Provided by Guy’s and St Thomas’ NHS Foundation Trust

Addiction Clinical Care Suite 1 (ACCS 1) dedicated to people who sleep rough/at risk of sleeping rough.

Our ACCS 1 offers five elective in-patient detoxification and stabilisation beds for people dependent on drugs and/or alcohol who also have high levels of co-occurring complex physical/mental health medical needs.

Our second unit Addiction Clinical Care Suite 2 (ACCS 2) offers six elective in-patient beds which is open to all people who are dependent on drugs and/or alcohol and is not specific to people who are sleeping rough/at risk of sleeping rough.

Our service is intended to address the gap in complex inpatient detoxification provision in London for those with co-occurring physical and mental health needs such as:

• severe alcohol and/or polydrug dependence
• diagnosed severe and enduring mental health illness
• a history of multiple detoxifications and relapse
• alcohol-related liver disease
• alcohol-related brain damage (ARBD)
• chronic obstructive pulmonary disease (COPD)
• pregnancy

ACCS 1 will treat people dealing with alcohol and/or drug dependency in a hospital-based setting by providing a wide range of specialist care to treat a complexity of health problems facing those who are sleeping rough/at risk of sleeping rough. ACCS 1 will provide a holistic support programme with access to specialist medical care, psychiatry and psychology to help those treated to begin a recovery from life on the streets and harmful substance use.

In addition to supporting people to safely withdraw from alcohol and drugs as part of the first steps in a treatment journey, ACCS 1 will provide peer support and activities alongside a range of other health promotion which will focus on stopping smoking, healthy eating, essential health screening, vaccinations and mental well-being.

The intention is to meet immediate needs while providing opportunities for long term change, contributing to ending rough sleeping and tackling entrenched health inequalities.

How to refer

Referrals to ACCS 1 will be made by a Lead Contact within each London Local Authority substance misuse team. Outreach teams and other providers who are aware of a person who is sleeping rough or at risk of sleeping rough can contact the relevant Lead Contact listed in this spreadsheet and discuss the referral with them. Please note: Lead Contacts in each Local Authority will have approval to make referrals and agree on funding packages.

Local Authorities will need to ensure that people who are admitted to the service have a discharge plan identified. 

Funding

The ACCS 1 is funded through a combination of a grant from the Department for Levelling Up, Housing and Communities (DLUCH), Local Government and Local Authority treatment budgets. Local Authorities will contribute £250 a night to the cost of the service, with the remainder of the costs covered by a block contract between the City of London and Guy’s and St Thomas’ NHS Foundation Trust.

Intermediate Rehabilitation Beds

Intermediate rehabilitation beds are available:

• if a Local Authority is unable to access a suitable rehabilitation facility at the time of referral to ACCS 1
• for those requiring on-going assessment and care post ACCS 1 stay i.e. additional support to manage co-existing physical and mental health needs/ongoing social care assessment

Local Authorities will contribute £800 a week to the cost of the service with with a minimum charge of 3 days. The remainder of the costs is covered by a block contract between the City of London and the Provider.

How to Refer to Intermediate Rehabilitation Beds

As with access to the ACCS 1, referrals for the Intermediate Rehabilitation beds are made by the Lead Contact within each Local Authority substance misuse team.

Stabilisation-based beds at The Mildmay Hospital  https://www.mildmay.org/rebuild

Please copy in: admissions.mildmay@nhs.net to your ACCS 1 referral to GSTT or another in-patient detoxification/stabilisation Provider. This will alert the Admissions Officer (Direct line: 020 7613 6347) at the Mildmay Hospital that a bed is required following your client’s discharge from the ACCS 1.  The Admissions Officer will contact the Lead Contact of the Local Authority substance misuse service to discuss the referral for the Intermediate Rehabilitation  bed.

The City of London also has a spot-purchase arrangement for Intermediate (abstinence or stabilisation) Rehabilitation beds, for more information please contact Nadia.Adigbli@cityoflondon.gov.uk .

No Recourse to Public Funds

Any non-UK national that is eligible for free secondary care services can be referred to ACCS 1 and Intermediate Rehabilitation beds through the normal pathway. Unclear entitlement of a non-UK national to access free secondary care must not be a barrier to consider a referral to ACCS 1 and please see below information to help identify whether someone may be eligible for free secondary care:

NHS entitlements: migrant health guide

https://www.gov.uk/guidance/nhs-entitlements-migrant-health-guide

Resources

• Referral form and eligibility criteria (Word document)
• Information for boroughs
• Dogs on the Streets website: www.dogsonthestreets.org and information sheet

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