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Active and Independent Living Programme
Tuesday 26th September 2017
Susan Kelso, AHP Lead Early Intervention
National Lifecurve Survey Some Initial Analysis
AHPs working in partnership to enable healthy,
active and independent lives by supporting personal outcomes for health
and wellbeing
Health and wellbeing
Awareness
Access
Partnership
Research and
innovation
Workforce
Allied Health Professions Co-creating Wellbeing with the people of Scotland
The Lifecurve is rooted in….
Partnership
People Performance Prevention
Prevention, anticipation, early intervention, self management – where? What does it look like?
Time since starting on
‘curve’
Run half a mile
Hike several miles
Walk on a slippery surface
Walk a brisk mile
Run to catch a bus
Carry and climb stairs
3 flights inside
I flight outside
Get up from the floor
Walk several blocks
Get up from low couch
Cognitive
Risk
Health
Connections
Care
Rehab/reablement
Reactivation
Compensation
Care and support
Prevention: preventing what?
Prevention
Anticipation
Early Intervention
Primary
Secondary Tertiary
ACP
Intergenerational disruption
Falls Manage
ment
Move and
Improve Communication
http://www.evaluationsupportscotland.org.uk/
The first 100
Age by Gender at 2016
0
10
20
30
40
50
60
18-44 45-64 65+ All
Male
Female
Urban/rural classification
1
2
3
4
5
6
not known
Living where? - Urban/rural Classification
Scottish Indicator of Multiple Deprivation
0
2
4
6
8
10
12
14
16
Mostdeprived
Leastdeprived
SIMD classification
33% in 1-3
What Services?
0
5
10
15
20
25
30
Series1
Which Allied Health Professions?
0
5
10
15
20
25
30
35
40
45
50
Band/Grade/Designation of AHP staff
Band 2
Band 4
Band 5
Band 6
Band 7
Band 8
unknown
Reason for AHP visit?
first appointments
return appointments
Unknown
Intervention type
0
5
10
15
20
25
30
35
40
45
Series1
Intervention type Scottish Population (5.29M) • 61% adults and 73% children meeting moderate physical activity guidelines • People with MH difficulties more likely to die 15/20 years early • 50% have at least 1 LTC • 29% in most deprived areas with both physical and mental health difficulties • 21% of adults and 12% children meeting 5 a day guidelines • 65% adults overweight with 29% obese/70% children at a healthy weight Ref: The Scottish Health Survey (2015)
Additional Questions: responses for the 100
AHP setting: 68% community/32% inpatient Referral source: 80% NHS Living with?: 54% with others/36% alone Carers: 90% report they are not Work/regular activity: 75% no regular activity/20% work, volunteer, provide family support Home suitable?: 50% yes/46% struggling or needing help Emotional Wellbeing 64% good/very good 35% ok/not good/very bad Communication needs: 68% report having none
Additional Questions AHP setting: 68% community/32% inpatient
Living with?: 54% with others/36% alone
Communication needs: 68% report having none
Work/regular activity:
75% no regular activity/20% work, volunteer, provide family support
Carers: 90% report they are not
Home suitable?: 50% yes/46% struggling or needing help
Emotional Wellbeing
64% good/very good
35% ok/not good/very bad
Referral source: 80% NHS
Long Term Conditions by Gender
0
1
2
3
4
5
6
7
8
9
10
All
Male
Female
Unknown = 43
100 People service use profile
No records for 6 people
No. Gen Admission
No. people LTCs Male Female
Average Age
Age Range
SIMD 1-4
UR 1-3
1 19 0 or 1 4 15 66 18-101 8 15
2 3 0-4 1 2 45 25-63 2-9 2
3 1 1 1 0 82 82 6 2
5 1 1 1 0 27 27 3 5
non known 75 0-5 37 32 45 18-85 1-10 25
Using What Services in 2015/16?
Number General inpatient admissions
No. people
Length of stay
No. A+E
No. Outpatients
No. MH inpatient
Length of MH stay
Total prescriptions
1 19 220.66 15 14 2 8 1622
2 3 84.66 11 8 0 0 276
3 1 7 2 0 0 0 18
5 1 8.33 7 4 7 140 63
Unknown General
inpatient 75 0 20 40 19 2244 1708
Service use 2010 - 2015
Service Type 2010/11 2011/12 2012/13 2013/14 2014/15
in patient General admissions 27 23 18 16 27
Total LOS 78.6 333 83 133.6 191.6
maternity 2 0 0 0 n/a
in patient MH admission 6 8 25 31 36
Total MH LOS 538 918 1131.3 1220 1492
Total Outpatient 50 34 48 37 51
A+E episodes 47 25 33 43 34
Total BNF items 1789 3993 4136 4420 4884 Unknown General inpatient admission 81 82 84 85 84
National Lifecurve Survey 3 lines of enquiry
Potential areas for investigation • People with 5 or more A+E presentations – who saw them? Did they have care at
home services? No social care data.
• For those with high A+E attendances – is there potential to work with Alliance Scotland (3rd Sector) to change peoples’ trajectories? How do we ‘interrupt’ trajectories at an earlier stage? – ?via Community Led Support test sites?
• This sample has a significant number of MH inputs – so what does this mean for Primary Care and MH – potential for OT input? How do we to test across Scotland?
• Within the larger group – there appear to be 3 distinct cohorts – what does prevention/early intervention look like for each? Thinking about Primary/Secondary/Tertiary levels – eg How is ACP approached? How do we test?
• What are the implications for AHPs contribution to SDS – an approach to social work services? – eg working with independent providers? With care at home services?
• The Lifecurve is based on underlying physical functioning – what about groups who have particular patterns of ‘functioning’ – people with learning disability who experience aging earlier? – People with mental health difficulties – Disabled people who need social care support and the removal of broader
societal barriers to be able to fully participate
Contact Details Susan Kelso, AHP Lead Early Intervention
Scottish Government E: [email protected]
Mob: 0794 308 3735 T: @susankelsoAHP
For More on the Lifecurve:
Go to https://ailip.lifecurve.uk
For more information on AILP programmes visit: http://www.knowledge.scot.nhs.uk/ahpcommunity.aspx