You may remember the Crisis Care Concordat from early 2014? â€“ very much led by Normal LAMB MP, who was then Minister of State for Mental Health. Â It led to a brief bureacracy that drove various meetings, plans and activities: including commitments by organisations to various things including a reduction in the use of police cells as a Place of Safety under the Mental Health Act 1983; a 30 minute response time by the Ambulance Service to detentions under s136 MHA (except in South East Coast Ambulance Service who would prefer to have an hour) and to much better training, data and cooperation across the piste.
The Concordat imposed deadlines which were publically monitored by which areas had to commit to delivering on the principles of the Concordat and then to the development of an Action Plan which outlines how problems, gaps and issues would be addressed. Once the public plan was uploaded on the CCC website, monitored by Mind, that somewhat completed the CCC process. Youâ€™ll notice the only thing that wasnâ€™t a part of the CCC process: actually delivering the action plan. Â Since the deadline to publish local plans, weâ€™ve had a General Election which has seen a change of minister. Â Alistair BURT MP has since written to all the national signatories to the Concordat recommitting the Government to deliver on its principles and encouraging closer cooperation by partner agencies against those local, published plans.
I wrote previously that in terms of accountability for progress, it might have been helpful if the Concordat framework involved a further deadline and another colour on the map â€“ the mapping process is â€˜completeâ€™ at the point where local plan is published; not when a local plan is delivered. I welcome the fact that the Government has recommitted to the importance of the project but it might be wondered whether there is now a certain sense of drift. I feel the Concordat is being talked about far less than it was six months ago â€“ perhaps that is because nothing further must happen by a particular time? In November the concluding Summit will be held in London after which it appears to be down to local areas to deliver â€“ or not â€“ on their action plan.
Of course we can point to progress: Street Triage initiatives spreading around the country, ongoing reduction in the proportion of people being detained under the Mental Health Act by the police who go to custody as a Place of Safety and so on. We also know how much there still is to do: the Care Quality Commission report recently published â€“ Right Here, Right NowÂ â€“ highlighted that there is considerable work still to be done about the atittudes of those who work in policing, health and social care towards those in crisis who are all too often battling to access services in a timely fashion. Â Next year, the College of Policing will deliver on itâ€™s main two responsibilities from this initiative: new national guidelines (known as Approved Professional Practice) and training packages for police officers and staff of a kind we havenâ€™t had before.
This BLOG is merely intended to remind us that the stuff which sat behind the need for a Concordat hasnâ€™t gone away and that whilst some progress has been made over the last eighteen months, much that needs to be done remains locked away on the local plans that were published in April 2015. Later in 2015 the Government will introduce a Policing and Criminal Justice Bill to Parliament which will begin the process of amending the Mental Health Act 1983 to change the way that sections 135/6 work. Â Amongst other changes, it is suggested that children should never be detained in police custody, no matter what; and the overall maximum time anyone can spend detained in any Place of Safety should be 24hrs.
There will be work to do on both of these points and areas Concordat plans will probably need adjusting accordingly. Only today, an NHS mental health trust was complaining on the BBC news website that no adult acute inpatient beds were available in England for someone who needed admission. If the law is changed to allow less time in a Place of Safety there will be, for those detained under ss135/6, less time after assessment to find a bed at the point where many AMHPs using social media will say itâ€™s getting ever harder to do so. The importance of the Concordat and of organisations working together to understand how their overlapping demand works has never been greater. Â This is the case, at just the point where formal oversight to drive the Concordat is coming to a conclusion.
And there is still loads to do, folks!
Winner of the Presidentâ€™s Medal from
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award.