Freedom of Information Request – Ref: 260-2024
Thank you for your recent Freedom of Information request. Please find our response below.
You asked:
Is FERN still operational and comprised of the same team members?
Our response:
FERN is still operational. We do have a police officer dedicated to supporting us for one day a week. Below explains what they do and how it is nothing like SIM.
The main FERN team are an assistant psychologist and lived experience practitioner who will co-create FERN plans with the individual. These are trauma informed, based on formulation about what helps and totally person centred. No trauma history is shared. The person decides what they think needs sharing to encourage responders to improve their responding.
There are caveats to FERN plans:
- The person will be identified as being ‘frequently engaging’ with blue light services (A&E, Ambulance, Fire or Police) and there are concerns that there may be unmet needs.
- If they want this plan – it is entirely optional.
- It is only shared with the agencies that the person wants this sharing with.
You asked:
If yes, is this not counter to NHS England’s position statement that police should not be involved in care?
Our response:
No our police officer is NOT involved in care. The FERN service places importance on the response network, not the person of concern. It is not about trying to change the actions of the individual who may continue to experience distressing periods of emotional overwhelm.
The emphasis is on the responding. We aim to reduce arrest, criminal sanction, use of restraint, and control over a person. We also aim to improve the compassion and confidence of the responders to use trauma informed approaches to try and improve the experience of people who may be regularly coming to attention of services. The role of the officer is largely to help us connect with the right people and to influence changes in practice more positively. Examples of this include:
Training by lived experience practitioners to all the Force Control Room call handlers. Presenting to the Police Professional Standards department, Vulnerabilities officers and safeguarding teams. Half day training also offered to all Paramedic, Nursing and Social Work students.
One of our latest achievements is making a film using 3 people who regularly experience life threatening distress. They talk to camera (although their faces are obscured) about how it feels to be suicidal and distressed. They discuss how good and bad interactions with police feel and impress on officers the importance of not overcrowding, not speaking loudly or pushing for answers when the person can’t even hear or process the question. This film is to be part of a whole local police training course and is intended to be shown to every officer.
Our police officer also visits people under FERN, if and only if they want this, and can then help shape police trigger plans accordingly. Sometimes just hearing the perspective of the police can be helpful. One example of this was a young woman we worked with who often self injured and police would turn up. She couldn’t understand why she was often met with hostility instead of compassion, making her more angry and likely to face arrest. A simple explanation by the police officer that they see a mentally unwell person with a bladed article and their first thought is about managing the episode from the perspective of a weapon. She was guided to tell responders that she has cut but here are her blades and she has no intention of harming anyone else. This worked really well. Her FERN plan included things like – talk to me about crystals, as this was an area of interest for her and would help her to ground. It was so effective that her police contact has been zero for the past 7 months and at it’s height there were as many as 27 incidents in a month.
We don’t aim to reduce crisis, but improve responding and this may in turn help reduce the distress people feel and enable more positive connections.
FERN has also helped people get housed, helped them improve their own understanding of what they can do at times of distress and improved relationships with services all round. Surprisingly one of the unexpected outcomes is better engagement with other services, possibly based on the patient, enduring approach we take to help people to feel safe with us.
You asked:
If no, what has replaced it and how has police involvement in care been “eradicated” as mandated by NHS England?
Our response:
As above – this is working more effectively with partner agencies and is part of a wider trauma informed intervention being steered by the complex emotional needs service in Gloucestershire.
- We run a successful family and friends course (12 weeks) also aimed at improving their responding to their loved ones and increasing compassion and understanding.
- We have a successful 3 day Multi Agency course – based on KUF – Knowledge and Understanding Framework – co-delivered with experts by lived experience.
- We coproduce everything we do and have also developed a 3 day a week open access therapeutic peer service using peer therapy. This again is jointly run with lived experience and operates as a mini therapeutic community.
Improving police, paramedic and hospital responses we believe is also paramount and the FERN service is something we are really proud of. We have run some data sets and found in a 6 month pre and post working with the FERN team that every measure representing control and restriction had reduced by 72-85%. Feedback from people who have FERN plans is very positive. They are person centred and get produced in the colours and shapes the individual chooses. Some keep them in wallets, bags, even the pocket of an assistance dog’s coat! They are usually laminated and the people report appreciating it when responders follow the plans set out. Blue light responders who have used them tell us they are helpful and easy to follow.
Next steps:
Should you have any queries in relation to our response, please do not hesitate to contact us. If you are unhappy with the response you have received in relation to your request and wish to ask us to review our response, you should write to:
Louise Moss
Head of Legal Services / Associate Director of Corporate Governance
c/o Gloucestershire Health and Care NHS Foundation Trust
Edward Jenner Court
1010 Pioneer Avenue
Gloucester Business Park
Brockworth, GL3 4AW
E-mail: louise.moss@ghc.nhs.uk
If you are not content with the outcome of any review, you may apply directly to the Information Commissioner’s Office (ICO) for further advice/guidance. Generally, the ICO will not consider your case unless you have exhausted your enquiries with the Trust which should include considering the use of the Trust’s formal complaints procedure. The ICO can be contacted at: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF.