Mental Health Step-down

Market Context

The Mental Health Step Down service is an integral part of the mental health pathway and has significantly reduced the number of individuals considered as No Criteria To Reside (NCTR). It operates alongside a Mental Health Step-Up service that is commissioned by system partners. Somerset Foundation Trust (SFT) would go to tender for the Step- Up service and Somerset Council for the Step- Down service.

The service is provided in Wells and in the Yeovil with a capacity of 4 beds for each location. A support service is in place from 9am until 5pm, 7 days a week.

Individuals accessing the service no longer require to be in hospital, but need further support upon discharge to maintain independence in their communities. The service:

• Ensures continuity of support for the individual/ system flow of inpatient and community mental health services
• Provides trauma informed and support the recovery of individuals following their stay in hospital
• Supports individuals to access universal services

Market Rating

Market Quality: Good

Market Supply: Stable

Current market status

The current contract for this service will end in 2026 and work is taking place do determine future commissioning arrangements for this support alongside the support commissioned by system partners.

Market Data

All data is as at [insert date]

Distance from desired commissioning objectives

• The service is performing well, operating mainly to capacity with a ‘good’ move on rate considering the challenges attached to the local housing market.
• System partners, who are part of the contract reviews, value the service provision and confirm that it continues to be key to enabling people timely discharge from hospital with the relevant support.
• All individuals referred to the service are individuals seeking housing with low to medium needs.
• Upon discharge from the MH step down service, individuals are moving to a permanent or temporary accommodation and may also (depending on needs) be supported by community groups for extra support to support the transition to the accommodation.
• Individuals are discharged without the need for support from Adult Social Care.

Market Risks

• Recruitment and retention of staff is challenging in the current market.

Current areas of focus for commissioners

• To determine, and then implement, the future commissioning arrangements for this service alongside the Step-Up service that is commissioned by system partners.