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Research shows that people who have multiple and chaotic social and lifestyles needs, place disproportionately high demands on the emergency services. This includes repeat 999 calls, A&E attendances, high use of doctors and other walk in services, and unplanned admissions to hospital.

‘Support First’ is designed to address this issue in Bolton by supporting such people on a one-to-one basis in a range of practical ways that reduces the need for them to access acute care services in crisis. The project builds greater stability and self-sufficiency in the lives of service users, with the support of local community-based services and networks.


01204 385848


Urban Outreach Office,
Environ House,
Salop Street,
Bolton BL2 1DZ

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    How it works

    Support First works in partnership with and receives referrals from the NHS, the North West Ambulance Service, the Police, the GM Mental Health Partnership  and Bolton Integrated Drug and Alcohol Service. Local mental health support charity BAND (Building A New Direction) provide befriending support to clients who access the service. The service is presently funded by the Big Lottery’s ‘Help Through Crisis’ Fund which is principally intended to help individuals who have difficulty accessing mainstream health services.

    Those who benefit from our Support First service often present with a range of complex issues. These may include mental health difficulties, alcohol/drug dependency, learning difficulties or a history of offending. They may be a victim of domestic violence or may exhibit anti-social behaviour. Frequently they are struggling in insecure and unsuitable accommodation or are homeless.

    Our support workers identify problems, offer advice and practical assistance to individuals and couples. This they do largely through home visits and in providing support into other specialist services where this would be beneficial.


    Over the year, 19 service users were referred (down from 31 the previous year). A total of 42 service users were provided with intensive support (down from 61). This reduction was a result of some referral pathway and staff deployment difficulties. These have now been overcome and we have developed good new referral processes with GP practices and our ‘Street Life’ nurses.

    During the year we were able to close files on 45 cases mainly as a result of their needs being largely met. As a consequence of our work, hospital attendances of those we worked with reduced by 84%; unplanned admissions to hospital reduced by 65% and A&E attendances reduced by 23%. 50% of our service users made meaningful progress in the area of mental health; 56% saw progress in the area of their alcohol dependency; 28% made progress if the area of drug use; 33% were supported in the area of domestic abuse and 47% felt their self-esteem had increased.

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