Neighbourhood Liaison & Diversion

The evaluation of the Neighbourhood Liaison and Diversion intervention commenced in September 2018 following an extensive stakeholder consultation exercise in January 2018. University of Plymouth worked alongside partners in Devon and Cornwall Police, Devon Partnership NHS Trust (DPT) and Cornwall Partnership NHS Foundation Trust (CFT) to develop a service evaluation plan. The service evaluation was approved by the University of Plymouth Faculty of Health Research Ethics and Integrity Committee, and was registered with DPT and CFT Research Development Departments. The first stage of the evaluation was conducted from September 2018-March 2019 to support the early set up and implementation of the intervention. The second stage of the evaluation was conducted from September 2019-January 2020, with the evaluators based in Sentinel Healthcare, to feedback later stage implementation issues and patient experience of the intervention.

Aims

This service evaluation aimed to provide timely, formative recommendations for the refinement, and development of the new service model. We focused on the mechanisms that are most effective, how the service could be improved and collected and interrogated available data to define how the new service works.

The service evaluation aimed to:

  • define key operational components and activities within the service
  • identify facilitators to service implementation and delivery
  • identify barriers to service implementation and delivery
  • identify potential improvements to service delivery
  • understand perceptions of key stakeholders, including service users, police officers and mental health professionals delivering the interventions.
  • understand how the service is being implemented on the ground.

Findings

The service user data presented above shows the impact of effective delivery of the intervention. Relational continuity, partnership working, focus on the development of trust and working alongside the individual all contribute to enhancing outcomes for those to whom the intervention is delivered. Furthermore, a clear referral process, colocation and regular attendance at appropriate operational police meetings enhance the number and quality of referrals. The following sections present four categories of recommendations to enhance implementation and delivery of the intervention, including recommendations for intervention implementation; intervention delivery; project coordination and evaluation and monitoring.

Intervention implementation

Regular operational team meetings with representation from delivery teams (including management and practitioner representatives), project coordinator, service managers and evaluators. Operational meetings should meet regularly throughout delivery, with particular attention to ensure greater frequency of meetings in the early implementation phase to support early organisational communication strategies and referral processes.

  • Delivery teams to develop working relationships with Neighbourhood Officers through (i) colocation and (ii) identification of and attendance at appropriate operational meetings to (i) enhance referrals and (ii) enhance partnership working with patients.
  • Inclusion in training/intervention communication for all police officers to consider if a NL&D referral is appropriate in all interactions with individuals regarded as vulnerable.
  • Timely availability and assurance of funding in order to recruit staff to posts.

Intervention delivery 

  • Development of an intervention delivery platform including an intervention manual and specific intervention training to ensure:
    (i) parity of understanding of inclusion/exclusion criteria; aim of the intervention
    (ii) practitioners are able to make use of the full range of the intervention
    (iii) parity of provision across sites.
  • Clear, straightforward referral process through central team email in order to:
    (i) assess criteria
    (ii) allocate practitioner
  • Where possible and appropriate, joint working should be conducted with individuals with both intervention practitioners and neighbourhood officers
  • Time taken to develop trust with the individual (through taking time; showing kindness and non judgemental) by intervention practitioners, STR workers and police officers working with the intervention, should be a core component of the intervention.

Project coordination

  • Jointly commissioned project/intervention manager to coordinate early implementation across both mental health and police services
  • Regular points of monitoring of referral numbers, intervention activity and outcomes in order to troubleshoot barriers to implementation/delivery

Research/evaluation and monitoring

  • Development of an agreed common dataset to support monitoring of referrals, intervention activities and outcome
  • Regular monitoring of intervention fidelity to ensure that the intervention is delivered as intended.
  • Secure research funding to:
    (i) test and refine the proposed theory of change (ie how the intervention is proposed to work) represented in the draft logic model
    (ii) test the effectiveness of the intervention in terms of; increasing access to appropriate care/services, enhancing mental health and wellbeing of patients and reducing police contact.