New ways of delivering prevention and

self care services to patients

Dr Chris Jones, Clinical Lead & Programme Director and Sarah Fatchett, Strategic Lead West Wakefield Health and Wellbeing Vanguard Patricia Parker, Commissioning Manager, Prevention and Supported Self-Care West Cheshire Way – Multispecialty Community Provider Dr Helen Rostill and Kirsty Scarlett, North East Hampshire and Farnham Primary and Acute Care Vanguard. Dr Andy Knox, GP and Lancashire North CCG Executive lead for Health and Wellbeing Jacqui Thompson, Senior Manager, Planning and Partnerships, Lancashire North CCG Chair: Martin Routledge – Director, Coalition for Collaborative Care

Panel Members Contact Details:

• Dr Chris Joan's chris.jones@westwakefield.org.uk

• Sarah Fatchett, Strategic Lead chris.jones@westwakefield.org.uk

• Patricia Parker , West Cheshire Clinical Commissioning Group – patricia.parker6@nhs.net

• Dr Andy Knox, GP and Lancashire North CCG Executive lead for Health and Wellbeing andy.knox@nhs.net

• Jacqui Thompson, Senior Manager, Planning and Partnerships, Lancashire North CCG jacqui.thompson@nhs.net

• Dr Helen Rostill, North East Hampshire and Farnham Primary and Acute Care helen.rostill@sabp.nhs.uk

• Martin Routlege, Coalition for Collaborative Care martin.Routledge@nhs.net

Disruptive Prevention The School as a place of care

• Schools App Challenge

• School Nurse Role Redesign

• HealthPod

• Dental Health of under-5s

Disruptive Prevention The Local Authority as a place of care

• Fluoridation

• Care Home Dental Assessments

The Community as a place of Care

• Community Anchors

• Community-based engagement workers

• Micro-commissioning

• Self-care approaches via Five Ways to Wellbeing

Community Models of Care – prevention

• Obesity ‘Daily Mile’ initiative with local primary schools

• Wellbeing coordinators - enablers and facilitators

• Integrated wellness service

• iVan – community and primary care cluster working

• Pharmacy First

• Brightlife

• Healthy High-street

• Big Community Conversation – social movement

• Community engagement

Prevention and Self-Care

Prevention and Self-Care Community Models of Care – supported self-care

• Diabetes essentials (including pre – diabetes prevention)

• Self-Management UK – self-care for life (children, young people and adults)

• Peer led ‘one to one’ coaching – less activated patients (adults)

• Apps and telehealth/telecare

• iVan – community and primary care cluster working

Primary and Acute Care System Pilot

Happy, Health, at Home

Identifying Our Priorities Main Causes of Death and Disease for our Citizens

• Cancer

• Cardiovascular diseases

• Respiratory

• Diabetes

• Mental illness (Suicide)

• Accidents ( children and young people

Main Risk Factors to Target

• Smoking

• Hypertension

• Obesity/Poor Diet/Lack of Exercise

• Alcohol

• Social Isolation

• Falls

• Care of the under 5’s

• Lack of road safety awareness

• Being a carer

• Poor mental health

Happy, Healthy at Home Solutions Social Prescribing • Our aim is to reduce risk factors leading to ill health and enable local citizens to meet their goals

and desires to lead a happy, healthy life at home. • Making Connections Co-ordinators identify need, offering bespoke health and wellbeing solutions

and build relationships with community resources. • Create a community of volunteering and social responsibility.

Healthy Living Pharmacies • A nationally recognised model in which pharmacies offer a breadth of front line health advice and

interventions. • They can play a significant role in reducing health inequalities and improving access to primary

care within the local community. Caring for Carers • Establishment of carers’ hubs in localities and a carers’ forum.

The Safe Haven Café & Recovery College

The purpose of the service is to give people a safe place to turn to if they need mental health support out of hours, in addition to existing out of hours and crisis provision.

• Alternative to A&E

• Staffed by professionals, who are supported by volunteers, giving people the opportunity to talk to someone who has also lived with a mental health problem.

• Access to a range of community information on mental health and wellbeing

• Invaluable peer support which promotes integration into the community.

• Recovery college programme offering a range of support - information on job seeking, harm reduction, socialising, activity and diversionary work

• The Safe Haven Project (Time Out Café) is a pilot project funded by the North East Hampshire and Farnham Clinical Commissioning Group.

• Partnership working - Surrey and Borders Partnership Foundation NHS Trust, mcch and The Welcome Project.

Taking A Citizen-Led Approach

• In 2011, Mind commissioned an independent inquiry into acute and crisis

mental health services.

• During 2012, a consultation was conducted in North East Hampshire and

Farnham by an independent organisation, Uscreates, involving service

users, carers, statutory, primary care and third sector providers as to why

people use A&E for their mental health needs.

• In 2011, Surrey and Borders Partnership FT conducted a comprehensive

project to review the pathway for urgent assessments.

• In February 2014, the Mental Health Crisis Care Concordat was published

outlining principles of good practice and multi-agency working.

Safe Haven Café

What People Tell Us

It has

prevented two

crises from

escalating

If the Safe Haven

wasn’t here I

wouldn’t have

recovered as well as I

have

I would

have had

more crises

I feel cared

about, that I

matter, that I

am worth it

I can come

here and sit

quietly if I

want to but

I’m not on

my own

On several

occasions I

have narrowly

avoided going

into crisis by

going to the

Safe Haven

The Safe Haven

is somewhere I

can come and

be myself, feel

accepted and

listened to

It’s good that its open in

the evenings because

evenings are a difficult

time for me and a lot of

others

It is

somewhere

where I can

come and

feel safe

Safe Haven Café Impact

• April – June 2014 saw an average of 167 attendees a month, with an overall score of 95% positive feedback from surveys of people using the service

• One year later, the average number of attendees from April – June 2015 had leapt to 415 (1,245 attendances in total)

• Of the total attendees over these three months, 206 reported their attendance as an alternative to A&E; most people attend to maintain wellbeing during difficult times.

• The evaluation report highlighted considerable support for the Safe Haven from all partners and those that had used the service; for some people the Safe Haven is now an integral part of their care plans.

• A separate study carried out for SABP by Mental Health Strategies found that from April to October 2014, the number of admissions to acute in-patient psychiatric beds fell by 33% from within the Safe Haven catchment area.

The Carnforth Conversation

Life in Carnforth