Intensive and Assertive Outreach Service: Recovery and Outreach Sub-Contracted Element

The contract for services will be awarded in the form of the NHS Standard Sub-contract. This Service is for the provision of an Intensive and Assertive Outreach (I&A) Service across Norfolk and Suffolk.

The Service is designed to deliver intensive, proactive, and flexible community-based care for individuals with Serious Mental Illness (SMI) who present with elevated levels of complexity and risk and for whom engagement with traditional mental health services is a challenge.

Delivery will be through a blended model between Norfolk and Suffolk NHS Foundation Trust (NSFT) as the Head Provider and Sub-Contractors (encouraging Voluntary, Community, Faith, and Social Enterprise (VCFSE) interest), ensuring a comprehensive offer that integrates clinical expertise with community-based engagement and recovery support.

The Sub-Contractor will play a critical role in enabling engagement, promoting recovery, and addressing the wider determinants of health, working as a fully integrated partner alongside NSFT clinical teams.

The Sub-Contractor(s) contribution is central to achieving the core ambition of the service:

No individual is excluded from care due to disengagement, complexity, or social circumstances.

Assertive Engagement and Outreach

The Sub-Contractor must:

• Deliver proactive, persistent outreach, particularly where individuals are disengaged
• Provide frequent contact, including daily visits in line with the care plan
• Engage individuals in a variety of settings, including:
• Their home
• Community settings
• Places where they feel safe
• In-reaching into hospitals or prisons if required to establish engagement and promote continuity of care
• Use creative and flexible engagement approaches, including:
• Doorstep engagement
• Accompaniment to appointments
• Informal relational contact
• Demonstrate the ability to sustain engagement over extended periods, particularly where trust is low

The sub-contractor(s) will provide:

• Assertive Engagement and Outreach
• Practical Support for Daily Living
• Community Participation and Social Inclusion
• Support to Access Healthcare (Including Mental Health Care)
• Medication Support (Non-Clinical)
• Substance Misuse and Harm Reduction
• Carer and Family Support
• Contribution to Risk Management

Sub-Contractors will work mainly in the Community travelling to Service Users and must demonstrate their ability to deliver outreach across urban, rural and coastal communities, including service users placed outside their immediate locality.