Our Bristol Community Rehabilitation Services team recently hosted a learning event to share their pathway and approach with colleagues from other areas of the country interested in developing similar services.
The team from Avon and Wiltshire Partnership Trust (AWP) and Second Step welcomed colleagues from rehabilitation services in the Black Country, Buckinghamshire, Berkshire, Swindon, London, Somerset and the Midlands to our Pennywell Road office recently.
After a brief overview of the Bristol context from Senior Operations Manager Chris Kinston and Consultant Psychiatrist Will Hall, colleagues from Bristol Community Rehabilitation Services shared their experience and expertise.
Key themes that emerged during the day were the power of collaboration, learning from one another and the value of community-focused approaches to rehabilitation.
Cohort & Pathways
Senior Practitioner Michelle Spikker and Consultant Psychiatrist Becky Sullivan gave an overview of the people who use our rehabilitation services and pathways. They presented an outline summary of the components of the pathway, including inpatient ward, community team, residential unit and out of trust team. Connections with other parts of local mental health services, especially referral and discharge pathways, were also highlighted.
Bristol Community Rehabilitation Service
Clinical Lead Psychologist Damian Taylor and Michelle Spikker told the meeting about who uses this service, who works in it, what it aims to help people with and the kind of evidence-based interventions it offers. They highlighted the essential value of working as a partnership voluntary sector and NHS service as being able to connect deeply with communities.
Recovery Navigator Elaine Lawlor and Occupational Therapist Emily Parker showcased some of the groups they run, including an allotment group and Forest Friday. Launched in partnership between Bristol Community Rehabilitation Service and the Forest of Avon Trust, Forest Friday is an opportunity for clients to benefit from being in nature.
“Our aim with these groups is to reduce isolation and give people a sense of purpose and hope,” said Emily. “Groups like Forest Friday and the allotment group lend themselves to less formal styles of communication that clients often appreciate.”
“It’s always good to see people who have been disengaged for so long connect with others through nature,” added Will.
Wellbridge House
Service Manager Gaelle Carrera introduced Wellbridge House, a residential unit where people are encouraged to work in equal partnership to identify and build on their own strengths and hopes.
People who are ready to participate receive tailored support, to help ensure their stay is a meaningful part of their ongoing recovery. Everyone receives their own personal recovery plan, where they can document their progress and feelings.
“We’ve tried to make Wellbridge House as much like a home as possible and have developed our own identity over time,” said Gaelle. “We have community meals and invite residents to shop and cook together. We also run therapeutic workshops including yoga and mindfulness, and expressive art sessions that are led by a Peer Recovery Navigator and Volunteer.”
Gaelle was joined by clients Tom and Oli, who each shared their experiences of Wellbridge House.
“My experience was the best I could have had,” said Oli. “I was at Wellbridge House for two years. I moved there because I’ve got bipolar disorder and needed to move out of my mum’s house. Everyone there was fantastic, helping me to learn skills like budgeting, cooking and helping me work on my relationships with my mum and my sister. My experience with Wellbridge House has made me realise I want to become a mental health worker. I want to help people. I want to save lives.”
Alder Ward & inpatient pathways
Ward manager Kyla Padfield and senior nurses Matt Jones and Brin Davies introduced the service and shared some pictures of the ward. Run mostly as a Bristol service, but with some patients from North Somerset and South Gloucestershire, Alder Ward has 10 beds and offers high dependency inpatient rehabilitation to men and women. People typically stay between three to six months to try to minimize the risk of institutionalisation, but sometimes longer stays can be helpful.
Most people come from acute psychiatric wards with the majority on treatment orders. The ward works closely with the Community Rehab service and Wellbridge House, with about half of people who go there discharged to these services. There is a strong ethos of personalised care, multidisciplinary assessment of needs, positive risk taking and support towards sustainable community care that prevents future admissions.
Out of Trust Pathway
Social Worker Luca Bartozzi gave an overview of the Out of Trust pathway approach that’s been in place since 2021 for Bristol, North Somerset and South Gloucestershire. This covers all people who might need or are using very high dependency inpatient rehabilitation wards, which are not provided locally by the NHS, and can be many miles away from home.
There are two parts to this. A bimonthly professional’s forum made up of clinicians and managers from across the system review referrals for this provision and then monitor people’s progress and outcomes in these wards. Working in tandem, a small team of clinicians engages with people who have entered this pathway and work proactively to help return them to their community. So far this approach has significantly reduced the number of people in the pathway.
The day closed with a group of around 30 discussing the key attributes of rehabilitation services with a lot of interest in partnership working. There were some real-world discussions about the barriers to developing services and the importance of making the financial argument. There was also interest in the active approach to generating referrals that we use in Bristol.
To sum up the event, Will said:
“It has been great to get together with so many colleagues from across the country to share what we have in Bristol and think together about how we continue to improve our services. I’m struck by how modern rehab services can support the rest of the mental health system by helping people who often get stuck in acute pathways. By working intensively with them on person-centred goals, we can help them to achieve sustainable recovery.”
Find out more about Bristol Community Rehabilitation Services.