Milestone’s Intermediate Care Unit


New Report Shows ‘Life-Changing’ Impact of Waverley Care’s Milestone for Edinburgh’s Most Vulnerable.

Waverley Care is incredibly proud of this collaborative project that has made such a life changing impact to some of Edinburgh’s most vulnerable citizens. We hope that this report will help to secure the long-term future of this vital service.

Grant Sugden, Waverley Care Chief Executive

A revolution in the approach to care for the most vulnerable in Edinburgh has been shown to make a life-changing impact according to an evaluation report of an Intermediate Care Unit set up in April 2020 at Waverley Care’s Milestone residential facility.

The residential service based in Oxgangs was founded by Waverley Care in 1991 as the UK’s first purpose-built AIDS hospice; but in response to increased pressure for hospital beds during the pandemic, the Milestone Intermediate Care Unit (MICU) opened its doors to vulnerable people who have complex needs.

The MICU is the only service of its kind in Scotland, led by a hospital in-reach team from the Cyrenians, and delivered and managed by Waverley Care, with support from City of Edinburgh Council services and other partners. It provides a ‘no wrong door’ approach, where service users – many of whom are experiencing homelessness or are at risk of homelessness, and who have an addiction to alcohol and/or drugs as well as a range of chronic health issues – can access a wide range of services in one place.

The evaluation report highlights the incredible impact the MICU has had on the people who have used the service during an incredibly challenging time. The report found that, between April 2020 and April 2021:

  • Upon admission to the MICU, a majority of those using the service, lived in temporary accommodation or had no fixed home, however on planned discharge from the MICU 83% of people moved into sustainable accommodation.
  • The MICU reduced the risk of drug-related deaths and supported 67 out of 80 individuals in their recovery from drug addiction.
  • The MICU helped to improve hospital efficiency and saved NHS Lothian over £150,000.
  • Service users described the MICU as ‘absolutely life-changing’ and said that it ‘gave a chance for a fresh start.’
  • Several recommendations are outlined in the report to ensure the important work of the MICU can continue. Examples include ensuring services are person-centred and trauma-informed; using the MICU model of care to develop alternatives to attendance at
  • A&E, minimising the need for hospital admission; and supporting access to residential beds to provide a place of safety for those who are at highest risk of drug overdose.

Dr Gerry Mitchell, a Social Policy Researcher commissioned to carry out the evaluation, said: “My research highlights that Milestone is a valuable example of a Covid innovation that now needs to be capitalised on and locked into future provision. Developing from a need for hospitals to make effective use of beds during the pandemic, it uses a whole system joint approach to serve some of Scotland’s most vulnerable people and has a track record of delivering remarkable outcomes for those who use it.”

Bridie Ashrowan, Chief Executive of EVOC, said: “We were delighted to be commissioned by the Edinburgh Health & Social Care Partnership to deliver an evaluation of the impact of Milestone. The report that Dr Gerry Mitchell has produced, in collaboration with the Milestone Steering Group, illustrates the life-changing impact of a ‘no wrong door’ approach that is person-centred and trauma informed. This is particularly clear in this feedback from someone who benefitted from a stay at Milestone… ‘I am leaving with so much hope and determination for the next chapter’.”

Download the full report (2.16 MB)