Enter and View: Mental Health Liaison Team (RAID Team), A&E Royal London

Healthwatch Tower Hamlets team did an announced Enter and View visit to the Mental Health Liaison Team/RAID, based at the Royal London Hospital A&E, on 26th July and 5th of September, 2016. This visit was conducted to make observations and gather patient feedback, after a member of Mental Health Task Group, expressed some concerns.

The RAID/Mental Health Liaison service is a team of health professionals who assess, treat and manage people with mental health problems who come to the emergency department of Royal London Hospital or who are a patient on the wards (Mile End & Royal London & St Bartholomew’s Hospitals) who have a physical health problem and who may need additional support due to a mental health difficulty.

The RAID team also manages the Tower Hamlets Crisis Telephone line and run a nurse led Outpatient Clinic, to follow up on patients after the A&E discharge process.

The first visit took place on Tuesday 26th July to the RAID service (A&E) and the following was observed:

• The 2 monitors were near the reception area and could be seen by people/patients passing by (members feel that this is an intrusion of privacy).

• The toilet in the assessment room was not very clean.

• Inside the assessment room, one of the doors ‘rattled’.

• Waiting area is not ideal for people in mental health crisis.

HW representatives did not find it appropriate to gather feedback on this visit and felt that it was best to visit the outpatient clinic for feedback which took place on Monday 5th September 2016, 10-11am. On that day feedback from 3 patients and listening to their stories produced the findings below:

Overall the RAID service, is an extremely invaluable service, with positive aspects such as good staff, good follow up support and invaluable outpatient service. The report also lists concerns including lengthy waiting times, intrusion of privacy (monitors displaying recording placed in an exposed part of the reception area) and staff struggling to see patients at A&E and answering the Crisis Line at the same time.

Recommendations made by the Healthwatch team included:

• Changing the positioning of the two monitors to facing backward instead of forward. This concern was to be highlighted by ELFT to Barts, and if not resolved Healthwatch would raise this issue with Barts senior management.

• ‘Tower Hamlet Crisis Line’ should be a separately funded service with dedicated staff members to man the phones

• All Barts frontline staff working at A&E should be trained in Mental Health First Aid

• The ‘Assistant Liaison Practitioner’ post should become a permanent post as it is a vital link whilst patients are waiting in A&E to be seen by the RAID staff.

• ELFT should promote the A&E and Crisis Line element of the service more widely in the community as not many people are aware of this service.

• Improve the waiting area experience of patients at A&E

A response was given from the service manager and the A&E matron to 3 questions asked by the healthwatch team based on their visit.