Introducing CREST SEN

CREST, the West Yorkshire Community Rehabilitation Enhanced Support Team, is celebrating the soft, or informal, launch of its CEN (Complex Emotional Needs) pathway.

It has reached this milestone thanks to the dedication and hard work of its team and collaboration with a wide range of partners since 2021.

CREST serves people from Bradford, Kirklees, Calderdale, Wakefield, and Leeds and has been regionally commissioned to reduce the use of Level 2 settings (formerly known as locked rehabilitation) and support greater independence for individuals closer to their homes.

Over the past 2½ years, CREST has:

• Supported over 21 discharges from Level 2 inpatient settings into community placements, serving a population of men and women over 18 with severe mental illness and associated problems related to multiple or extended use of inpatient services.
• 19 of these service users have sustained ongoing community placement without requiring inpatient readmission, crisis or criminal justice services.
• We established a comprehensive multidisciplinary team incorporating specialist roles in substance misuse, family support, practice development, dietetics, and third-sector peer support and recovery.
• Implemented the ASCEND™ clinical model, providing specialist transition-focused input aimed at community repatriation and admission prevention.
• Integrated psychologically-informed practices and co-production in both clinical delivery and service development.

CREST built on its learning from its original pathway, Severe Mental Illness (SMI) and leveraged both the clinical/operational processes and vibrant stakeholder relationships to lead to the current soft launch of the new pathway within CREST, specifically designed for service users with complex emotional needs – CREST-CEN.

Key features of CREST-CEN include:

• Tailored delivery to meet the unique needs of this specific user group, mirroring the broader offer of CREST.
• The soft launch phase, where the team works with a pre-identified group of service users in Level 2 settings, was clinically reviewed in 2022-2023. The full launch, anticipated in Q1 and contingent on ongoing recruitment, will expand to include new referrals and those at risk of Level 2 setting placements.

CREST-CEN, with its focus on addressing Level 2 usage, will work closely alongside, rather than replace, existing services for complex emotional needs, like colleagues within EMERGE in Leeds and York Partnership Foundation Trust and trauma-informed pathways within South West Yorkshire Partnership Foundation Trust and Bradford District Care Trust.  Going forward, it will utilise the existing clinical and operational governance processes within LYPFT Eating Disorders and the Rehabilitation service line and the WYMHLDA board to provide relevant updates.

The programme and CREST-CEN team expressed gratitude to Leeds and York Partnership Foundation Trust, South West Yorkshire Partnership Foundation Trust, Bradford District Care Trust, CREST SMI, wider stakeholders, and the service users and their families who have been instrumental in developing this new pathway.

For more details, see Complex Rehabilitation and CREST; West Yorkshire Health & Care Partnership (wypartnership.co.uk). For inquiries please contact Clinical Lead: Ashley-christopher.fallon@nhs.net, Medical Lead: Julie.hankin4@nhs.net, Clinical Operation Manager: jeanette.lawson@nhs.net