COMMENT
i Force-specifi c support
With the street triage scheme, BTP aims to replicate the London partnership in the North West. The pilot will involve a referrals system, where nurses are available via telephone, as well as intervention in cases that need medical attention and coordinating with the NHS on the BTP’s behalf.
Other street triage pilots will see nurses out on patrol with offi cers, but Smith explained that BTP’s geographical spread made this unfeasible. Instead of restricting coverage to that accessible by car, a phone system will allow nurses to cover a wider area: “Manchester, Liverpool, Preston, Wigan: all of that area will be able to benefi t from that service.”
The funding will allow the force to give “the same quality of service to people across the country rather than just a pocket in London where we’ve had the benefi t of NHS staff working with us,” Smith said.
In London, the team consists of around six BTP staff with up to four nurses, and the workload is “quite high”. With around 80 fatalities a year, the demand for the service is clear. As the rail network shuts around 1am, it means the triage scheme can also be arranged around these hours as needed.
Right resources for known demand
The BTP has been working with Dr Geraldine Strathdee, NHS England national clinical director of mental health, to ensure the demand that transport infrastructure creates on local
services is known to local commissioners and understood. The police must create relationships with local CCGs to ensure the right resources are available for demand for mental health services, and their data can help to identify this.
For example, Smith explained how some London boroughs actually “import” demand from other areas – people travelling by train before attempting suicide. Closer coordination with the BTP could help the NHS uncover this hidden demand.
He said: “We want to make sure that we [engage with] local Health and Wellbeing Boards where we can. I know it hasn’t been an especially easy task for police to get a foot in that area at the moment because of a lot of fl ux and change. We want to get representation at a national level so that people understand the transport- related issues.”
Standardising good practice
Disproportionate numbers of people attempting suicide are connected to wider community- related issues, such as population, poverty and, crucially, health. In the boroughs of Ealing and Hillingdon, where this is a particular issue, BTP offi cers are working closely with the West London Mental Health NHS Trust to help promote preventative messages and care to people “before they come into crisis”.
This was an example of one of the “pockets of good work” that are going on, which must be standardised to provide access to quality care across the network.
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“These two public protection units, in the north and the south, will be able to foster those relationships with the mental health trusts and the NHS,” Smith said.
Managing risk
In terms of training, there have been “some big strides forward on training our staff to recognise vulnerability”. While greater medical responsibilities for police, such as very basic assessments around mental capacity, could be a consideration for the future, Smith cautioned that this would involve signifi cant issues around liability and quality of care.
One thing that could benefi t from improvement would be resolving “a mismatch of understanding between police and health as to the application of the section 136.” Smith explained that from a policing point of view, this is often the only power available to manage someone they have concerns about, who could be a risk to themselves or others.
“So we use it regularly. Then when we take people for assessment, more often than not, they are released without further detention or assessment. And then we have a problem; because they’re back with us and the risk remains. There needs to be a better understanding of where we’re both coming from on this. Police are looking to manage risk, health are looking to diagnose, and somewhere in the middle sometimes the risk element gets left out.”
FOR MORE INFORMATION
www.btp.police.co.uk
public sector executive Sep/Oct 13 | 25
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