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Easily accessible to referrers
Target
a) The CRT has no paperwork preconditions before referral.
b) The CRT is directly contactable for referrals by phone.
c) The CRT decides whether to assess clients directly following referral and does not ask another service to assess them first.
d) The CRT contact details and referral routes are publicly available.
Why this is important
Crisis Teams being easily accessible to referrers is vital to ensure as quick response as possible. Having a clear and efficient referral route is crucial if the CRT is to quickly assess new service users. Until the CRT team have assessed someone referred to the team, the level of risk and most appropriate service response are not known. If the CRT is able to respond directly, this reduces delays for service users and also the burden on other services. If Crisis teams direct clients to A&E, this leads to a burden of extra work for them and can be frustrating for service users.
Being able to access the CRT quickly and easily is highly valued by all referrers.
Ways of doing this well
Clear contact details and referral routes
South Wiltshire Intensive Service and Medway and Swale CRHTT both have very clear contact details in their leaflets, which also provide clear information about the role of the crisis team:
Some NHS websites are much clearer than others about how to get help in a crisis. The Black Country Partnership Trust use their website to provide information about how to access help in a crisis, their role, and referral routes.
A written acute care pathway distributed to all local services can aid clarity about how and when to contact the CRT and provide a pathway of entry and exit to and from the service.
Directly contactable for referrals by phone
Having one office-based experienced clinician able to speak to referrers directly and decide on an appropriate course of action may be helpful to referrers and ultimately save CRT time doing unnecessary assessments.
Assess directly
Many Trusts now use a separate Assessment Team or Single Point of Access to triage all new referrals. If service users referred to your service come through via a Single Point of Access or Access and Assessment team, accessing crisis support can still be quick and straightforward for the service user if they are not then reassessed by the CRT. Continuity between an assessment team and the CRT may be aided by: a) agreement to conduct joint assessments for all new, apparently urgent referrals; b) local protocols enabling the CRT to accepts service users assessed by the Assessment Team as needing CRT care.
Examples of good practice
In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:
- South Gloucester CRT, Avon & Wiltshire Mental Health Partnership NHS Trust
- Sunderland, Northumberland, Tyne and Wear NHS Foundation Trust
- Wyre Forest, Bromsgrove and Redditch HTT, Worcestershire Health and Care NHS Trust
- Pontypool CRHTT, NHS Wales
- West Gwent CRHTT, NHS Wales
- Northamptonshire South CRHTT, Northamptonshire Healthcare NHS Foundation Trust
- Northamptonshire North (Kettering) CRHTT, Northamptonshire Healthcare NHS Foundation Trust
- North East Kent CRHTT, Kent and Medway NHS and Social Care Partnership Trust
- Shropshire CRT, South Staffordshire & Shropshire Healthcare NHS Foundation Trust
- Newham Psychiatric Acute Community Team, East London NHS Foundation Trust
- South Tyneside Initial Response Team, Northumberland, Tyne and Wear NHS Foundation Trust
- Barking, Dagenham, Havering HTT, North East London NHS Foundation Trust
- Great Yarmouth CMHT, Norfolk & Suffolk NHS Foundation Trust
- West Berkshire CRHTT, Berkshire Healthcare NHS Foundation Trust
- Eastbourne CRT, Sussex Partnership NHS Foundation Trust
- Manchester North, Manchester Mental Health and Social Care Trust
- Hounslow HTT, West London Mental Health NHS Trust
- East Berkshire CRHTT, Berkshire Healthcare NHS Foundation Trust
- Bath Intensive Team, Avon & Wiltshire Mental Health Partnership NHS Trust
- Mendip CRHTT, Somerset Partnership NHS Foundation Trust
- Teignbridge CRHTT, Devon Partnership NHS Trust
- South Hams and West Devon CRHTT, Devon Partnership NHS Trust
- North Devon CRHTT, Devon Partnership NHS Trust
- East and Mid Devon CRHTT, Devon Partnership NHS Trust
- Taunton and Bridgewater CRHTT, Somerset Partnership NHS Foundation Trust
- Wandsworth CHTT, South West London and St George's
- Gloucester CRT, 2gether NHS Foundation Trust
- Barnet HTT, Barnet Enfield and Harringay Mental Health NHS Trust