How our Hospital to Home service could get you home, improve patient experience and reduce the demand for inpatient resources

Info for Commissioners, Partnership Working

Individuals who suffer a mental health crisis can find themselves without the support they need to take the necessary steps to be able to return home to independent living. This can be both stressful and frustrating for the patient, detrimental to their mental health recovery journey, as well as creating a financial burden to the tax payer with expensive inpatient treatment.  

However, with the right experienced support, there is an alternative for people in an acute mental health crisis who would otherwise require hospital admission.  

Our dedicated Bridge Back Home Team (BBH) integrates a local Voluntary Sector Support who currently provide floating support and supported accommodation within Greenwich, with the Oxleas Clinical Home Treatment Team (HTT).  HTT is a multi-professional team who operate 24 hours a day, 365 business days a year, and includes a consultant psychiatrist, associate specialist, qualified nurses, social workers, and recovery (STR) workers. 

The aim of the Bridge Back Home Team is threefold; to improve patient experience, reduce the average length of stay for Greenwich Acute inpatient wards and HTT, and reduce the number of admissions made via HTT.

Introducing the Bridge Back Home (BBH) Team 

The BBH team of experienced workers is based with the Greenwich HTT at Oxleas House in Queen Elizabeth Hospital. The team work alongside colleagues to identify people who could be supported at home, with a particular focus on non-clinical interventions and tasks. A range of support is provided which is flexible and dependent upon the individual needs of the patient, and which can be delivered primarily at home.

The team work collaboratively with the patient and their family or carer, with the aim to not only provide support to manage a current or ongoing situation but also to identify potential issues that could trigger a future crisis and formulate potential coping strategies.

Non-clinical, flexible and proven support from community services 

This support from BBH links clients with a wide range of community services. These can build resilience and a network enabling clients to further reduce the need for clinical support both in the immediate future and longer term. We understand the challenges they face, and support can be packaged appropriately to meet their needs, whatever stage they are at with their recovery.  

Our proven community services include 24 hour supportmedium supportflexible support designed to bridge the gap between medium support and independent living; women only services; support with finding and maintaining accommodation; and Recovery College which is for anyone who has been affected by mental health to acquire personal, social, academic, and practical life skills.  

The pathway we recommend is designed to be flexible. The pathways grow with clients as their requirements change.  

For example, we can offer practical support to clients and their families to facilitate an earlier discharge home. This could be home visits to arrange repairs to make a home safe and habitable to return to or providing support in managing personal finances such as applying to claim for benefits, budget planning and developing other money management skills.   

When patients and families have a need for emotional support, we can deliver this both via face to face and telephone contacts throughout the day. This is beneficial in helping clients to focus on specific areas of concerns and identifying goals that they wish to achieve with the team.  

Our experience means we recognise the challenge in providing mental health services that serve the needs of the individual in a health care system which is continually under pressure due to increasing demand and shrinking budgets.  

At Bridge, we have a proven track record in providing cost-effective, proven pathways to support people with long-term mental health conditions in the community which bridge a gap between in-patient mental health services and independent living. Our BBH team is committed to providing this support collaboratively with the Greenwich HTT team to enable clients to navigate their way back to independent living and away from hospital.   

Please help us raise awareness about this by sharing this post with your network. For more information about our Hospital to Home service or any of our community mental health services, please visit our website, or contact us. Thank you for your support.   

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24 Hour Support

Medium Support

Flexible Community Support

Forensic Services

Recovery College

Women Only

How you can work with us

As well as the normal tendering process, you can commission our services in the following ways:

  • Use our contact form
  • Pick up the phone to speak to us on 020 8298 9677
  • Email us to discuss spot contracting OR delivery of a bespoke service that meets your needs