Published: 05/08/2004, Volume II4, No. 5917 Page 5

Only half of the 335 mental health crisis resolution teams required by the NHS plan to be set up by December 2004 are in place, HSJ can reveal.

With just four months to go until the key deadline for mental health services arrives, a Department of Health spokesman revealed that just 175 teams are now in place.

And he admitted that meeting the December target presented a 'challenge' to the service.

The government now appears to be focusing on encouraging the service to meet a more ambitious - but later - deadline. The December 2005 target demands that the NHS will be able to offer 24-hour crisis resolution to every patient requiring it.

The planning framework and targets published last month for 2005-08 makes no mention of the December 2004 target in its list of commitments to be achieved before March 2005. However, a DoH spokesman insisted the target remains in place.

The multidisciplinary teams aim to offer an alternative to hospitalisation through diagnosis, treatment and intensive support at a patient's home until a crisis has been resolved. The teams should be made up of consultants, nurses, support workers, occupational therapists, service users, development workers and administrative support.

Charities Rethink and the Sainsbury Centre for Mental Health expressed concern about the lack of progress towards the target. Rethink blamed the lack of cash available for organisations to set up the teams when they had historic debts to deal with. An SCMH spokesman expressed concern about the quality of the teams likely to be set up, saying it seemed likely that some trusts would 'nominally' hit the deadline by introducing crisis teams that were not 'fully functioning'.

Nottinghamshire Healthcare trust chief executive Jeremy Taylor claimed his trust was on target to meet its quota of teams by December. But he agreed that ensuring teams were genuinely multi-disciplinary was a greater challenge. He said trusts needed to be 'pragmatic' in their approach to filling vacancies on the multi-disciplinary teams. Mr Taylor said trusts should be 'flexible in implementing the scheme while maintaining fidelity' [to the crisis resolution mode].

Although Mr Taylor said he did not believe the DoH was 'fudging' the targets so that national failures on the 2004 target could be ignored, he said it was welcome that 'strategic health authorities have been able to agree flexibility' about the precise models of teams set up as well as about the timing.

County Durham and Darlington Priority Services trust chief executive Sandy Taylor (no relation) said he expected his trust to have its three teams fully functioning by the end of March 2005 - three months after the set-up deadline, but ahead of the final December 2005 deadline.

He said it was important to have a set-up deadline and a later access deadline due to the complexity of the new system.

'This system required significant changes - staff who were providing mainstream community or existing inpatient services have had to be given time to bed in - but it has already had an impact on inpatient admissions.

We are moving into a new, smaller mental health unit due to the success of crisis resolution.'