London Mental Health Crisis Hubs Evaluation Summary

December 19, 2022

In the first wave of the Covid-19 pandemic, London NHS mental health trusts put in place mental health crisis hubs to provide safe access to mental health crisis care without having to attend an accident and emergency (A&E) department. 

A mental health crisis hub is a service for people who are experiencing mental health crisis, who would otherwise have to go to A&E. Mental health crisis hubs are not designed for people who need urgent care for physical medical conditions. People who need urgent physical healthcare will usually have to go to A&E to be treated initially. 

Each mental health crisis hub was set up in a different way. This is due to the different population needs in each location.

In February 2022, NHS England and Improvement (NHSEI) London asked the Health Innovation Network to complete an evaluation with three aims. 

  1. To better understand the different mental health crisis hub models and their impact at a service user, carer, medical professional, and service-level across London. 
  2. To find out what factors affect the roll out and sustainability of NHS mental health crisis hubs.
  3. Find out the core requirements for mental health crisis hubs to be effective for Integrated Care Systems (ICSs) and Integrated Care Boards (ICBs) to use as an alternative to Accident & Emergency (A&E).
Therapy session

Key terms

  • Heath Innovation Network (HIN): The Academic Health Science Network (AHSN) for south London. It is one of 15 AHSNs across England. An AHSN connects NHS and academic organisations, local authorities and third sector and industry, in order to increase innovations across large populations quickly. 
  • UCLPartners (UCLP): AHSN for North London to the Essex coast. It is another one of the 15 AHSNs across England (like the HIN). 

Evaluation findings

Although it is relatively early in the lifetime of the two hubs that allow direct access (CANDI – St Pancras Hospital and NELFT – Goodmayes Hospital, which were set up around the Covid-19 pandemic two years ago), the evaluation shows that both hubs are providing a timely service that enables service users and carers to be seen on arrival by a mental health professional.

These hubs are seeing more people going directly to the hub themselves, rather than being referred by other services. The majority of service users who provided feedback said that they felt safe, had privacy, and were treated with kindness and respect by staff who had a good understanding of mental health. However, service users, staff, carers and stakeholders also gave their opinions on how the crisis hubs could be improved.

Key findings

Where possible and relevant, we have compared mental health crisis hubs to hospitals providing support via the traditional A&E route (the business as usual, or BAU, model). 


The recommendations below are intended to inform the key factors of an effective mental health crisis hub. A full list of 22 recommendations is available in Section 8 of the full report. 

  1. Mental health trusts should continually improve services using the London Mental Health Crisis Hubs Assessment Framework with the six key quality areas – Safe, Timely, Effective, Efficient, Equitable and Person Centred.


  1. Mental health trusts need to collect and report safety data. 


  1. Mental health trusts should make sure mental health crisis hubs are easy to reach and are accessible. 


  1. Mental health trusts should consider having staff trained in physical health, alongside mental health professionals within the hub. 
  2. Mental health trusts should understand what happens following discharge to improve care for service users and their carers within the community. 
  3. Mental health trusts should gather regular feedback from mental health crisis hub staff for continued improvement. 


  1. Integrated Care Boards should communicate to the public, service users, carers and service providers on how to be referred and access the mental health crisis hubs directly. They should communicate this through a variety of methods, eg posters, leaflets, email, texts and websites and should include why a person may be transferred from A&E to a mental health crisis hub. 
  2. Mental health trusts should consider developing a direct access route to mental health crisis hubs so people do not need to go to A&E first.  


  1. ICBs to engage with the local community to ensure equal access to mental health crisis hubs for all.
  2. ICBs to have culturally relevant discharge support services.
  3. Mental health trusts to improve recording of service users’ ethnicity and sexual orientation. 
  4. Mental health trusts to give service users of all races and ethnicities the chance to feedback (in line with the Patient and Carer Equality Framework).

Person Centred

  1. Mental health trusts should apply effective methods for regular feedback from service users and carers on their mental health crisis hub experience to drive continual improvement. 
  2. Mental health trusts should continually train staff to improve patient care. Where possible they should involve service users and community services in the design and delivery of this training.

This page was co-created with experts by experience – people with real-life experience of health and care services – to help make the report findings accessible to all.