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Adults with complex psychosis often face fragmented care, lengthy inpatient stays and placements far from home, which can impact recovery and lead to poorer experiences for service users and their families.

To address this, staff from North London NHS Foundation Trust’s Haringey Community Rehabilitation team have created a more joined-up and consistent approach to care. 

The team supports adults living in 24-hour supported accommodation, helping them regain independence and transition to lower levels of care. The team works closely with service users to identify strengths, set realistic goals and develop coping strategies, alongside providing psychological, social and practical support.

To ensure consistent, coordinated and recovery-focused care throughout the rehabilitation journey, the team developed a rehabilitation pathway, which provides support from inpatient admission through to community reintegration.

A key feature of the pathway is continuity of care. Each individual is supported by a dedicated High Dependency Specialist, who serves as a main point of contact, coordinating care and providing ongoing support throughout inpatient stay and continued rehabilitation in the community for up to 18 months following discharge.

This consistent approach has contributed to a significant reduction in readmissions. At 18 months, service users supported through the pathway recorded just 14 readmission days, compared to 316 days for those discharged through standard routes. 

The team, led by Kerby Francis, recently presented on the success of their rehabilitation pathway at the Royal College of Psychiatrists International Congress, presenting a poster which highlighted the pathway’s impact over its first 18 months.

On presenting the poster, Kerby Francis said “I’m proud to share our rehabilitation pathway poster at this year’s Royal College of Psychiatrists International Congress. This reflects the incredible effort from colleagues over the past two years in implementing the pathway in Haringey and we’re now completing our two-year evaluation, with plans to submit our findings to the BMJ. Encouragingly, we’ve had just one readmission lasting 14 days since the pathway began. A big thank you to everyone involved.”

The work supports wider NHS ambitions to reduce out-of-area placements and improve patient experience by enabling more people to receive care closer to home.

This achievement reflects the collective effort of colleagues across Haringey over the past two years, showcasing innovation, research and service development. 

Find out more about the Haringey Community Rehabilitation Team.