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New guidance on psychosocial and mental health care

9 November 2018

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New guidance on psychosocial and mental health care for pre-hospital care practitioners and first responders

Edinburgh/Birmingham - 09 November 2018

Recent events, such as the terrorist attacks in Manchester and London; the Grenfell Tower fire; the increase in knife crime; flooding and other effects of severe weather highlight the increasingly demanding role of everyone who is involved in pre-hospital care. The Secretary of State for Health in England, Matt Hancock, speaking to The Telegraph newspaper on 23 September 2018, talked about how, although there had been positive changes in how society perceives people with mental health problems, this had not yet found its way into supporting clinicians working on the frontline who face traumatic events in the course of their work.

Pre-hospital care is a well-established branch of medicine, delivered by a broad range of practitioners including first aiders, ambulance staff including paramedics, doctors and nurses as well as by other first response organisations including police, fire, mountain rescue and the RNLI.

The Faculty of Pre-Hospital Care (FPHC), at The Royal College of Surgeons of Edinburgh ( ), Britain’s oldest surgical Royal College, is launching a new project to develop practical guidance for paramedics, doctors, trainee doctors and nurses who work in pre-hospital care. The guidance will improve detection, prevention and alleviation of psychosocial and mental health problems among colleagues, as well as patients.

Two groups will be responsible for delivering the project. One will produce guidance describing the nature and impact of distress as it affects people working in pre-hospital settings and how to meet better the psychosocial and support needs of these practitioners. The guidance will be tailored to professional responders who are likely to be first at the scene of any situation.

The other group will develop guidance to help staff support patients whose behaviour is causing concern, and which may indicate mental disorder or substance misuse, or who are threatening to harm themselves in pre-hospital settings.

A major part of the project is to disseminate and implement the guidance developed.

Professor David Lockey, Chair of the FPHC, said:

“The Faculty is aware of the emotional labour that working in pre-hospital settings necessarily creates. Sadly, recent events, such as the terrorist attacks in Manchester and London, knife attacks ,the Grenfell fire and the tram crash in Croydon, have emphasised the importance of us providing leadership in this area, but the day-to-day toil involved in responding to more common emergencies is also demanding. The Faculty wants to ensure that it can give the best possible support to practitioners of pre-hospital care by providing guidance on improving the care of practitioners themselves, including doctors, trainee doctors, paramedics and nurses, as well as offering guidance regarding the management of patients who may be of concern to staff.”

Professor Richard Williams, currently the Adviser on Disaster Management to the President of the Royal College of Psychiatrists, will direct the project. Professor Williams said:

“The project, which is based on appropriate current scientific evidence, best clinical and managerial practice and emerging guidance, will learn from recent emergencies. We are keen to engage practitioners in contributing their knowledge and experience to developing the guidance as well as its dissemination and implementation. To this end, we are establishing two project delivery groups.”

Dr Andrew Wood, a senior trainee in anaesthetics who has completed training in pre-hospital emergency medicine, said:

“Increasingly, we aware of the challenges and risks posed to the health of staff who respond to emergencies and crises.  We aim to produce up-to-date guidance to help organisations offer better support to their frontline staff.  Central to this is our awareness that fulfilled and healthy staff provide compassionate, high-quality care for their patients. Our guidance is important; it will help healthcare providers meet their duty to care for the wellbeing and mental health of staff who respond to emergencies, as well as reinforcing our commitment to compassionate care for everyone.”

Professor David Lockey said:

“We want this project to provide a sound basis for delivering high quality, consistent, evidence-based care and support for practitioners who work in pre-hospital environments.”

The project launched in September 2018 and will run over a period of two years.


Notes to editors

Psychosocial: this adjective refers to the psychological, social and physical experiences of people in the context of particular social, cultural and physical environments. It describes the psychological and social processes that occur within and between people and across groups of people.

Mental health care: refers to delivering biomedical interventions from which people who have mental disorders may benefit. Usually they also require psychosocial care as a platform on which their mental health care is based.


Source: Williams R, Kemp V. Psychosocial and mental health care before, during and after emergencies, disasters and major incidents. A chapter in C Sellwood, A Wapling, (eds). Health Emergency Preparedness and Response. Oxford, England: CABI International; 2016.




About The Faculty of Pre-Hospital Care

The Faculty of Pre-Hospital Care covers medicine practised by a broad range of practitioners from first aiders, paramedics, doctors, nurses, first responders, voluntary aid workers and remote medics including multi agency teams such as police, fire and armed forces. The Faculty's aim is to set and maintain clinical standards for all practitioners in this evolving specialty by promoting the highest quality education and teaching and effectively integrating the efforts of all participants.

The FPHC is part of one of the oldest surgical corporations in the world, the RCSEd ( Established as the Barber Surgeons of Edinburgh in 1505, and with a membership approaching 25,000 in over 100 countries worldwide, it is home to the UK’s only Faculty of Surgical Trainers, open to all those with an interest in surgical training regardless of College affiliation. Other faculties include the Faculty of Dental Surgery, Faculty of Dental Trainers, Faculty of Perioperative Care, and Faculty of Sports and Exercise Medicine. With 80% of the College’s UK membership based in England and Wales, a new UK office opened in Birmingham in 2014, followed by a third in Malaysia in 2018 to enhance its international activities.

The College is based at Nicolson Street, Edinburgh, EH8 9DW and can be reached on 0131 527 1600 or

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For media enquiries contact Tingy Simoes or Philippa Short on 020 7549 2863 or




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