Aneurin Bevan University Health Board
People with severe and complex psychological needs face many disadvantages - including reduced life expectancy, inadequate access to treatment, barriers to employment, and stigma. Individuals presenting with emotional dysregulation with associated high levels of risk can be placed outside Aneurin Bevan Health Board (ABUHB) for intensive residential treatment (including low-secure placements) and can be challenging to repatriate – often resulting in hospital admissions away from home for many years.
Experiences collected from service-users and staff across ABUHB indicated a gap in skilled, flexible community provision that provides intensive, socially and vocationally orientated services which can respond to rapidly fluctuating needs, flexibly and consistently. The identified need was for a service which would reduce the cycle of service-use and enable individuals to live meaningful, fulfilled lives in their own local communities.
The Bespoke Repatriation Service (BRS), an innovative partnership project with United Welsh Housing Association (UW), was commissioned and developed to repatriate individuals with long-term, complex, mental health problems, in high-cost, out of area placements. A stakeholder group was formed, including a range of professionals within the division, experts by experience, and family members.
ABUHB encouraged bids from third sector providers for a tender offering an innovative repatriation model. The team was recruited and trained jointly by UW, the Hiraeth Team (ABUHB), and service-users – including individuals who had experienced low-secure placements, and individuals using the BRS.
The service has been continually evaluated, with UW providing detailed quarterly reports. Eight individuals have been supported to acquire their own tenancy, and to move from lengthy hospital admissions to living independently in the community. Six of these individuals remain living independently in the community, without having experienced further hospital admission.
Clare Sandford
clare.sandford@wales.nhs.uk