NHS England accused of ‘massive betrayal’ over police-led SIM scheme

NHS England has been accused by campaigners of a “massive betrayal” as it appeared to shelve a long-awaited policy to safeguard mental health patients accessing emergency care.

A policy to protect patients from the controversial Serenity Integrated Mentoring (SIM) scheme was signed off by senior figures at NHS England and the NPCC in January before its publication was delayed indefinitely last week with no explanation, according to campaigners spoken to by Liberty Investigates.

Users of mental health services have been working alongside clinicians with NHS England since December 2021 on a review of SIM, a programme that sees officers embedded with health teams to help manage patients who persistently call emergency services.

The scheme was rolled out six years ago but criticised by clinicians and patients, including the group StopSIM which voiced concerns police officers were helping draw up plans for patients, many at high risk of self-harm, instructing A&E, ambulance, mental health services and police not to treat them for fear of reinforcing “attention seeking” behaviours.

NHS England’s mental health lead Tim Kendall wrote in May 2021 that SIM appeared to have “no evidence base” and asked NHS Mental Health Trusts to submit reviews.

Some of the reviews, obtained by FOI last year by Liberty Investigates and the Observer, revealed serious misgivings within trusts, including one stating there was “no reasonable way to defend” it.

Yet other information, also obtained by FOI, suggested the model was still in use. In response to questions from reporters, three trusts and four police forces said they still had patients on SIM.

StopSIM said it began working with NHS England in December 2021 to create a policy designed to safeguard patients and reduce the risks of SIM-type models.

According to spokespeople from the group, the policy was agreed in January this year, along with an accompanying statement in which NHS England accepted responsibility for the roll-out of SIM.

StopSIM said NHS England’s refusal to publish either the policy or the statement is a “massive betrayal” and that they feared their cooperation had been used by NHS England as a shield from criticism.

“People will continue to be harmed if there isn’t robust action. People continue to suffer under these models. It’s devastating for service users,” a spokesperson said.

Amy Wells, communications manager at the National Survivor User Network (NSUN), said she hopes the policy and statement will still be published. “NSUN is incredibly disappointed by the decision not to publish this important policy that members of the StopSIM coalition have dedicated so much time and energy to, already facing significant delays and barriers along the way,” she added.

Andy Bell, interim chief executive of the Centre for Mental Health, said: “It is vital that people experiencing acute distress get compassionate support without the use or threat of coercion.

“The SIM model was extended nationwide without adequate proof that it was safe, acceptable or effective. The NHS needs to ensure that it puts people’s safety and wellbeing first, and that it listens to the views and concerns of people who use services when making changes to the ways they work.”

StopSIM say they will not participate in further policy development with NHS England, but will reboot their campaign and continue to call for the publication of the policy and the implementation of reforms for the welfare of patients.

In response to the comments, NHS England told Liberty Investigates it will write to all NHS trusts making clear “SIM or similar models must no longer be used” and that it will work with trusts to ensure issues raised by StopSIM are “eradicated”.

“We are grateful to the StopSIM coalition for initially highlighting concerns about the SIM model, for giving these concerns a platform via their campaign and also for the time they have put into assessing the model and making constructive proposals for change,” said a spokesperson.