Women's Mental Health - blended secure service

St Andrew's Healthcare is one of three hospital sites chosen by NHS England to pilot a Women's Blended Secure Service. Negating the need for secure transitions between medium and low security levels, our blended service aims to reduce people's length of stay by providing an innovative model of care on one ward environment. The service intends to offer a better experience for patients with a clear emphasis on recovery and progression.

Spacious living area

Arts and activities room

Modern bedrooms

Bright dining area

Ward courtyard

on site swimming pool

Vocational workshop oppotunites

Admissions criteria

Our blended service is appropriate for adult women including transgender who are 18 years+:

  • who require a secure physical framework
  • with a diagnosis that can include mental illness, personality disorder, complex trauma, post traumatic stress disorder (PTSD), substance misuse, borderline intellectual disability
  • with a forensic history
  • who have complex needs and who pose a significant risk to themselves or others.

Service aims and objectives

By blending our medium and low secure services we aim to:

  • significantly reduce inpatient length of stay by removing the transition from medium to low secure services
  • provide women with a more progressive clinical experience through a new, trauma informed/relational security operating model
  • improve our discharge process and effectiveness, increasing the number of women able to discharge directly from a secure environment into community accommodation.

A number of measures have been developed with NHS England to measure every aspect of the service, helping us understand the impact of this model of care. The measures will include:

  • mental and physical health
  • patient experience
  • functional and living skills development
  • social and family networks
  • discharge destination and length of stay.

An innovative care model

To achieve the ambitious aims and objectives of the service, an innovative care model has been co-produced by patients and experts by experience.  This has resulted in a trauma informed and responsive relational security model of care with a focus on recovery and progression.

This bespoke treatment programme encourages self-care and self regulation, challenging women in secure settings to understand and manage the they experience in the early stages of their treatment and preparing them for their next step. Therapies are adapted to specific needs and may include:

  • dialectical behavioural therapy (DBT)
  • cognitive behavioural therapy (CBT)
  • understanding trauma 
  • building life and community skills
  • feeling safe and being safe.

Our Location


Each patient will have a care team comprised of a Consultant Psychiatrist, a Speciality Doctor, Nurses and Healthcare Assistants, a Psychologist, Teachers, an Occupational Therapist, a Social Worker, and an Assistant Practitioner. The team also has access to other professionals such as a Dentist, a Physiotherapist, a pharmacist, a Dietician, a Speech and Language Therapist, a Physical Healthcare Nurse, a Self-Care and Body Image Therapist and General Practitioners. Other staff that will facilitate timetabled sessions include OT/TI, Teaching TI and Sport and Recreation Facilitators. Each patient will have a designated Care Co-ordinator.

The multidisciplinary team are skilled in assessing a range of different areas including mental health and mental disorder, cognitive assessment, neurodevelopmental disorders including Autistic Spectrum Conditions and structured risk assessments.


Discharge planning and next steps

To reduce length of stay the service will work with Home Area Teams to improve collaboration and partnership working. A working group, including the patient, their family, carers, the Home Area Team and the care team will be formed from the point of admission to ensure that a clear care and discharge plan is developed.

It is expected that the majority of patients from the Blended Service will transition to suitable community accommodation. To support this objective we have created an Outreach Team which will liaise with local community teams to facilitate community transitions. This will include family and carer liaisons, engagement with community mental health teams and crisis planning and support.Where suitable accommodation is unavailable locally, we will work to develop community packages with the local teams to facilitate this transition at the earliest stage.

 Kirsty Pape

Kirsty Pape

  • Occupational Therapist
  • I qualified as an Occupational Therapist in 2011
  • Has a strong interest in the Vona du Toit Model of Creative Ability which has recently been implemented on Stowe ward
  • Has experience in working within secure men's, older adult and community mental health teams
 Iain Holland-Hay

Iain Holland-Hay

  • Nurse Manager
  • Has over 10 years experience at St Andrew's, predominantly within medium secure female mental health settings.
  • Has managerial and operational responsibility for the running of the ward and all aspects of its performance
 Katie Cawdell

Katie Cawdell

  • Clinical Nurse Leader
  • TBC
 Sharon Kilby

Sharon Kilby

  • Clinical Nurse Leader
 Jennifer Martin

Jennifer Martin

  • Senior Social Worker
 Dr Samudra Sarkar

Dr Samudra Sarkar

  • Consultant Psychiatrist
  • Completed specialist training in Forensic Psychiatry and has a particular interest in Women’s Mental Health.
  • Practises as a Consultant Forensic Psychiatrist for the Women’s care pathway at St Andrew’s
 Hugo Nel

Hugo Nel

  • Consultant Clinical Psychologist
  • BA, C Psychol, AFBPsS
  • Has over 17 years’ experience as a Clinical Psychologist
  • Expertise in performing detailed and comprehensive psychological and risk assessments across a range of mental health problems
  • Expertise in delivering Psychological Therapy (DBT and CBT) to patients with complex mental health difficulties