Repeat attenders seem to be a permanent feature of A&E working life. FRANCES YULE describes why and how her team set up a protocol and care plans for their management

As a mental health development nurse working at Ipswich Hospital’s A&E department, my role involves assessing patients with mental health problems, providing bereavement support, staff support, and teaching and developing policies related to mental health. Over some time, I observed that several patients were attending the A&E regularly, often as a result of deliberate self-harm, alcohol misuse or social issues.