STEP utilises a ‘hub and spoke’ model. As stated in section 3.7.2 of the guidance document, such models may be necessary in sparsely populated rural areas. The STEP team provides support for people either at risk of or experiencing first episode psychosis.
Demonstrating positive practice in relation to statement 1, 3 and 8 of the Psychosis and Schizophrenia in Adults NICE quality standard:
1. Adults with a first episode of psychosis start treatment in early intervention in psychosis services within two weeks of referral.
3. Family members of adults with psychosis or schizophrenia are offered family intervention.
8. Carers of adults with psychosis or schizophrenia are offered carer-focused education and support programmes.
Somerset county population, incidence and workforce for 16–64 year olds
Predicted cases per year (from Fingertips data)
Incidence per 100,000 person years (from Fingertips data)
‘Hub and spoke’ EIP service
The ‘hub’ consists of a consultant psychologist (0.2 WTE), team manager (0.4 WTE), clinical psychologist (0.2 WTE), assistant psychologist (1 WTE) and an administrator (0.6 WTE). There are four ‘spokes’: Somerset Coast (care coordinators, 1.8 WTE and support worker, 1.0 WTE); Mendip (care coordinators, 2.4 WTE); Taunton (care coordinator, 2.0 WTE); and South Somerset (care coordinator, 2.0 WTE and support worker, 0.4 WTE).
Somerset Partnership NHS Foundation Trust
http://www.sompar.nhs.uk /what-we-do/mental-health/early-intervention-in- psychosis-step/
STEP utilises a ‘hub and spoke’ model.
As stated in section 3.7.2 of the guidance document, such models may be necessary in sparsely populated rural areas. The STEP team provides support for people either at risk of or experiencing first episode psychosis. In line with NICE guidelines and the access and waiting time standard, the team accepts anyone suspected of experiencing first episode psychosis regardless of their age.
A strong emphasis is placed on access. A recent audit from Year 8 Evaluation (September 2013 to August 2014) found that the service currently meets quality statement 1 with an average time from referral to the service user attending their first appointment being seven days (median: four days, n = 89). To streamline this process, STEP’s information department is changing its electronic records system (RiO) to enable staff to capture new information as part of assessment screens.
In keeping with quality statements 3, 5 and 8, STEP emphasises the importance of working with families and supporting service users to access employment. The 2013–2014 data show that 64.3% of families were invited to the initial assessment, 41.1% of families received regular separate support and that 58.9% of service users were in employment or education.
Training to ensure the provision of NICE-recommended care
- In-house workshops are provided to staff in the following areas: assessment, motivational interviewing, CBT and CBT for psychosis skills and Triangle of Care (family inclusive practice).
- Working with Plymouth University, STEP runs a one-year accredited family intervention course.