What is HOPE(S)
The HOPE(S) model is an ambitious human rights based approach to working with individuals in segregation developed from research and clinical practice.
The clinical model was developed by Mersey Care NHS Foundation Trust. It reduces the use of long term segregation sometimes experienced by autistic adults, adults with a learning disability and children and young people.
Mersey Care has been commissioned by NHS England to deliver a national programme. We have specially trained practitioners working at sites across the country. Mersey Care has wide experience of good practice in complex care settings and continue to collect clinical evidence as part of our commitment to learning.
This programme has been funded by NHS England to roll out the model across services in England. It is subject to national scrutiny and Mersey Care is working closely with Manchester Metropolitan University to provide academic oversight and research into the success of the model. So far, over 2400 clinical staff have been trained by Mersey Care in the use of this model. There has been significant learning in how to do this, not just in the NHS, but also for our partners in community services.
Some of the programme’s recent successes and outcomes for patients were described at our national conference, held in Liverpool in May 2024. You can hear from conference keynote speakers Professor Rafferty and Sir Norman Lamb in the videos on this page. At that event we also heard from people with lived experience directly recounting their stories, as well as from senior healthcare leaders and our research partners at Manchester Metropolitan University. The organisers would like to thank everyone who attended, supported or contributed to the success of the event.
The HOPE(S) clinical model has what is described as “a relentlessly positive” approach to supporting people in long term segregation.
Left: CEO Prof Joe Rafferty CBE. Right: Gavin Harding MBE, NHS England advisor and expert by experience.
Mersey Care was pleased to receive a major award from the Restraint Reduction Network for HOPE(S) as the best initiative of the year 2023. It recognises that this programme is delivering results across the country as we work with a range of providers, experts by experience and of course many service users, who are now able to move on from long term segregation.
The model describes:
- It encourages teams to Harness the system through key attachments and partnerships
- Create Opportunities for positive behaviours, meaningful and physical activities;
- Identify Protective and preventative risk and clinical management strategies;
- Build interventions to Enhance the coping skills of both staff and people in services
- Whilst engaging in these tasks clinical teams and the System needs to be managed and developed to provide support throughout all stages of the approach.
The Diploma provides the foundation of the key principles of the HOPE(S) model and equips clinicians with the core skills required to administer the Barriers to Change Checklist and formulate key intervention targets to reduce long-term segregation. In addition, it covers human rights-based practice, trauma informed care, Positive Behavioural Support and other frameworks to reduce restrictive practice and associated harms.
The qualification aims to provide a learning and skills development pathway enabling people to become effective practice leaders.
The Diploma Practice Leadership in the HOPE(S) model is delivered by the Restraint Reduction Network (RRN).
The HOPE(S) model is led by Mersey Care. Clinical psychologist Dr Jennifer Kilcoyne is the co-author and Director.
Lead nurse Danny Angus is the co-author and Associate Director. In the below film from Mersey Care, Dr Jennifer Kilcoyne and Danny Angus, along with Lead Practitioner Dr Leanne Franks, introduce the programme:
In this 45 second film, National Mental Heath Director Claire Murdoch, explains why NHS England is rolling out this programme to provide ‘a revolution in care’:
Mersey Care sees research as central to improving healthcare. Our Centre for Perfect Care has commissioned Manchester Metropolitan University (MMU) to conduct an independent rigorous research evaluation for the HOPE(S) programme.
They will capture lived experiences and accounts of professionals and family members, as well as changes with regards to key health outcomes following the introduction of the programme. The mental health team at MMU will be using a mixed-methods design to address these objectives, including:
i. narrative and semi-structured interviews;
ii. focus groups;
iii. co-design/service improvement events; and
iv. secondary analysis of routinely collected anonymised clinical data.
The evaluation will produce evidence-based research findings and recommendations to inform practice and policy in this area. The first report will be shared in early 2024 with final results in 2026.
Involving people with lived experience of learning disabilities, autism or long-term segregation and their families is central to the conduct and dissemination of this research. This includes producing an accessible version of the findings. The research team are currently working closely with people with lived experience part of the HOPE(S) steering groups and their networks. This will make sure that recruitment to the research is appropriate and participation is accessible and supported.
Research team
- Dr Alina Haines-Delmont, Associate Professor / Reader in Mental Health and Coercion - Chief Investigator (CI)
- Researcher – Dr Kathryn Fradley, Post-doctoral Research Associate in Mental Health
Contact information
For general queries about the research element of HOPE(S) please contact Dr Alina Haines-Delmont by email: a
Address: Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, England. M15 6GX.