Arc Day Programme

Arc Day Programme provides an intermediate level of care that sits between community services and specialist inpatient treatment with the aim of reducing hospital admissions. A CNWL multidisciplinary team provides family-based therapy alongside nutritional, medical, and psychological care for young people, while empowering parents and carers to support their young person’s recovery.

This innovative model of care has been wholly commissioned by North West London Child and Adolescent Mental Health Services (CAMHS) Provider Collaborative (PC). It is a key component of the north-west London eating disorder treatment pathway and services, improving patient outcomes and reducing reliance on inpatient services. Arc is part of Best For You, a new model of mental health care designed for – and in consultation with – young people and their families.

Best For You is run in partnership by Central and North West London (CNWL) NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, West London NHS Trust, and CW+ (the official charity of Chelsea and Westminster Hospital NHS Foundation Trust).

The Arc Day Programme provides an intensive therapeutic intervention of integrated nutritional, medical and psychological care for young people with an eating disorder diagnosis. It works alongside family-based treatment in the community, equipping parents, carers, and family members with skills to help them better support the young person at home. Young people and their parents or carers attend the programme for between three and six weeks.

The programme can accommodate up to eight young people and their families. The state-of-the-art space has been co-designed by young people and experts from the CW+ Arts Team, using evidence about design and wellbeing and consultation events to create the optimum environment for recovery. Arc provides a relaxed and therapeutic space for family therapy, supported mealtimes and family meals, and group and individual therapy.

The programme is delivered by a multidisciplinary team of specialist staff including psychiatrists, nurses, clinical psychology, family therapy, occupational therapy and dietetics.

The programme is community-based and provides an intermediate level of care between community services and specialist inpatient treatment.

The key outcomes are:

• preventing people from dying prematurely
• enhancing quality of life for people with long-term conditions
• helping people to recover from episodes of ill-health or following injury
• ensuring people have a positive experience of care
• treating and caring for people in a safe environment and protecting them from avoidable harm
• reducing acute and inpatient hospital admissions
• providing step down care for young people after paediatric and CAMHS inpatient care
• providing step up care for young people who are not making sufficient progress with community treatment
• improving families’ confidence in their ability to manage the young person’s eating disorder

Bus: C3, 14, 211, 328, 345, 414

Tube: South Kensington, Fulham Broadway, and Earl’s Court

Parking is limited and you will need to book it in advance.

We are wheelchair accessible. We have step free access, including a ramp from the main road to a carpark with lift access to the unit on the first floor.

Phone: 07354 848854

Email: arcdayprogramme@nhs.net

Arc Day Programme accepts referrals from CNWL and West London Children and Young People Eating Disorder (CYPED) community teams and CAMHS inpatients units. The young person may be receiving treatment in the community, a paediatric bed, or specialist eating disorder unit (SEDU).

The service spec contains detailed referral criteria.

Inclusion criteria

The Day Programme will accept referrals that meet the following criteria:

• the young person is a resident in and is registered with a GP in one of the eight central north-west London boroughs of Westminster, Kensington and Chelsea, Hammersmith and Fulham, Brent, Ealing, Harrow, Hillingdon, or Hounslow
• the young person I between the ages of 13-17 years old (younger ages may be considered on a case-by-case basis
• the young person is engaged with their ED community team
• the young person has an eating disorder diagnosis
• the young person is at risk of needing Tier 4 admission
• parent(s) and carer(s) are able to commit to attending for the duration of the programme

Exclusion criteria

The Day Programme is not suitable for young people who:

• have high levels of behaviour that causes harm to themselves or others (and which cannot be managed safely in the day programme setting)
• would need 1:1 observation in the day programme
• are unable to manage their own medication or whose parent or carer is unable to support their medication regime. Day Programme staff do not administer regular medication.
• are unable to take nutrition, fluids and medication orally. The day programme does not routinely provide nasogastric (NG) feeding. Where a young person has had an NG tube, it is expected that it will have been removed before they attend the day programme.

Referrers in CNWL and West London Children and Young People Eating Disorder (CYPED) community teams and CAMHS inpatients units should complete an NHSE Form 1 and email it to: arcdayprogramme@nhs.net

GPs and paediatric hospital wards in north west London should refer young people to the relevant borough’s community children and young people’s eating disorder service, who can then refer into Arc Day Programme if appropriate.

What happens after I refer?

Once the Arc Day Programme team receive the referral:

• The clinical team will triage the referral within one working day. Someone from the programme may contact the referrer to check and verify any information before the referral is reviewed.
• Professionals will review the referral at the multi-agency clinical network meeting, which is held once a week. At this meeting, a decision will be made about suitability for admission.
• If the outcome is that the programme is deemed not suitable for the young person, someone from the programme will notify the referrer of the decision by email. If the referral is accepted, someone from the programme will notify the referrer. The Arc Day Programme team will contact families, parents, or carers and invite them to attend a pre-admission assessment appointment with the young person to jointly decide if the Arc Day Programme is suitable for them.
• At the pre-admission appointment, a clinician from the Arc Day Programme will provide information about the programme, including what would be expected of the young person and their parents and carers. The clinician(s), young person, and parents or carers will work together to decide whether the young person and their family are ready to attend and able to commit to the programme.
• If everyone agrees that the Arc Day Programme is suitable, a start date will be agreed. If the young person and their parents or carers are not ready for or able to commit to the programme, the decision may be taken not to accept the young person’s referral, and Arc staff will liaise with CYPED community team to support appropriate ongoing care.