Status and development of critical incident stress management services in the United Kingdom National Health Service and other emergency services combined: 1993-1996

Surveys conducted amongst members of the Association of NHSOccupational Physicians indicate few changes in the status anddevelopment of Critical Incident Stress Management Services(CISMS) in the United Kingdom National Health Service between1993 and 1996. Limited CISMS are confirmed by the majority ofrespondents in the two surveys with developments having typicallyoccurred within long-established staff care services such ascounselling. In 1996 NHS provision is typically based on theindependent use of own resources. A 1996 comparison of NHS withpooled returns from Ambulance Services, Fire Brigades and SocialServices Departments indicates few variations in status, provisionand levels of expertise in the delivery of CISMS. Other emergencyservices co-operate to a greater extent with each other thandoes the health care sector. Occupational Health Departmentresponders confirm availability of expertise resources to provideCISMS, but low priority status frustrates delivery of CISMS.Survey results indicate the NHS is at risk of not fulfillingits duty to care for staff after major incidents. The establishmentof regional centres of CISMS excellence with local and nationalresponsibilities is advocated.