Women's Mental Health/Personality Disorder - blended secure service

St Andrew's Healthcare is one of three hospital sites chosen by NHS England to pilot a Women's Blended Secure Service. Negating the need for secure transitions between medium and low security levels, our blended service aims to reduce people's length of stay by providing an innovative model of care on one ward environment. The service intends to offer a better experience for patients with a clear emphasis on recovery and progression.

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Designing the service

"I believe that if I hadn't gone from one hospital to another, where I had to start my story from the beginning, I believe that my length of stay would have been a lot less."

Sue Denison, Expert by Experience

This service was co-produced with patients and experts by experience. To find out more about the value of a blended approach watch our videos below featuring Sue who tells her own story of navigating secure care and a clinical perspective on this model.

Admissions criteria

Our blended service is appropriate for adult women including transgender who are 18 years+:

who require a secure physical framework
with diagnosis that includes mental illness, personality disorder, complex trauma, post traumatic stress disorder (PTSD), substance misuse, borderline intellectual disability
with a forensic history
with complex needs, who pose a significant risk to themselves or others.
women likely to require prolonged and intensive support and stabilisation will initially be considered for our Sunley medium secure service, before transition into this blended service.

We accept referrals from across England with approval from the local Leicestershire and Lincolnshire Area Team. The service is only available to NHS England patients.

Service aims and objectives

By blending our medium and low secure services we aim to:

significantly reduce inpatient length of stay by removing the transition from medium to low secure services
provide women with a more progressive clinical experience through a new, trauma informed/relational security operating model
improve our discharge process and effectiveness, increasing the number of women able to discharge directly from a secure environment into community accommodation.

A number of measures have been developed with NHS England to measure every aspect of the service, helping us to understand the impact of this model of care. The measures will include:

mental and physical health
patient experience
functional and living skills development
social and family networks
discharge destination and length of stay.

More information

Womens Blended Summary

Wards

There are three wards in our blended women's service:

Willow

Bracken

Maple

All three wards are located within FitzRoy House in our Northampton hospital.

An innovative care model

To achieve the ambitious aims and objectives of the service, an innovative care model has been co-produced by patients and experts by experience. This has resulted in a trauma informed and responsive relational security model of care with a focus on recovery and progression.

This bespoke treatment programme encourages self-care and self regulation for women in secure settings to understand and manage the difficult emotions they experience in the early stages of their treatment and preparing them for their next step. Therapies are adapted to specific needs and may include:

dialectical behavioural therapy (DBT)
cognitive behavioural therapy (CBT)
understanding trauma
building life and community skills
feeling safe and being safe.

Service Summary

Click HERE for a one page summary of this new service

For further information contact Mr Hugo Nel, Consultant Clinical Psychologist: HNel@standrew.co.uk

Discharge Planning

Using collaborative and partnership working, the Blended Service will work with Home Area Teams to reduce people's length of stay.

A working group including the patient, their family, carers, the Home Area Team and the care team will, from the point of admission, ensure that a clear care and discharge plan is developed. It is anticipated that the majority of patients from the Blended Service will transition to suitable community accommodation and an Outreach Team, comprised of family and carer liaisons, community mental health teams and crisis planning and support networks, has been created to ensure that we achieve this objective.

Where suitable accommodation is unavailable locally, we will work to develop community packages with the relevant local team.