Mental health nurses and paramedics to respond together to reduce avoidable hospital admissions

Case study summary

Thousands of Londoners experiencing a mental health crisis will be sent a specialist nurse and a paramedic in a car on blue lights.


By responding together, the specialist ambulance crew is expected to reduce mental health hospital admissions from 58,000 to 30,000 per year once it is rolled out across the capital.

The London Ambulance Service scheme aims to treat patients at home, which is often a better environment for those experiencing mental health problems.

When an emergency mental health call comes in, the 999 call handlers work alongside a mental health nurse in the control room to decide whether to dispatch the mental health car.

At the scene, both clinicians will assess the patient, with the nurse able to assess mental health and provide brief psychological interventions and the paramedic able to assess their physical needs.

Claire Murdoch, National Clinical Director for Mental Health at NHS England, said: “As we develop a long term plan for the NHS, it’s imperative we focus on bringing together health and social care professionals, providing a tailored service for patients and making the most of every penny. The London Ambulance mental health nurse and paramedic pioneer scheme is an excellent example of how patients can get more appropriate care closer to home and avoid unnecessary trips to hospital.”

The car will operate seven days a week initially covering boroughs across south east London – an area with one of the highest rates of patients taken to hospital because of mental health problems.

Chief Quality Officer at London Ambulance Service, Trisha Bain, said: “We have now launched our five year strategy aiming to help us improve the speed and quality of care we provide to our patients. Our new mental health scheme is one of several pioneering services we are introducing dedicated to providing specialist care, improving patient experience and preventing unnecessary hospital admissions.”

Once the mental health nurse and paramedic have arrived at the scene and assessed the patient, they can encourage them to make a GP appointment, refer them to their mental health team, or call an ambulance if they think they need to go to hospital. During the shifts to test the concept, no patients were taken to hospital at all.

Mental Health Lead at London Ambulance Service, Carly Lynch said: “Emergency departments are not always the right place for someone experiencing a mental health crisis, and can often be traumatising for these patients, directing them to alternative care is often a better and more appropriate option for them.”

Across the NHS, 14 Integrated Care Systems (ICS) and many Sustainability and Transformation Partnerships are seeing NHS and local government join forces to pool resources and budgets and simplify systems for the patient across primary and secondary care. Spreading this approach will be a key part of the long term plan for the NHS that is being drawn up over the coming months.

Pioneer schemes like the mental health car will be piloted in one STP and then, following a formal evaluation, rolled out across the wider London STPs. The mental health pioneer scheme will improve parity of care between patients with physical and mental health needs