NSFT – A Warning from History: “Assertive Outreach was simply airbrushed out”

Pinocchio Muppet

NSFT claims to the EDP:

Has the trust taken on board the concerns about the scrapping of the Assertive Outreach Team? If so what has been done?

“Following the integration of the assertive outreach function into our adult community teams we constantly review how best we can support those who have severe and enduring mental health problems.

“This has seen the introduction of the Flexible Assertive Community Treatment model (FACT) in our community services, which allows teams on the ground to increase, within hours, the support a patient receives if they appear to be escalating, to avoid a crisis and need for an admission.”

A former senior clinician at Norfolk & Suffolk NHS Foundation Trust responds:

The Assertive Outreach Team (AOT)

It is factually incorrect to suggest this function was integrated into community teams. The AOT was simply airbrushed out.

If you check the minutes of the Central Locality Management Meeting in the summer of 2012, I raised concerns that the transition plan had simply failed to mention the AOT at all. I pointed out the fact we would be in breach of the National Service Framework for the prevention of suicide risk not to have it as a minimum as functioning within a community team.

People from the AOT had made presentations and representations to those responsible, there was no reason why those responsible for changes were not aware of the risks they were running in simply abolishing this provision. I was advised to discuss my concerns at the clinical governance meeting that same day. I did but despite assurances the service was simply dismantled gradually by redeploying the staff elsewhere.

At no time was the AOT function integrated properly into existing community teams. Further the report points published by the EDP makes it clear that the FACT model as implemented is not going to meet the needs of AOT clients since it requires that the patients need to be escalating their behaviour and at risk of admission to enable additional support – AO should be aimed at severely unwell people who are under the radar, so to speak, to prevent and reduce the risks of escalation, what is actually described is more like a crisis intervention.

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