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Performance Monitoring Information Section 136 Mental Health Act 1983 & patients who are AWOL

Mental Health Partnership Board Working Group

MENTAL HEALTH PARTNERSHIP BOARD 8 APRIL 2015

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Table of contents

Executive Summary ........................................................................................................................................................................................................................................................................................................ 4

Table 1 Conveyance of patients detained under S.136 to places of safety by conveyance type for 2014/2015 ................................................................................................................... 6

Chart 1 Conveyance of patients detained under S.136 to places of safety by conveyance type for 2014/2015 ................................................................................................................... 7

Chart 2 Grading of LAS responses to requests for transporting patients detained under S136 MHA 1983 for period January 2014 – February 2015 inclusive ................. 8

Chart 3 Average actual response times in minutes for requests to transport patients detained under S136 MHA 1983, period Jan 2014 – Feb 2015 ..................................... 9

Table 2 Section 136 detainees who were taken to a Metropolitan Police station as a place of safety, 2013, 2014, 2015 ............................................................................................. 10

Table 3 Reported episodes of police officers with S.136 patients being turned away from places of safety -‐ Metropolitan Police .......................................................................... 11

Table 4 Reported episodes of police officers with S.136 patients being turned away from places of safety -‐ British Transport Police ................................................................. 12

Table 5 Reported episodes of police officers with S.136 patients being turned away from places of safety – City of London Police ...................................................................... 13

Chart 4 Overview of Section 136 detainees turned away from places of safety between Sept 2014 – Feb 2015 .............................................................................................................. 14

Table 6 Reasons for being turned away from places of safety British Transport Police, period December 2014 – February 2015 ......................................................................... 15

Table 7 Reasons for being turned away from places of safety City of London Police, period Dec 2014 – Feb 2015 ........................................................................................................ 17

Table 8 Section 136 assessments at places of safety -‐ Timeliness and availability of AMHPS – Office Hours Only .......................................................................................................... 18

Table 9 Section 136 assessments at places of safety -‐ Timeliness and availability of AMHPS – Outside Office Hours Only ......................................................................................... 19

Table 10 Section 136 assessments at places of safety -‐ Timeliness and availability of Doctors – Office Hours Only ....................................................................................................... 20

Table 11 Section 136 assessments at places of safety -‐ Timeliness and availability of Doctors – Outside Office Hours Only ..................................................................................... 21

Chart 5 Overview of AMHP responses to places of safety between Jun 2014 – Feb 2015 ........................................................................................................................................................... 22

Chart 6 Overview of examining Doctor responses to places of safety between Jun 2014 – Feb 2015 .................................................................................................................................... 23

Table 12 Total number of AWOL Episodes reported by MHT .................................................................................................................................................................................................................. 24

Chart 7 Overview of AWOL reports by MHTs in London for 9 months ending February 2015 ................................................................................................................................................. 25

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Table 13 AWOL episodes per 100 beds year by year comparison 2014 / 2015 .............................................................................................................................................................................. 26

Chart 8 AWOL episodes per 100 beds year by year comparison period Jan – Feb 2014 with equivalent period 2015 .................................................................................................. 27

Table 14 AWOL Episodes per 100 detained patients ................................................................................................................................................................................................................................... 28

Table 15 Incidents where the police were requested to assist ward staff to manage a difficult, aggressive or otherwise disturbed patient Jun 2014 – Feb 2015 .......... 29

Chart 9 Incidents where the police were requested to assist ward staff to manage a difficult, aggressive or otherwise disturbed patient Jun 2014 – Feb 2015 ............. 30

Table 16 Incidents of physical restraint of an in-‐patient by one/more staff in response to aggressive behaviour or resistance to treatment May – Dec 2014 ................ 31

Chart 10 Incid of phys restraint of an in-‐patient by 1 or more members of staff in response to aggressive behaviour or resistance to treatment. ........................................ 32

Chart 11 Incidents of physical restraint of an in-‐patient etc by Ward Security type. ..................................................................................................................................................................... 33

Table 17 Formal detentions under the Mental Health Act 1983 Section 136, May 2014 – Dec 2014 ..................................................................................................................................... 34

Chart 12 An overview of Section 136 May – December 2014 inclusive ............................................................................................................................................................................................... 35

Tables 18 – 26 Formal detentions under the Mental Health Act 1983 Section 136 by ethnicity .............................................................................................................................................. 36

Table 18 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ BEH .......................................................................................................... 37

Table 19 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ C & I ......................................................................................................... 38

Table 20 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ CNWL ...................................................................................................... 39

Table 21 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ E London ................................................................................................ 40

Table 22 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ NELFT ..................................................................................................... 41

Table 23 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, OXLEAS .................................................................................................... 42

Table 24 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, SLAM ......................................................................................................... 43

Table 25 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, SWLSTG ................................................................................................... 44

Table 26 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, WLMHT .................................................................................................... 45

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Executive Summary Introduction This report has evolved as additional measures have been introduced and existing ones modified, resulting in periods of measurement that do not always align. Nonetheless we are now in a position where in some cases more than 12 months of data have been collected and more meaningful comparisons can therefore be made. This monitoring report has been modified to reflect this and other changes agreed with the chair of the Mental Health Partnership Board and the co-‐chairs of the working group. For demonstrative purposes only, a possible aspirational target has been added to the section on transport. There may be scope to introduce similar aspirational targets in other areas such as timeliness and availability of AMHPs and Doctors. Section 136 transport Well over half of section 136 detainees are still transported by police vehicle instead of by ambulance. There are signs of a slight improvement in January and February of this year compared with last year’s totals but this could just be a result of seasonal variation. More meaningful comparisons will be available later in the year. The aspirational target of 80% transported by ambulance has been inserted simply for illustrative purposes and has not been formally agreed. A significant proportion of ambulance response gradings remain beyond 30 minutes. The crisis concordat proposes response times within 30 minutes. A significant number of actual responses (as distinct from gradings) are also outside this time. See pages 5 – 9 for more detail. Access to places of safety Sharp reductions in the use of police stations as places of safety indicates that locating a hospital to take a section 136 detainee is almost always successful. Nevertheless, finding a place of safety in some cases continues to present challenges with 29 recorded cases of detainees being denied access this quarter. The Metropolitan Police were unable to provide any information on this occasion so this figure is likely to undercount the problem. A variety of reasons are reported for denying access at a place of safety, the most common being lack of space to accommodate. Reasons such as the patient not being the responsibility of the hospital or because the patient was there the previous evening are less common but difficult to understand. See pages 10 – 17 for more detail. Timeliness/Availability AMHPs and Doctors The timely attendance of AMHPs and Doctors at the place of safety directly affects the speed with which patients are processed through the system and in consequence the availability of staff to accommodate new arrivals, potentially leading to the difficulties associated with denials of access. The wide variation in performance indicates that some MHTs have few difficulties in this area. See pages 18 – 23 for more detail.

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AWOL Total reports of AWOLS have declined over the 9-‐month period for which data has been collected. It is difficult to compare MHTs using raw AWOL numbers due to size differences in terms of bed and patient numbers. AWOL rates per 100 beds and per 100 patients are arguably better indicators. These could signal that some MHTs manage patients in ways that lead to less AWOL episodes and that good practice might be shared with MHT’s who have much higher rates of absence. See pages 24 – 28 for more detail Patient Restraint Monitoring the number of occasions when the police are requested to assist hospital ward staff to manage difficult in-‐patients is of interest to the partnership. The overall trend for the last 9 months is down. In an attempt to explain why there is such large variation between MHTs when calling for police assistance, the total numbers of restraint by staff on patients is also presented. This indicates that some MHTs who call the police more frequently have less total staff restraints on patients than some MHTs who rarely call the police. This could suggest scope for further investigation to identify any learning or sharing of good practice to reduce such requests. Information for East London, North East London and Camden & Islington is incomplete due to gaps in the August and September data. See pages 29 – 33 for more detail Section 136 detentions & ethnicity breakdown The trend is currently stable with no current indication of a decrease or increase. Information for Camden & Islington is incomplete due to gaps in the August and September data. The ethnicity breakdown of section 136 detentions within each Mental Health Trust is compared with ONS census data for 2011 aggregated to MHT level from borough-‐based information. Such a comparison assumes that all section 136 detainees were residents in the MHT area where they were picked up. The data has so far only been collected for a 5-‐month period and the pattern of ethnicity breakdown might change over time as the information begins to span a longer period. At this stage, there are signs of some under representation in the Asian or Asian British group and some over representation in the Black or Black British Group but not in all MHTs. Information for Camden & Islington is incomplete due to gaps in the August and September data. See pages 34 – 45 for more detail. Note that throughout all the tables that follow a “ – “ indicates the data was not supplied and a blank indicates it was not collected for that period. Michael Partridge On behalf of the Mental Health Partnership Board. 08 April 2015

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Table 1 Conveyance of patients detained under S.136 to places of safety by conveyance type for 2014/2015 All 3 tables compare year to date with JAN – DEC 2014 for MPS and JUN – DEC 2014 for BTP & CITY

Metropolitan Police

Conveyance Type Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total (2014) 2015

LAS 60 31 31% 43%

Police 68 46 62% 53%

Other 5 4 7% 4%

Total 133 81

British Transport Police


LAS 21 21 36% 38%

Police 20 20 38% 36%

Other 18 10 26% 25%

Total 59 51

City Police


LAS 1 3 48% 20%

Police 3 3 52% 30%

Other 4 6 0% 50%

Total 8 12

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Chart 1 Conveyance of patients detained under S.136 to places of safety by conveyance type for 2014/2015

This information is drawn from Table 1. The proposed aspirational target is based upon the revised code of practice to the Mental Health Act 1983 which indicates that Section 136 detainees should be conveyed to the place of safety by ambulance *** National figures are taken from the www.hscis.gov.uk and are for year ending April 2014 2015 data is for January and February only. 2014 data is for the period Jan – Dec for the Metropolitan Police and for Jun – Dec for BTP and City

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

MET BTP CITY National Lowest *** National Average *** National Highest ***

The percentage of Section 136 detainees conveyed to the place of safety by LAS transport

(2014)

2015

Proposed Aspirational Target

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Chart 2 Grading of LAS responses to requests for transporting patients detained under S136 MHA 1983 for period January 2014 – February 2015 inclusive (Data supplied by LAS)

The data for the period Jun – Aug 2014 was inaccurate and has been omitted. The Mental Health Crisis Concordat proposes a response within 30 minutes. Areas of the charts coloured blue indicate response gradings that satisfied this, red areas reflect the proportion of incident gradings in excess of 30 minutes. Good performance is therefore indicated by a largely blue pie chart Please note these figures measure gradings not actual response times

Jan -‐ May 2014

targ resp time <30 min

targ resp time >30 min

Sep -‐ Nov 2014



Dec -‐ Feb 2015



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Chart 3 Average actual response times in minutes for requests to transport patients detained under S136 MHA 1983, period Jan 2014 – Feb 2015 (Data supplied by LAS) The data for the period Jun – Aug 2014 was inaccurate and has been omitted The Mental Health Crisis concordat target is shown as a proposed aspirational target Good performance is indicated when the bars are below the line

0

10

20

30

40

50

60

70

80

targ resp time <30 min targ resp time >30 min

Jan -‐ May 2014

Sep -‐ Nov 2014

Dec -‐ Feb 2015

crisis concordat target

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Table 2 Section 136 detainees who were taken to a Metropolitan Police station as a place of safety, 2013, 2014, 2015 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2014

4 0 0 0 0 7 5 1 0 2 1 2 22

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2015

0 1 1 (In 2013 there were 87 section 136 detainees taken to London police stations, monthly figures are not available for 2013)

0

100

200

300

400

500

600

700

800

900

National Low 2014

***

National Avg 2014

***

National High 2014

***

MPS 2013 MPS 2014 MPS ytd (2015)

Section 136 detentions in a police station 2013, 2014 and Jan -‐ Feb 2015

Section 136 detentions in a police station

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Table 3 Reported episodes of police officers with S.136 patients being turned away from places of safety -‐ Metropolitan Police

2014 2015

May Jun Jul Aug Sep Oct Nov Dec* Jan* Feb* Mar Apr Totals

BEH 0 0 0 0 0 1 0 -‐ -‐ -‐ 1

C&I 0 0 0 0 0 0 1 -‐ -‐ -‐ 1

CNWL 1 0 1 0 0 0 0 -‐ -‐ -‐ 2

E LONDON 0 0 0 0 0 0 0 -‐ -‐ -‐ 0

NELFT 0 0 0 2 0 0 0 -‐ -‐ -‐ 2

OXLEAS 1 0 0 0 0 0 0 -‐ -‐ -‐ 1

SLAM 2 4 3 1 1 2 1 -‐ -‐ -‐ 14

SWLSTG 2 0 0 0 0 0 1 -‐ -‐ -‐ 3

WLMHT 0 0 0 0 0 0 0 -‐ -‐ -‐ 0

TOTAL 6 4 4 3 1 3 3 -‐ -‐ -‐ 24

*The Metropolitan Police were unable to supply information for the period December 2014 to February 2015

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Table 4 Reported episodes of police officers with S.136 patients being turned away from places of safety -‐ British Transport Police

2014 2015

Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Totals

BEH 1 2 1 0 3 1 -‐ -‐ -‐ -‐ -‐ 8

C&I (See Whitt & UCG) (1) 0 (3) (2) (4) 0 -‐ -‐ -‐ -‐ -‐ (10)

CNWL 1 0 3 4 0 0 -‐ -‐ -‐ -‐ -‐ 8

E LONDON 0 0 0 0 0 0 -‐ -‐ -‐ -‐ -‐ 0

NELFT 0 0 0 2 0 0 -‐ -‐ -‐ -‐ -‐ 2

OXLEAS 0 2 0 0 0 0 -‐ -‐ -‐ -‐ -‐ 2

SLAM 0 0 2 0 3 0 -‐ -‐ -‐ -‐ -‐ 5

SWLSTG 0 1 0 1 1 1 -‐ -‐ -‐ -‐ -‐ 4

WLMHT 0 0 0 0 0 0 -‐ -‐ -‐ -‐ -‐ 0

NORTH MIDD UNIV HOSP*** 1 0 0 0 0 0 -‐ -‐ -‐ -‐ -‐ 1

WHITTINGTON*** 1 0 2 1 3 0 -‐ -‐ -‐ -‐ -‐ 7

NW LOND HLTH TRUST*** 0 1 0 0 0 0 -‐ -‐ -‐ -‐ -‐ 1

LEW & GREEN NHS TRUST*** 0 1 0 0 0 1 -‐ -‐ -‐ -‐ -‐ 2

HOMER UNIV H. NHS FT*** 0 0 1 0 1 0 -‐ -‐ -‐ -‐ -‐ 2

BARTS*** 0 0 2 0 0 0 -‐ -‐ -‐ -‐ -‐ 2

UCH*** 0 0 1 1 1 0 -‐ -‐ -‐ -‐ -‐ 3

KGS COLL HOSP NHS TRUST*** 0 0 0 0 0 1 -‐ -‐ -‐ -‐ -‐ -‐ 1

TOTAL 4 7 12 9 12 4 ***Acute Trust

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Table 5 Reported episodes of police officers with S.136 patients being turned away from places of safety – City of London Police

2014 2015

Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Totals Homerton University NHS

Foundation Trust 2 0 1 3

BARTS 1 0 0 1

TOTAL 3 0 1

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Chart 4 Overview of Section 136 detainees turned away from places of safety between Sept 2014 – Feb 2015

The British Transport Police began collecting this information in September and the City of London police from December. The Metropolitan Police have not provided any data for December 2014 – February 2015.

0

2

4

6

8

10

12

14

Sep Oct Nov Dec Jan Feb

Reported episodes of section 136 detainees being turned away from places of safety Sep 14 -‐ Feb 15

MPS

BTP

City

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Table 6 Reasons for being turned away from places of safety British Transport Police, period December 2014 – February 2015

Date Trust Place of safety Reason 06/12/2014 CNWL Park Royal Centre for Mental Health No beds available 06/12/2014 CNWL Northwick Park Mental Health Unit Patient not their responsibility 15/12/2014 NELFT Goodmayes Full 17/12/2014 C & I (managed by acute trust) University College Hospital Full 17/12/2014 C & I (managed by acute trust) Whittington Full 18/12/2014 NELFT Goodmayes Due to alcohol consumption 18/12/2014 CNWL Northwick Park Mental Health Unit Not their patient, No beds 20/12/2014 CNWL Gordon Hospital Patient not their responsibility directed to St Charles 29/12/2014 SWLSTG Springfield Hospital Full 05/01/2015 BEH Chase Farm Hospital Full 12/01/2015 Homerton University Hospital

NHS Foundation Trust (acute) Homerton Hospital No reason provided

15/01/2015 SWLSTG Springfield Hospital Full 15/01/2015 SLAM Lambeth Hospital Closed 16/01/2015 SLAM Maudsley Full 16/01/2015 SLAM Lambeth Full 20/01/2015 C & I (managed by acute trust) Whittington Hospital Because he was a patient the previous evening

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Date Trust Place of safety Reason 21/01/2015 BEH Chase Farm Busy 21/01/2015 BEH St Annes Alcohol 21/01/2015 C & I (managed by acute trust) Whittington Full 21/01/2015 C & I (managed by acute trust) University College Hospital No reason provided 26/01/2015 C & I (managed by acute trust) Whittington Hospital Because he was a patient previously & Full 05/02/2015 Lewisham and Greenwich NHS

Trust (acute) Queen Elizabeth Hospital No reason provided

06/02/2015 Kings College Hospital NHS

Foundation Trust Kings College Hospital Full

07/02/2015 BEH Chase Farm Hospital Staff decided that A & E treatment required 15/02/2015 SWLSTG Springfield Hospital No reason provided

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Table 7 Reasons for being turned away from places of safety City of London Police, period Dec 2014 – Feb 2015

Date Trust Place of safety Reason

December 2014 BARTS Royal London Hospital Intoxication December 2014 Homerton University NHS Foundation Trust (acute) Homerton Hospital Full / Unable to facilitate December 2014 Homerton University NHS Foundation Trust (acute) Homerton Hospital Full / Unable to faciltate February 2015 Homerton University NHS Foundation Trust (acute) Homerton Hospital Intoxication

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Table 8 Section 136 assessments at places of safety -‐ Timeliness and availability of AMHPS – Office Hours Only The percentage of occasions that more than 4 hours elapsed between the time that an AMHP was requested to attend the place of safety and the time that an AMHP arrived

2014 2015

Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Average

BEH 18% 50% 20% 22% 33% 33% 66% 0% 50% 32%

C & I 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

CNWL 8% 16% 9% 16% 21% 22% 10% 11% 14% 14%

E LONDON 13% 7% 3% 0% 2% 2% 2% 2% 0% 3%

NELFT 32% 15% -‐ 60% 75% 50% 21% 0% 0% 32%

OXLEAS 33% 0% 66% 40% 40% 14% 40% 40% 25% 33%

SLAM 4% 4% 6% 0% 5% 4% 4% 8% 4% 4%

SWLSTG 37% 33% 25% 0% 0% 0% 42% 55% 43% 26%

WLMHT 9% 6% 3% 8% 5% 5% 10% 10% 11% 7%

BARTS (RLH) 0% 11% 0% 0% 0% 17% -‐ -‐ -‐ 5%

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Table 9 Section 136 assessments at places of safety -‐ Timeliness and availability of AMHPS – Outside Office Hours Only The percentage of occasions that more than 4 hours elapsed between the time that an AMHP was requested to attend the place of safety and the time that an AMHP arrived

2014 2015


BEH 44% 35% 0% 35% 47% 33% 60% 32% 29% 35%

C & I 3% 4% 3% 0% 0% 0% 0% 0% 0% 1%

CNWL 14% 32% 16% 31% 24% 10% 18% 5% 16% 18%

E LONDON 3% 13% 17% 10% 12% 7% 9% 5% 3% 9%

NELFT 5% 7% -‐ 13% 14% 10% 12% 11% 8% 10%

OXLEAS 29% 45% 25% 40% 41% 40% 52% 48% 26% 38%

SLAM 11% 13% 14% 14% 15% 11% 17% 5% 15% 13%

SWLSTG 42% 39% 48% 0% 0% 0% 0% 0% 0% 14%

WLMHT 26% 19% 24% 18% 16% 18% 29% 20% 19% 21%

BARTS (RLH) 13% 11% 0% 0% 0% 0% -‐ -‐ -‐ 4%

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Table 10 Section 136 assessments at places of safety -‐ Timeliness and availability of Doctors – Office Hours Only The percentage of occasions that more than 3 hours elapsed between the patient’s time of arrival in the place of safety and the time that an assessment by a doctor began

2014 2015


BEH 0% 0% 0% 22% 50% 38% 83% 10% 50% 28%

C & I 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

CNWL 13% 16% 9% 12% 12% 5% 2% 5% 0% 8%

E LONDON 3% 10% 0% 2% 0% 0% 2% 2% 0% 2%

NELFT 0% 0% -‐ 0% 0% 0% 0% 0% 0% 0%

OXLEAS 33% 0% 0% 0% 0% 0% 20% 0% 0% 6%

SLAM 0% 0% 0% 1% 0% 0% 2% 2% 3% 1%

SWLSTG -‐ -‐ 50% 83% 82% 100% 0% 0% 0% 45%

WLMHT 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

BARTS (RLH) 0% 0% 0% 0% 0% 0% -‐ -‐ -‐ 0%

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Table 11 Section 136 assessments at places of safety -‐ Timeliness and availability of Doctors – Outside Office Hours Only The percentage of occasions that more than 3 hours elapsed between the patient’s time of arrival in the place of safety and the time that an assessment by a doctor began

2014 2015


BEH 0% 0% 0% 54% 53% 54% 60% 32% 41% 33%

C & I 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

CNWL 11% 6% 8% 13% 17% 7% 10% 4% 7% 9%

E LONDON -‐ -‐ -‐ 13% 7% 4% 7% 0% 5% 6%

NELFT 0% 0% -‐ -‐ -‐ -‐ 0% 0% 0% 0%

OXLEAS 11% 13% 0% 10% 2% 15% 3% 12% 4% 8%

SLAM 4% 3% 4% 6% 8% 6% 11% 6% 0% 5%

SWLSTG -‐ -‐ 85% 77% 82% 78% 0% 0% 0% 46%

WLMHT 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

BARTS (RLH) 0% 0% 0% 0% 0% 0% -‐ -‐ -‐ 0%

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Chart 5 Overview of AMHP responses to places of safety between Jun 2014 – Feb 2015

0%

5%

10%

15%

20%

25%

30%

35%

% of occasions Jun 14 -‐ Feb 15 during ofiice hours when AMHP arrival at POS is > 4 hours

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

% of occasions Jun 14 -‐ Feb 15 outside ofiice hours when AMHP

arrival at POS is > 4 hours

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Chart 6 Overview of examining Doctor responses to places of safety between Jun 2014 – Feb 2015

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

% of occasions during ofiice hours that time to iirst doctor examination in place of safety > 3 hours , for

period Jun 14 -‐ Feb 15

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

% of occasions outside ofiice hours that time to iirst doctor examination

in place of safety >3 hours for period Jun 14 -‐ Feb 15

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Table 12 Total number of AWOL Episodes reported by MHT

2014 2015

Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Total

BEH 18 7 11 13 6 10 7 1 8 81

C & I 20 21 17 19 23 17 14 20 19 170

CNWL 33 36 44 51 36 37 47 30 35 349

E LONDON 31 31 19 21 23 14 21 19 21 200

NELFT 14 17 7 8 10 13 14 10 7 100

OXLEAS 8 17 10 12 15 18 9 7 6 102

SLAM 40 52 41 41 43 26 32 24 31 330

SWLSTG 9 5 9 17 15 10 13 20 17 115

WLMHT 10 15 11 12 14 6 15 13 8 104

Total 183 201 169 194 185 151 172 144 152

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Chart 7 Overview of AWOL reports by MHTs in London for 9 months ending February 2015

0

50

100

150

200

250

Jun Jul Aug Sep Oct Nov Dec Jan Feb

AWOLS in London 9 months ending Feb 2015

AWOLS in London 9 months ending Feb 2015

Linear (AWOLS in London 9 months ending Feb 2015)

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Table 13 AWOL episodes per 100 beds year by year comparison 2014 / 2015

2015

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec AVG Jan -‐ Feb 2015

AVG Jan -‐ Feb 2014

BEH 1 5 3 3.5 C & I 13 12 12.5 7.0 CNWL 9 11 10 2.5 ELFT 6 7 6.5 7.5 NELFT 7 5 6 10.5 OXLEAS 5 4 4.5 6.5 SLAM 5 4 4.5 3.5

SWLSTG 12 11 11.5 -‐ WLMHT 6 4 5 9.0

All data rounded to whole numbers. Please note this is a year-‐by-‐year comparison with the equivalent period

2014

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec YEAR AVG

BEH 4 3 2 5 6 12 4 7 8 4 6 4 5.4 C & I 10 4 4 4 5 15 15 13 12 14 10 9 9.6 CNWL 3 2 8 9 4 7 8 9 16 11 11 14 8.5 ELFT 7 8 3 4 4 10 10 6 7 8 5 7 6.6 NELFT 10 11 6 7 6 10 12 5 6 7 9 10 8.3 OXLEAS 6 7 1 2 3 5 12 7 8 10 5 6 6.0 SLAM 3 4 6 7 10 8 10 8 8 8 5 6 6.9

SWLSTG -‐ -‐ 8 4 5 6 3 6 11 9 6 8 6.6 WLMHT -‐ 9 12 12 11 5 7 5 6 7 3 7 7.6

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Chart 8 AWOL episodes per 100 beds year by year comparison period Jan – Feb 2014 with equivalent period 2015

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

BEH C & I CNWL E LONDON NELFT OXLEAS SLAM SWLSTG WLMHT

Year on year comparison AWOL episodes per 100 beds

Jan -‐ Feb 2014

Jan -‐ Feb 2015

28

Table 14 AWOL Episodes per 100 detained patients

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec YEAR AVG

BEH 3 8 9 16 6 10 13 6 10 6 8.7 C & I 6 5 7 21 22 18 17 20 15 13 14.4 CNWL 6 6 3 5 5 6 13 9 10 10 7.3 ELFT 11 15 13 15 15 9 14 15 9 9 12.5 NELFT 10 12 10 13 15 6 6 9 11 12 10.4 OXLEAS 4 5 8 9 19 11 14 17 9 8 10.4 SLAM 8 10 13 11 14 11 15 16 10 15 12.3

SWLSTG 6 3 4 8 4 8 15 14 9 11 8.2 WLMHT 18 18 16 7 11 8 8 10 4 11 11.1

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec AVG 2015

AVG 2014

BEH 1 6 3.5 8.7 C & I 19 18 18.5 14.4 CNWL 6 7 6.5 7.3 ELFT 8 9 8.5 12.5 NELFT 9 6 7.5 10.4 OXLEAS 6 6 6 10.4 SLAM 11 10 10.5 12.3

SWLSTG 17 14 15.5 8.2 WLMHT 9 6 7.5 11.1

All data rounded to whole numbers Year by year comparisons with equivalent periods will not be possible until more than 12 months of data has been collected

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Table 15 Incidents where the police were requested to assist ward staff to manage a difficult, aggressive or otherwise disturbed patient Jun 2014 – Feb 2015

2014 2015 Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May TOTAL

BEH 2 1 1 0 2 5 3 1 2 17

C & I -‐ -‐ -‐ 0 1 3 1 2 0 7

CNWL 3 4 2 4 0 1 0 0 0 14

E LONDON 2 1 2 2 1 2 2 4 2 18

NELFT 0 0 0 0 0 0 0 0 0 0

OXLEAS 0 0 0 2 3 0 0 1 2 8

SLAM 6 5 7 5 6 2 1 3 7 42

SWLSTG -‐ -‐ -‐ 0 0 0 0 0 0 0

WLMHT 1 1 1 2 0 3 1 0 0 9

TOTAL 14 12 13 15 13 16 8 11 13

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Chart 9 Incidents where the police were requested to assist ward staff to manage a difficult, aggressive or otherwise disturbed patient Jun 2014 – Feb 2015

0

2

4

6

8

10

12

14

16

18

Jun Jul Aug Sep Oct Nov Dec Jan Feb

Requests for police assistance on wards Jun 2014 -‐ Feb 2015

Requests for police assistance on wards Jun 2014 -‐ Feb 2015

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Table 16 Incidents of physical restraint of an in-‐patient by one/more staff in response to aggressive behaviour or resistance to treatment May – Dec 2014

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec TOTALS

BEH 19 21 28 45 28 36 41 47 197

C & I 25 22 24 -‐ -‐ 24 22 26 72

CNWL (144) (155) (121) 36 40 61 56 73 266

E LONDON 54 97 89 -‐ -‐ 74 94 90 258

NELFT 31 4 0 1 0 12 0 20 33

OXLEAS 21 29 31 27 27 27 31 25 137

SLAM (227) (212) (169) 19 10 26 19 34 110

SWLSTG (99) (75) (130) 52 58 80 75 50 315

WLMHT 55 43 42 38 30 42 39 62 211

( source starting August 2014 : Mental Health Minimum Dataset – MHMDS and Mental Health and Learning Disabilities Dataset -‐ MHLDDS ) Only data collected starting August 2014 is comparable. This is because the numbers in parentheses were sourced from local systems and not from MHLDDS.

32

Chart 10 Incid of phys restraint of an in-‐patient by 1 or more members of staff in response to aggressive behaviour or resistance to treatment.

0

50

100

150

200

250

300

350


Total Restraints Aug -‐ Dec 2014

Total

33

Chart 11 Incidents of physical restraint of an in-‐patient etc by Ward Security type.

0

50

100

150

200

250

300


Restraints by Ward Security Type August -‐ December 2014

General

Low

Medium

High

34

Table 17 Formal detentions under the Mental Health Act 1983 Section 136, May 2014 – Dec 2014

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total

BEH 36 41 31 30 55 31 24 16 264

C & I -‐ -‐ -‐ -‐ -‐ 46 42 31 119

CNWL 67 52 70 53 80 71 66 68 527

E LONDON 31 31 31 39 40 30 39 33 274

NELFT 43 40 43 43 53 47 44 43 356

OXLEAS 21 31 32 26 40 48 39 32 269

SLAM 86 76 74 67 58 66 57 46 530

SWLSTG 41 33 38 56 57 28 44 40 337

WLMHT 47 42 35 27 39 22 34 25 271

BARTS (RLH) 10 8 9 0 9 -‐ -‐ -‐ 36

Total 382 354 363 341 431 389 389 334 2983

(source: Mental Health Minimum Dataset – MHMDS and Mental Health & Learning Disabilities dataset -‐ MHLDDS)

35

Chart 12 An overview of Section 136 May – December 2014 inclusive

36

Tables 18 – 26 Formal detentions under the Mental Health Act 1983 Section 136 by ethnicity The ethnic groups in the tables that follow are structured according to the definitions in the MHLDDS Master Patient Index which is shown in the right hand column below. This differs slightly from the 2011 ONS ethnicity census data where Chinese ethnicity is aggregated for inclusion under “Asian or Asian British” not “Other Ethnic groups”. In order to permit meaningful comparisons between MHLDDS data from Mental Health Trusts and the ONS Census data, the Chinese ethnic sub-‐group has been removed from Other Ethnic Group (within MHLDDS) and counted for inclusion under the Asian or Asian British Ethnic Group to align with ONS Census Data 2011.

The information sources used to construct the tables were as follows : Section 136 counts by ethnicity type – MHLDDS post deadline final extract refresh submissions within each Mental Health Trust. (VBA code used to compute this information from final extract csv files is available on request) Population ethnicity data – 2011 Census, Detailed Characteristics for Local Authorities in England and Wales, downloaded 21 March 2015 from http://www.ons.gov.uk/ons/publications/re-‐reference-‐tables.html?edition=tcm%3A77-‐306085

White British Irish

Any other White background

Mixed White and Black Caribbean White and Black African

White and Asian Any other mixed background

Asian or Asian British

Indian Pakistani

Bangladeshi Any other Asian background

Black or Black British

Caribbean African

Any other Black background

Other Ethnic Groups Chinese

Any other ethnic group Not Stated Not Known

37

Table 18 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ BEH

Ethnic Group BEH BEH S136 Profile

BEH Population Profile

Crude Ratio of Disproportionality

White 86 55.13% 62.09% 0.9

Mixed 11 7.05% 5.51% 1.3 Asian or Asian British**** 8 5.13% 13.53% 0.4

Black or Black British 27 17.31% 13.96% 1.2

Other Ethnic Groups 24 15.38% 4.92% Total 156 **** Chinese ethnic sub-‐group removed from Other Ethnic Group and placed into Asian or Asian British Ethnic Group to align with ONS Census Data 2011

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00%

BEH S136 Proiile

BEH Population Proiile

38

Table 19 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ C & I

Ethnic Group C & I C & I S136 Profile

C & I Population Profile

Crude Ratio of Disproportionality

White 67 56.30% 67.20% 0.8

Mixed 15 12.61% 6.02% 2.1

Asian or Asian British** 23 19.33% 12.77% 1.5


Other Ethnic Groups 13 10.92% 3.61% -‐

Total 119 ** Chinese ethnic sub-‐group removed from Other Ethnic Group and placed into Asian or Asian British Ethnic Group to align with ONS Census Data 2011

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

White Mixed Asian or

Asian British

Black or

Black British

Other Ethnic Groups

C & I S136 Proiile

C & I Population Proiile

39

Table 20 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ CNWL

Ethnic Group CNWL CNWL S136 Profile

CNWL Population Profile

Ratio of Disproportionality

White 217 64.20% 52.17% 1.2

Mixed 9 2.66% 4.67% 0.6





0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00%

CNWL S136 Proiile

CNWL Population Proiile

40

Table 21 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ E London

Ethnic Group E London E London S136 Profile

E London Population Profile


White 75 41.44% 42.23% 1.0

Mixed 14 7.73% 4.96% 1.6





0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%

E London S136 Proiile

E London Population Proiile

41

Table 22 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014 -‐ NELFT

Ethnic Group NELFT NELFT S136 Profile

NELFT Population Profile


White 152 66.09% 59.33% 1.1

Mixed 8 3.48% 3.96% 0.9





0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00%

NELFT S136 Proiile

NELFT Population Proiile

42

Table 23 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, OXLEAS

Ethnic Group OXLEAS OXLEAS S136 Profile

OXLEAS Population Profile


White 126 68.11% 76.62% 0.9

Mixed 3 1.62% 3.59% 0.5





0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%

OXLEAS S136 Proiile

OXLEAS Population Proiile

43

Table 24 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, SLAM

Ethnic Group SLAM SLAM S136 Profile

SLAM Population Profile


White 170 57.82% 55.03% 1.1

Mixed 5 1.70% 6.93% 0.2





0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00%

SLAM S136 Proiile

SLAM Population Proiile

44

Table 25 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, SWLSTG

Ethnic Group SWLSTG SWLSTG S136 Profile

SWLSTG Population Profile


White 172 76.44% 74.55% 1.0

Mixed 8 3.56% 4.29% 0.8





0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%

SWLSTG S136 Proiile

SWLSTG Population Proiile

45

Table 26 Formal detentions under the Mental Health Act 1983 Section 136 by Ethnicity, Aug – Dec 2014, WLMHT

Ethnic Group WLMHT WLMHT S136 Profile

WLMHT Population Profile


White 82 55.78% 54.27% 1.0

Mixed 8 5.44% 4.58% 1.2





0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

WLMHT S136 Proiile

WLMHT Population Proiile

Documents

Performance Information S136 + AWOL 8 April 2015 · ThedatafortheperiodJun –!Aug!2014!was!inaccurate!and!has!been!omitted!!! TheMentalHealthCrisis! concordattargetisshownas aproposedaspirational