Project Overview
An NHS Mental Health Trust with a 24/7 crisis line (1,400 calls/month) needed to build a digital crisis triage...
Technology Stack
Compliance & Standards
The Challenge
An NHS Mental Health Trust with a 24/7 crisis line (1,400 calls/month) needed to build a digital crisis triage platform — providing structured safety assessment tools, digital safety plans, and follow-up contact scheduling for service users in crisis. DTAC all 5 domains, DCB0129 (clinical safety in mental health crisis context — highest patient safety risk), NHS Safe Messaging guidance (Samaritans), UK GDPR Article 9 (mental health data — special category), and the NHS Long Term Plan mental health transformation requirements were mandatory. Budget: £90,000.
Our Approach
Clinical framework
NHS Crisis and Intensive Home Treatment (CIHT) standards, Columbia Suicide Severity Rating Scale (C-SSRS) digitised as structured assessment, and NHS Practitioner Health Programme acute risk criteria.
Assessment workflow
triage clinician completes C-SSRS on behalf of service user (not self-report in acute crisis), risk formulation structured (protective factors, risk factors, immediate safety need), and safety plan co-produced with service user.
Highest hazard
system unavailability during active crisis call — mitigated by: 99.9% uptime SLA with automatic failover, mobile-first design works offline for completed assessment forms, and paper backup protocol (printed on clinician workstation).
Second highest hazard
data loss of partially completed safety assessment — mitigated by: auto-save every 30 seconds, optimistic locking, and conflict resolution.
Samaritans Safe Messaging Guidelines
all text content reviewed against safe messaging standards (no method mentions, no glorification, focus on recovery).
NHS content design
- plain English (Flesch score >
- 60), no clinical jargon in service user-facing content, accessibility (WCAG 2.1 AA).
Peer review
all clinician-facing content reviewed by the Trust's clinical lead and a service user experience panel before release.
UK GDPR Special Category and Mental Health Data
Article 9(2)(h) basis: processing necessary for provision of health or social care.
Mental health data sensitivity
NHS DSP Toolkit Standard 1 mandatory, CQCC (Care Quality Commission) inspection readiness.
Data minimisation
only crisis assessment data collected — no historical record review in the triage platform (clinician accesses RiO/SystmOne separately).
Retention
8 years post-discharge (NHS mental health statutory minimum).
The Results
DTAC approved all 5 domains.
DCB0129 accepted first submission.
Platform live at 16 weeks, £82,000 — under budget.
Crisis safety plans created digitally: 94% of assessed service users (target: 80%).
Follow-up contact completion: 78% within 24 hours (pre-platform: 61%).
Re-contact rate (service user initiates further contact within 72 hours): 34% reduction.
CQC inspection: digital crisis pathway cited as outstanding practice.
WCAG 2.1 AA: zero non-compliances.
“CQC cited the digital crisis pathway as outstanding practice. 78% follow-up contact completion within 24 hours versus 61% previously — those 17 percentage points represent real people who received follow-up contact during the most vulnerable period. DCB0129 first submission accepted. The safe messaging review process was the most clinically important piece of the build." — Medical Director, NHS Mental Health Trust (name withheld)”
Project Details
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