Tuesday 28 October 2025
From October 2020 to March 2021 our trust initiated a pilot to improve access to mental health support for patients across Teesside. The pilot saw two mental health nurses working with 31 rural and urban GP surgeries. These are collectively known as Primary Care Networks (PCNs). During the first three months of the pilot, 670 appointments were held with 483 patients. Remarkably, only 19 patients required referral to more specialist mental health support. This demonstrated the effectiveness of early intervention. In addition, a review of referrals from GPs to our trust’s services led to some patients being returned to the care of their local surgery, supported by the mental health nurse. The pilot was prior to the national introduction of the NHS Mental Health Additional Roles Reimbursement Scheme (ARRS).
The pilot aimed to offer patients contacting their GP surgery with mental health concerns direct appointments with a mental health nurse. This includes concerns such as anxiety, depression, or difficulties following bereavement. These appointments could be face-to-face, by phone or online. They provided early support through brief assessments, signposting to appropriate services, and delivering interventions where necessary.
Following these positive results, the programme has been embedded across Tees Valley and Durham, with roles part-funded by PCNs and our trust. This gives patients mental health support as part of the GP team, improving the speed and quality of care.
There are now over 51 practitioners working into 27 Primary Care Network’s across Tees Valley and Durham. This includes:
- nurse prescribers
- community mental health practitioners
- mental health and wellbeing practitioners
- SMI (severe mental illness) practitioners.
Our advanced practitioners and first contact practitioners have availability for over 60,000 appointments per year. Our first contact practitioners and advanced practitioners offer up to 15 20-minute appointments per day. There are also up to 9000 appointments available with our mental health and wellbeing practitioners and SMI practitioners.
Reducing barriers and empowering patients
The new model allows for rapid access to specialist advice. This is often without the need for an initial GP consultation or a lengthy referral process. This means patients do not have to repeat their experiences, making the process less daunting. Where mental health nurses are qualified as non-medical prescribers, they also review patients’ long-term medications and can adjust these where appropriate, further personalising care.
The mental health nurses update patients’ GP records, providing instant access to appointment outcomes and agreed next steps. They also offered guidance to reception and clinical staff, ensuring patients are directed to the right appointments and support.
Laura Cattermole, programme lead for mental health practitioners in Teesside’s primary care networks, said: “Having mental health nurses available as part of the GP surgery team just makes sense – mental and physical health can be very interlinked. Many people contact their GP with mental health concerns including anxiety, low mood, hearing voices, depression and concerns following life events such as bereavements and relationship breakdowns. Through the pilot, the GP surgeries have been able to make sure patients get the support they need much quicker. For many patients, a chat with the mental health nurse can point them in the right direction of self-help resources to build coping strategies and resilience. For others, it might be signposting to the right service to support their needs or, for some, where needed, the nurses can offer interventions and medication reviews.”
Supporting GP surgeries and reception teams
The trust worked closely with PCNs to introduce mental health practitioners into GP surgeries.
Faye Nesbitt, team manager, said: “We know that a large proportion of cases seen in GP surgeries can involve mental health needs. This can take up a considerable amount of GP time.
“The practitioners can see people with a severe mental illness or complex emotional needs who are too complex for talking therapies but do not meet the thresholds for secondary care services.
“They can also reduce the need for referrals to secondary mental health services. This is by offering early interventions and working with other services and community-based organisations to address people’s wider needs and to provide alternative support.”
Feedback from both GPs and patients has been positive. One patient shared that their “problem was almost resolved immediately in a simple but highly practical and helpful 20-minute telephone consultation”. Another said: “I was listened to and the medication is working well, still early days but I feel so much better.”
GPs welcome enhanced support
Dr Jen Standen, GP Partner and Practice PCN Clinical Lead at Parkway Medical Centre, commented: “Having a mental health nurse as part of our general practice team has been fantastic. Our patients really value the care and additional support she provides, and they often tell me how much her input has helped and supported their recovery journey. It has been great working together with TEWV to help support patients to access the right care, in the right place sooner.”
Dr Kate Harvie, Senior Partner at Hillside Practice in Skelton, says: “I was very excited to hear about the mental health pilot in practices when it was first mentioned, and was keen to have this take place in my own practice at Hillside in Skelton. We were fortunate to have a mental health practitioner with us during the pilot for one day a week for just over three months. Patients were able to book an appointment directly with her and she was also available to the GPs to ask for advice. As well as being highly appreciated by patients, this was helpful if GPs were considering a referral, because the mental health practitioner would be able to assess the patients really quickly and often provide the same kind of advice that patients would have had after a referral and a wait to be seen in an unfamiliar location. I am really pleased that after the completion of the pilot this is going to be made into a permanent arrangement.”
A patient’s view
Jayne received support from Heather, a mental health and wellbeing practitioner working in the Tees Valley Primary Care mental health team. She explains: “When I first accessed the service I wasn’t in a good place. Then I met Heather. As we built a rapport, I found it so easy to talk”
Walter, who also receives support from Heather added: “I feel relaxed using the service. We meet in a neutral place and talk on a one-to-one basis. I’ve found my mental health has stabilised and remains buoyant.”
Looking ahead
The success has set a benchmark for integrated mental health support in primary care. It demonstrates that having mental health nurses within GP surgeries improves patient outcomes and eases pressure on GPs.
Strengthening our primary care services will help our trust transition certain mental health services from secondary to primary care. The change will place more specialist staff in GP practices for early intervention, brief support, navigation, and medication reviews. This will support in delivering a neighbourhood place-based model of care. We aim to make mental health support more accessible and effective by making support available at the first point of contact. This streamlines patient pathways, reduces service duplication and administrative burdens, and fosters closer collaboration between primary and secondary care. Ultimately, we want to build on recent improvements to create a more responsive mental health system for local communities.
