fund NHS mental health crisis services while instructing police forces across the country to step back from mental health calls is an unsafe and frankly irresponsible decision.
“The UK government must slow down the rollout of [RCRP] and put the needs of people with mental health problems and the public first.”
The Association of Ambulance Chief Executives has also asked for more resources for capacity to make up for the police reducing input.
An NHSE spokesperson said: “Mental health services including those in urgent and emergency care and community crisis services are working hard to care for more patients than ever before, treating record numbers and seeing significant increases in referrals… emergency departments are now offering 24/7 access to a mental health liaison service or local crisis support.”
They added: “Further funding is putting almost 90 specialist mental health ambulances on the road.”
Source: HSJ
Date: 23 May