Department of Health and Social Care
Central Government
Action Planned
The Department of Health and Social Care mentioned plans to improve A&E waiting times, reduce ambulance response times, expand mental health services through NHS111, and invest in mental health infrastructure. They are also deploying mental health professionals in 999 call centers and clinical assessment services. (AI summary)
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Dear Anita,
Thank you for your Regulation 28 report to prevent future deaths dated 20 December 2023 about the death of James Campion. I am replying as the Minister with responsibility for mental health and patient safety.
Firstly, I would like to say how saddened I was to read of the circumstances of James’ death and I offer my sincere condolences to his family and loved ones. The circumstances your report describes are concerning and I am grateful to you for bringing these matters to my attention. Please accept my sincere apologies for the significant delay in responding to this matter.
Your report raises concerns over delays in the dispatch of ambulance and the provision of urgent and emergency mental health care.
The Department recognises the significant pressure the urgent and emergency care system is facing. That is why we published our Delivery plan for recovering urgent and emergency care services, which aims to deliver sustained improvements in waiting times. Our ambitions for this year are to improve A&E waiting times to 78% of patients to be admitted, transferred, or discharged from A&E within four hours by March 2025, and to reduce Category 2 ambulance response times to 30 minutes on average across this fiscal year. The plan is available at: www.england.nhs.uk/wp-content/uploads/2023/01/B2034-delivery-plan-for- recovering-urgent-and-emergency-care-services.pdf
Your report highlights that North West Ambulance Service (NWAS) was under high demand at the time of the incident. A primary aim of our delivery plan is to boost ambulance capacity. Ambulance services received £200 million of additional funding in 2023/24 to expand capacity and improve response times, and we are maintaining this additional capacity in 2024/25. This is alongside the delivery of new ambulances and specialist mental health vehicles. With more ambulances on the road, patients will receive the treatment they need more swiftly.
At a national level, we have seen significant improvements in performance this year compared to last year. For example, in 2023/24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13
minutes faster compared to 2022/23, a reduction of over 27%. NWAS’ average Category 2 response times were over 13 minutes faster, a 32% reduction.
We have also made significant investments in the ambulance workforce – the number of NHS ambulance staff and support staff has increased by over 50% since 2010. To help ensure we have the ambulance workforce to meet the future demands on the service, the NHS Long Term Workforce Plan sets out plans to boost the number of paramedics by up to 15,600 to deliver services in ambulance and other care settings.
The Government is committed to improving urgent mental health services. We have now made emergency mental health support through NHS111 available everywhere in England. For those with severe needs or in crisis, 24/7 urgent mental health helplines are already available in all areas of the country. These crisis lines currently take around 200,000 calls a month. Linking these through to NHS111 will provide a consistent route for people to access support across the country. Delivering this commitment will enable anyone experiencing mental health crisis to access assessment and, if appropriate, onward referral and treatment at any time of the day by calling NHS111.
It will mean that when an individual calls the NHS111 mental health option, a trained mental health professional will answer the call. They will often ask a number of important mental health related questions, which can lead to a number of outcomes including signposting and guidance, as well as onward referrals to other services.
To supplement this new NHS111 offer, we are also deploying mental health professionals in 999 call centres and clinical assessment services to help ensure that people experiencing a mental health crisis are directed towards appropriate services.
The Government also invested £98 million into NHS111 in 2021/22 to boost staff numbers, increasing call taking and clinical advice capacity, helping patients at home and avoiding unnecessary ambulance calls and conveyances to A&E. This was followed in 2022-23 with an extra £50 million to support additional NHS111 capacity.
In addition, we are providing £150 million of capital investment for mental health urgent and emergency care infrastructure over 2023/24 and 2024/25. This includes investment into a range of wider local mental health infrastructure schemes, including new and improved crisis cafes, crisis houses, health-based places of safety and improvements to emergency departments and crisis lines. Over 160 schemes have been allocated funding by NHS England so far and 99 have been completed. The funding will also provide for specialised mental health ambulances which will be rolled out across the country – and be supported by practitioners trained to provide advice and treatments in cases of co- occurring physical and mental health issues.
I hope this response is helpful. Thank you for bringing these concerns to my attention.
Thank you for your Regulation 28 report to prevent future deaths dated 20 December 2023 about the death of James Campion. I am replying as the Minister with responsibility for mental health and patient safety.
Firstly, I would like to say how saddened I was to read of the circumstances of James’ death and I offer my sincere condolences to his family and loved ones. The circumstances your report describes are concerning and I am grateful to you for bringing these matters to my attention. Please accept my sincere apologies for the significant delay in responding to this matter.
Your report raises concerns over delays in the dispatch of ambulance and the provision of urgent and emergency mental health care.
The Department recognises the significant pressure the urgent and emergency care system is facing. That is why we published our Delivery plan for recovering urgent and emergency care services, which aims to deliver sustained improvements in waiting times. Our ambitions for this year are to improve A&E waiting times to 78% of patients to be admitted, transferred, or discharged from A&E within four hours by March 2025, and to reduce Category 2 ambulance response times to 30 minutes on average across this fiscal year. The plan is available at: www.england.nhs.uk/wp-content/uploads/2023/01/B2034-delivery-plan-for- recovering-urgent-and-emergency-care-services.pdf
Your report highlights that North West Ambulance Service (NWAS) was under high demand at the time of the incident. A primary aim of our delivery plan is to boost ambulance capacity. Ambulance services received £200 million of additional funding in 2023/24 to expand capacity and improve response times, and we are maintaining this additional capacity in 2024/25. This is alongside the delivery of new ambulances and specialist mental health vehicles. With more ambulances on the road, patients will receive the treatment they need more swiftly.
At a national level, we have seen significant improvements in performance this year compared to last year. For example, in 2023/24, average Category 2 ambulance response times (including for serious conditions such as heart attacks and strokes) were over 13
minutes faster compared to 2022/23, a reduction of over 27%. NWAS’ average Category 2 response times were over 13 minutes faster, a 32% reduction.
We have also made significant investments in the ambulance workforce – the number of NHS ambulance staff and support staff has increased by over 50% since 2010. To help ensure we have the ambulance workforce to meet the future demands on the service, the NHS Long Term Workforce Plan sets out plans to boost the number of paramedics by up to 15,600 to deliver services in ambulance and other care settings.
The Government is committed to improving urgent mental health services. We have now made emergency mental health support through NHS111 available everywhere in England. For those with severe needs or in crisis, 24/7 urgent mental health helplines are already available in all areas of the country. These crisis lines currently take around 200,000 calls a month. Linking these through to NHS111 will provide a consistent route for people to access support across the country. Delivering this commitment will enable anyone experiencing mental health crisis to access assessment and, if appropriate, onward referral and treatment at any time of the day by calling NHS111.
It will mean that when an individual calls the NHS111 mental health option, a trained mental health professional will answer the call. They will often ask a number of important mental health related questions, which can lead to a number of outcomes including signposting and guidance, as well as onward referrals to other services.
To supplement this new NHS111 offer, we are also deploying mental health professionals in 999 call centres and clinical assessment services to help ensure that people experiencing a mental health crisis are directed towards appropriate services.
The Government also invested £98 million into NHS111 in 2021/22 to boost staff numbers, increasing call taking and clinical advice capacity, helping patients at home and avoiding unnecessary ambulance calls and conveyances to A&E. This was followed in 2022-23 with an extra £50 million to support additional NHS111 capacity.
In addition, we are providing £150 million of capital investment for mental health urgent and emergency care infrastructure over 2023/24 and 2024/25. This includes investment into a range of wider local mental health infrastructure schemes, including new and improved crisis cafes, crisis houses, health-based places of safety and improvements to emergency departments and crisis lines. Over 160 schemes have been allocated funding by NHS England so far and 99 have been completed. The funding will also provide for specialised mental health ambulances which will be rolled out across the country – and be supported by practitioners trained to provide advice and treatments in cases of co- occurring physical and mental health issues.
I hope this response is helpful. Thank you for bringing these concerns to my attention.