The Leeds EIP service – ‘aspire’ – NCCMH

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The Leeds EIP service, ‘aspire’, is aimed
at young people aged 14–35 who are experiencing first episode psychosis. The key principles of the service are engagement, hope and recovery. The service, which is delivered by Community Links, is a rare example of a third sector provider.

Co-Production

  • From start: No
  • During process: Yes
  • In evaluation: No

Evaluation

  • Peer: Yes
  • Academic: No
  • PP Collaborative: No

Find out more

Demonstrating positive practice in relation to statements 5 and 7 of the Psychosis and Schizophrenia in Adults NICE quality standard:

5. Adults with psychosis or schizophrenia who wish to find or return to work are offered supported employment programmes.

7. Adults with psychosis or schizophrenia are offered combined healthy eating and physical activity programmes, and help to stop smoking.

Table 1: Leeds population, incidence and workforce data for 16–64 year olds

Approximate population

513,295

Predicted cases per year (from Fingertips data)

126

Incidence per 100,000 person years (from Fingertips data)

24.6

Service model

‘Stand alone’ EIP service

Workforce

8 senior EIP practitioners (band 6), 9 EIP practitioners (band 5) and 6 EIP recovery workers, all of whom care coordinate. In addition: 1 part-time service manager, 2 team leaders, 1 clinical psychologist (0.8 WTE), 2 part-time consultant psychiatrists

(1.1 WTE), 1 part-time systemic family therapist, 1 employment worker, 1 support, time and recovery worker, and 1 part-time volunteer link worker.

Commissioner

Leeds North CCG
Leeds South and East CCG Leeds West CCG

Provider

Community Links

Website

http://www.commlinks.co.uk /sites/aspire

 

The Leeds EIP service, ‘aspire’, is aimed at young people aged 14–35 who are experiencing first episode psychosis. The key principles of the service are engagement, hope and recovery. The service, which is delivered by Community Links, is a rare example of a third sector provider. While allowing increased flexibility and creativity, this also introduces new challenges such as the ease of accessing NHS infrastructure (including informatics and pathology).

The service is currently meeting the referral to treatment element of the new access and waiting time standard. Monitoring, which occurs on a regular basis, is being improved through the expansion of monthly data checks. This will include formalised criteria for auditing when NICE-recommended care begins. Although a range of interventions are available, the service is not currently resourced to provide these to the full caseload. A recent audit suggested that while 65% of people on the caseload would seek specialist psychological therapy, only 25% have been able to access it.

The service, in line with quality statement 7, also places a strong emphasis on healthy living. Service users have access to a bespoke healthy eating plan. There is regular input from a consultant psychiatrist to ensure that monitoring is in line with the Lester tool.

Training to ensure the provision of NICE-recommended care

  • All care coordinators have weekly peer supervision groups, which are alternately facilitated by a clinical psychologist and a systemic family therapist.
  • The therapists in the team provide regular training and individual consultation for psychological and other family interventions.
  • A proportion of care coordinators have completed training in psychosocial interventions, CBT and systemic family interventions. One care coordinator is about to become a qualified family therapist and another will soon qualify as a CBT therapist.
  • Two members of staff are trained in nutritional/healthy living interventions and in-house training is being set up for all other care coordinators.
  • Some staff members are also trained in 
dual diagnosis/motivational interviewing, completing level 2 and level 3 modules provided by the local specialist addiction services in partnership with Leeds University.
Contacts
Fiona Ball, aspire Team Leader
barber@commlinks.co.uk
Emma Carpenter, aspire Team Leader
emma.carpenter@commlinks singulair cost.co.uk

There is a strong commitment to collaborative work to improve referrals and access to care (40% of service users have a duration of untreated psychosis of less than three months). Working relationships have been established with a range of internal and external sources, including the local NHS trust, acute services, CAMHS, the police and voluntary youth organisations. As part of this, increased effort is being made to connect with hard-to-engage communities. In an attempt to address the diverse needs of different groups, the service has specialists who work with the south-east Asian and African/African-Caribbean communities (the two largest black and minority ethnic groups in Leeds) and from the lesbian, gay, bisexual and transgender communities.

‘aspire’ also promotes involvement and social recovery through a support, time and recovery worker and offers social goal-orientated events. In keeping with quality statement 5, this includes facilitating return to employment. Since 2012, ‘aspire’ has achieved this for 77 of its service users, with 38 currently in permanent positions.

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