Delivering a Safe Haven amid the Five Year Forward View

This week marks the first anniversary of the launch of the NHS Five Year Forward View (5YFV) and progress on its delivery will feature as part of NHS England’s Annual General Meeting tomorrow.

Three main planks of the 5YFV involve prevention, new models of care and efficiency. One year on from the publication of the FYFV, 50 Vanguards across England are taking a lead on developing new care models which will act as the blueprints for the NHS and care system of the future.

North East Hampshire and Farnham Vanguard is among the first to be selected.

Dr Andy Whitfield, chair and clinical lead of its Clinical Commissioning Group, describes how their Safe Haven Café – designed with patients and partners – has proved a success, in some cases a lifeline for people in a crisis.  It has also helped to reduce the need for people to be admitted to hospital and is being rolled out to children and other areas:

Who would have thought that a café could mean so much? This isn’t just any café though – this is the Safe Haven at the Time Out Café in Aldershot, Hampshire.

It’s the essence of what being a vanguard is all about – working collaboratively with partners on new models of care. Finding new ways to deliver services that meet the needs of those who use them. It’s breaking down barriers and boundaries.

So, what’s different about the Safe Haven? What does it do to make it so highly regarded by its visitors? Why is it a trailblazer?

To understand that we need to wind the clock back to 2012, when independent research was commissioned to find out why people in mental health crisis went to A&E.

These people said that, when times get rough, they wanted a physical place to go, out of hours, where they could get support and advice in a safe and friendly environment.

The Safe Haven was born as a direct result of this consultation with service users, carers, and statutory, primary and third sector providers – a textbook example of: ‘You said, we did’.

The Safe Haven opened its doors on March 31, 2014, as a pilot project. It operates from 6pm-11pm Monday to Friday, and 12.30pm-11pm at weekends and bank holidays – 365 days a year.

We’re providing much more than somewhere to go for a cup of coffee. We offer people – who frequently walk through the door in crisis or near crisis – somewhere safe to go regardless of where they live and whether or not they are known to mental health services.

No one is turned away. This is a service for people in the area not based on postcode or town. It’s for anyone in mental health need.

The onus is on providing individuals with the opportunity to learn about their own response to crisis and to develop self-management skills to break that cycle of crisis. However, if people prefer to sit alone quietly, without intervention from staff or peers, that is equally welcomed. The most important thing is that people know the café is there for them, however they choose to use it.

It’s no exaggeration to say the Safe Haven has been an outstanding success. In its first month of opening there were almost 150 attendances. By September of this year, there were nearly 570.

It has also been evaluated independently by Mental Health Strategies and shown to have helped reduce acute psychiatric admissions to local hospitals by 33%.

Such has been its success that it is now embedded as part of mainstream mental health funding by NHS North East Hampshire and Farnham Clinical Commissioning Group (CCG).

Indeed, there are five more Safe Havens being developed across Surrey as a direct result of the success of this pioneering service in Aldershot, and CCGs elsewhere in Hampshire are looking with interest at the model too.

What’s even more exciting is that we’re looking closely at developing similar services for children across Hampshire, and work is underway to see how the concept can be rolled out and co-designed with children.

Feedback plays an important role in continuous improvement. These comments were taken from a survey earlier this year, and show how valued the Safe Haven is by the people who use it:

  • “The café has been an absolute lifesaver, it really has. It has completely and utterly turned my life around.”
  • “I would have taken an overdose if I didn’t have the support of the Safe Haven.”
  • “If I hadn’t come in tonight I would have self-harmed but talking to someone has relieved my crisis and helped me understand my situation, and what I need to do.”
  • “I know if the Safe Haven had not been here I may have been dead as I have thought about killing myself.”
  • “I had made serious plans to end my life and talking to ***** saved me. He understood and was supportive. Without him I wouldn’t be here to write this.”

By preventing a crisis, not only is an individual’s wellbeing improved but resources are used in the most effective way.

It’s reflects the true spirit of being a vanguard – providing new models of care designed by health and social care professionals in conjunction with local people.

The Safe Haven has won national recognition too. In September 2015 it was a finalist in the Kate Granger Awards for Compassionate Care, and this month won an award for improving care for people in mental health crisis, at the National Positive Practice Awards in Newcastle.

The greatest reward we have though, is knowing that the café is doing exactly what it was set up to do. It perfectly demonstrates that co-production – between agencies and the people who use services, some of whom continue to play an active role in its evolution by sitting on the steering group – can lead to real improvements in people’s lives.

Watch how the Safe Haven has turned one woman’s life around:

Find out more about the Safe Haven from the people who use it:

  • The North East Hampshire and Farnham vanguard (integrated primary and acute care system) programme is made up of clinicians and services managers from NHS North East Hampshire and Farnham CCG, Frimley Health NHS Foundation Trust, Southern Health NHS Foundation Trust, Surrey and Borders Partnership NHS Foundation Trust, Virgin Care, South East Coast Ambulance NHS Foundation Trust, North Hampshire Urgent Care and Hampshire and Surrey County Councils – all working in partnership with 222,000 local people.
Andy Whitfield

Dr Andy Whitfield is Chair and Clinical Lead of NHS North East Hampshire and Farnham Clinical Commissioning Group.

He has been a GP for 24 years after completing his medical degree at Sheffield University in 1985. Andy was initially a partner in a GP training practice in Surrey before leaving in 2004 to take over a GP practice in Farnborough, Hampshire.

He has been involved in commissioning of one form or another since the existence of primary care groups around 14 years ago.

Andy is passionate about ensuring patients have access to the most appropriate care in the most appropriate place.