New mental health 111 service reduces A&E visits by a third

Case study summary

A new phone service has reduced the number of people needing A&E care for mental health problems by a third in Cambridge and Peterborough easing winter pressures and saving up to £4.7m.


The First Response for Mental Health scheme sees those people who call 111 choose a special new local option where they are put through to a local team and pointed to the right place for treatment avoiding A&E where appropriate.

Over the period of 8 months (October 16 – May 17), nearly 10,000 people called and the effect on A&E admissions has been profound.

  • 97 per cent of calls to the 111 option2 number did not need A&E
  • 26 per cent fewer people overall needed to be taken to A&E by ambulance
  • 25 per cent fewer people needed A&E for mental health problems
  • 19 per cent reduction in overall A&E mental health admissions was seen.

There has been a 16 per cent reduction in the number of overdoses and estimates show the scheme could have saved the local health and care system between £2.2m and £4.7m.

Cambridge and Peterborough Sustainability and Transformation Partnership Mental Health Clinical Lead Dr Emma Tiffin, said: “By selecting a “mental health help” option using the current 111 system the person experiencing mental health crisis can be directed to the right team for assessment, onward treatment or advice. This 111 mental health pathway has proved to effectively reduce mental health related A&E attendances and hospital admissions.

“Ensuring that people are accessing the right service at the right time is key to reducing costs, duplication and confusion. Above all that, it means that patients will have a better experience of care and better outcomes first time.”

The area now has two sanctuaries with outreach facilities for rural areas which provide a safe space for people in crisis available all year round from 6pm-1am.

Caroline Meiser-Stedman, FRS Consultant Psychiatrist said: “Recently we had a call from a gentleman, who had never accessed mental health services before, but was worried about his wife. After speaking to 111 option2 staff, who calmed the situation down, they arranged an urgent face-to-face assessment.

“A couple of hours later a psychiatrist and a member of the crisis home treatment team visited their home. After some time talking to her, she agreed to come to the ward. If she had gone directly to A&E she would’ve almost certainly become very unsettled and left or it would have led to her being restrained under the Mental Health Act.

“This way we were able to get her the right help quickly.”

48 per cent of calls are self-referral with a significant number also from GPs, police and ambulance services