Patients with a history of complex trauma, frequently with diagnoses of Emotionally Unstable Personality Disorder (EUPD) or Borderline Personality Disorder (BPD),¹² are struggling with poor mental and physical health and a lack of services to turn to.

They tend to be very high users of both primary care, secondary care and ambulance services, as well as social care services.

They do not fit the criteria for the brief intervention psychological model used by the Wellbeing Service, nor the more medicalised model of the Assessment of Treatment Service (ATS), the adult secondary care mental health service.

They tend to be too unwell for one service and function just above the threshold for being accepted into the other service. This results in patients not having any consistent treatment plan, often going from one crisis to another, with the burden of care falling to primary care or A&E.

The emotional and behavioural impacts of CPTSD compound the mental and physical health. This cohort of patients is recognized to be struggling with compliance and engaging with suggested healthcare advice and recovery, resulting in poor physical and mental health outcomes and frustration on both sides.

Goldstone Primary Care Network (PCN) agreed to fund an innovative holistic year-long programme to treat patients with CPTSD/EUPD, using the 2019/20 primary care underspend allocated for the development of business cases.