Project team behind St Andrew\'s House in Derby reveal how they set about creating a benchmark for the future delivery of integrated drug and alcohol treatment services
The way the NHS delivers drug and alcohol treatment has been transformed with the opening of a ground-breaking new facility in Derby. Speaking exclusively to BBH this week, the project team behind St Andrew’s House revealed how their forward-thinking approach to the design of both services and the environment from which they are delivered is being closely monitored by trusts up and down the country as they report improved outcomes just weeks after opening
Patients in Derby who suffer from drug and alcohol dependency have historically accessed services from dedicated teams in five separate units across the city, depending on how far along the recovery process they are.
As well as the high costs associated with this fragmented system in terms of buildings and staffing, the set-up was also less than effective in helping users to access treatment quickly and in the most effective and joined-up way.
Best practice suggests that you can deliver the most effective care when you offer all services under one roof in a building that meets the needs of users
So, when the opportunity arose to create a new facility, the project team was keen to go against the grain and create a building that could become a benchmark for the future delivery of addiction services across the wider NHS.
Commissioned by NHS Derby City in conjunction with Derbyshire Healthcare NHS Foundation Trust and partners, the centre brings all five services together under one roof in surroundings specially designed to promote recovery.
Formerly social security offices, the site was refurbished as part of a project managed by Keith Turner, head of estates and facilities at Derbyshire Healthcare NHS Foundation Trust, in conjunction with staff and patients.
The early involvement of key stakeholders means the team has been able to create a facility that enables the service to be delivered in the best way possible, rather than being restricted by the limitations of the location.
And, as a result, just two months after opening managers have reported significant improvements in outcomes, an achievement that is now being closely monitored by NHS trusts across the UK.
We made a real commitment at the beginning of this project to develop an environment that would encourage recovery
Speaking to BBH, James Sutherland, lead commissioner from NHS Derby City, said: “Best practice suggests that you can deliver the most effective care when you offer all services under one roof in a building that meets the needs of users.
“At St Andrew’s House it was about providing an environment that was truly fit for purpose and fit for the changing needs of users as they progress through their treatment.”
We consulted users at every stage of the planning and design process and the building has been very carefully laid out so that service users can see the progression they are making, despite being in the same building throughout their treatment
Sarah Carter, assistant director of business strategy at Derbyshire Healthcare NHS Foundation Trust, added: “What we had before in terms of the buildings from which the services were delivered was not fit for purpose. We made a real commitment at the beginning of this project to develop an environment that would encourage recovery. Instead of five separate services, users can receive all their treatment under one roof. From the offset there was a commitment from all the partners to deliver the service in a very different way.”
But, while the building aims to brings services together, the project team was keen to ensure users still felt like they were progressing through their treatment.
Sutherland explained: “We consulted users at every stage of the planning and design process and the building has been very carefully laid out so that service users can see the progression they are making, despite being in the same building throughout their treatment.
“An example of this approach is in the design of the waiting areas, where service users were keen to see separate waiting areas so that those nearing the end of their treatment were not sitting with people who may have only been accessing the service for a matter or days or weeks. They also asked for two separate entrances so that they felt like they were progressing during their time with us. This has created a building truly fit for purpose and for changing needs and which has been designed around the service and not the other round.”
Working in mental health and learning disabilities services, we know that colour has an impact on the overall ambience of a building and on how it makes those who use it feel
Commenting on the involvement of stakeholders throughout the project, Carter added: “There was a commitment from all partners to deliver the service in a different way and what has been most helpful has been the way in which they have all worked together and this has made the service users feel really valued.”
Catering for 2,000 people with drug and alcohol problems, the centre is built over two floors and has 23 consulting rooms, an open-plan office, a Job Centre Plus service, group therapy rooms and facilities for infection screening, sexual health services and vaccinations.
Interior decoration was also an important consideration, with relaxing colours used widely throughout.
The complementary therapies room is one of a number of purpose-built facilities aimed at helping more people to successfully recovery from drug and alcohol addictions
Carter said: “Working in mental health and learning disabilities services, we know that colour has an impact on the overall ambience of a building and on how it makes those who use it feel. We were very conscious of that when we designed this facility and so have used quite a lot of green as it is a calming colour.”
And she added that since opening just a few months ago the feedback has been ‘fantastic’.
Performance analysis shows that in the first two months at the new facility, the number of people exiting treatment increased. We believe the improvements to the environment mean more people are successfully recovering
“It is early days,” she said. “However, performance analysis shows that in the first two months at the new facility, the number of people exiting treatment increased. We believe the improvements to the environment mean more people are successfully recovering.
“We will continue to monitor outcomes and I expect may other NHS trusts to be keeping a close watch as well.
“There are not many services like ours and the indications are that outcomes can improve by integrating services into one building. Innovation like this is being greatly encouraged across the NHS and hopefully we have set the benchmark for the future delivery of integrated alcohol and drug support services.”