Keeping Well in Communities Building Health Partnerships: self-care @IVAR_UK @SocialEnt_UK #BHPselfcare About Building Health Partnershi ps (BHP) @SocialEnt_UK @IVAR_UK
#BHPselfcare Designed to support local partners in health and care in delivering STPs by focusing on: strong engagement with the voluntary community and social enterprise (VCSE) sector and citizens activities and actions that promote wellbeing and selfcare in the local community Why we are here today To explore ways to utilise community asset based and social prescribing approaches to address some key (costly) health problems, prevent ill health and
promote wellbeing, and to see this better reflected in commissioning approaches and Sustainability & Transformation Plans across the North East. @SocialEnt_UK @SocialEnt_UK @IVAR_UK @IVAR_UK #BHPselfcare #BHPselfcare Core group Amanda Healy Director of Public Health, Durham Catherine Parker - Health & Wellbeing Programme Lead, Public Health England North East Chris Drinkwater Chair Ways to Wellness
Guy Pilkington Chair Newcastle Gateshead Clinical Commissioning Group Jane Hartley Chief Executive, VONNE Jenni McAteer Director Healthwatch North Tyneside Tom Hall Director of Public Health, South Tyneside Council @SocialEnt_UK @SocialEnt_UK @IVAR_UK @IVAR_UK #BHPselfcare #BHPselfcare https://vimeo.com/42332617 @SocialEnt_UK @IVAR_UK
#BHPselfcare Shared understanding of local priorities from last time Whole place approaches to address problems such as employability (recognising all contributions) Self-care training and workforce issues Use of technology and apps to support access to community assets How the money flows through the system to support self-care and how we can improve this Contracting arrangements including barriers to engaging the voluntary & community sector, what we measure and who this matters to
@SocialEnt_UK @SocialEnt_UK @IVAR_UK @IVAR_UK #BHPselfcare #BHPselfcare Guy Pilkington Chair of STP Prevention Work stream Chair of Newcastle Gateshead CCG @SocialEnt_UK @IVAR_UK
#BHPselfcare NHS England Commitment: We will work collaboratively with the voluntary sector and primary care to design a common approach to self-care and social prescribing, including how to make it systematic and equitable (p.45 Next Steps for the Five Year Forward View) www.england.nhs.uk 8 What messages are coming from NHSE
Were building a social prescribing movement across the NHS great energy and potential to help make the NHS sustainable It requires an asset-based approach what do we already have in our community that we can build on? Link worker connector model is key they have time to find out what really matters to people and connect them with community support Build it together, all partners in a local area are important Cant expect the voluntary sector to do everything for free!
www.england.nhs.uk Nationally what do we know ? We know that: Nearly half of all Clinical Commissioning Groups (CCGs) are investing in social prescribing Community navigator/link worker programmes. Social prescribing is included in 75% of Sustainable Transformation Plans (STPs). 1in 5 GPs regularly refer patients to social prescribing. 40% would refer if they had more information about available services (July 2017, GP Online Survey). In South Yorks & Bassetlaw STP area all GPs are able to refer to social prescribing community navigator/link workers www.england.nhs.uk
Catherine Parker, Public Health England Indications of need: Anti-depressant prescribing across the North East and Cumbria STP footprints @SocialEnt_UK @IVAR_UK #BHPselfcare What's happening nationally
The local picture Looking at some related indicators Looking at our assets National picture The number of antidepressants prescribed in England has risen sevenfold in the last 25 years according to one study of NHS England Data Driving the increase; - Increase in need driven by social factors? - More people coming forward, increased awareness, reduced stigma? - Doctor and employer recognition? - Access to (or lack of) psychological therapies? North East and Cumbria STP footprints- anti
depressant prescribing Indices of Multiple Deprivation Access to psychological therapies Access to IAPT services: people entering IAPT services (monthly) as % of those estimated to have anxiety/depression (based on GP practice code) And what about our assets? Thoughts.. Difficult to draw any firm conclusions from a very brief look at a small number of indicators BUT Prescribing levels are high for anti-depressants in our area There are some (but not consistent) correlations with
deprivation Associated costs mean even marginal improvement could potential result in real savings Access to therapies is comparatively good Evidence tells us that social connectedness and tackling isolation as well as medication and therapies are significant enablers for mental health improvement What does the problem look like? What's driving the increase in your communities? How might it be tackled collaboratively (and differently)? @SocialEnt_UK @IVAR_UK
#BHPselfcare Making it stick What are the big things we need to do next to make the change/tackle this problem? @SocialEnt_UK @IVAR_UK #BHPselfcare Break @SocialEnt_UK @IVAR_UK #BHPselfcare
Jane Hartley, CEO VONNE What can help @SocialEnt_UK @IVAR_UK #BHPselfcare VCSE Health and Wellbeing Fund Theme for 2017-18 is social prescribing Aim of the Fund To promote equalities and reduce health inequalities by building the evidence base around good practice in social prescribing, sharing lessons and widening adoption of interventions with a proven track record.
3 years funding - Funding of up to 300,000 for the first year Musts: Provide evidence of a commitment from local partners for resourcing of : 50% in year 2, 80% in year 3, 100% year 4 onwards Include the community navigator/link worker role within its social prescribing scheme model. Be able to demonstrate strong established links with local partners Deadline 21st Nov 2017 https://www.gov.uk/government/publications/health-and-wellbeing-fund-20 17-to-2018-application-form Social Prescribing Network Health professionals, researchers, academics, social prescribing practitioners, representatives from the
community and voluntary sector, commissioners and funders, patients and citizens. Sharing knowledge and best practice Social Prescription Network newsletters NE Yorks & Humber Social Prescribing Network established Summer 17. Next meeting in Newcastle Mon 15th January [email protected] Networks new publication: Making Sense of Social Prescribing What is social prescribing Why do social prescribing What do different models look like What makes a good link worker
What makes a good referral Governance and risk management Evaluation https://www.westminster.ac.uk/patient-outcomes-inhealth-research-group/projects/social-prescribing-ne twork Place Based Social Action Joint 4.5m programme between the Department for Digital, Culture, Media and Sport (DCMS) and Big Lottery Fund (the Fund) using National Lottery funding Aims to create positive change by enabling people, communities, local non-statutory organisations and the statutory sector to work collaboratively to create a shared vision for the future of their place, and address local priorities through social action 3 stage programme offering different levels of support and funding at each stage Phase 1 - Development - 5k available for 1 year for up to 20 places Phase 2 - Delivery - 240k over 3 years for up to 10 places
Phase 3 Scale and Sustain 5 partnerships awarded approximately 255,000 over 3 years one application from each lower or single tier Local Authority VCSE lead & must have evidence of partnership Deadline 28th November 2017 https://www.biglotteryfund.org.uk/global-content/programmes/england/place-based-soci al-action For the future from NHSE Common Framework for Measuring the Impact of Social Prescribing initial scoping underway Julie Daneshyar Public Health England
The Prevention Concordat @SocialEnt_UK @IVAR_UK #BHPselfcare Activate the ideas! @SocialEnt_UK @IVAR_UK #BHPselfcare Feedback and priorities @SocialEnt_UK @IVAR_UK
#BHPselfcare Thank you. Keeping Well in Communities Building Health Partnerships: self-care 30th October Event Summary @IVAR_UK @SocialEnt_UK #BHPselfcare Introduction On the 30th of October 2017 the North East Partnership held its second Building Health Partnerships Meeting at the Pioneering
Care Centre in Newton Aycliffe. The purpose of the session was to explore ways to utilise community asset based and social prescribing approaches to address some key (costly) health problems, prevent ill health and promote wellbeing, and to see this better reflected in commissioning approaches and Sustainability & Transformation Plans across the North East. The session was attended by representatives from voluntary and community organisations, local authorities and the NHS from across the Sustainability and Transformation Partnership areas. The workshop was designed to build upon what came out of the first partnership session and Core Group meetings to date. Rates of antidepressant prescribing as a theme to frame conversations. @SocialEnt_UK
@IVAR_UK #BHPselfcare Speakers: Guy Pilkington Chair of STP Prevention Work stream and Chair of Newcastle Gateshead CCG and Catherine Parker from Public Health England. The full presentation can be accessed via the VONNE Webs ite What does the problem look like?
Participants worked in groups according to their geography to answer the following questions about antidepressant use: Whats driving the increase in your communities? How might the problem be tackled collaboratively (or differently)? @SocialEnt_UK @IVAR_UK #BHPselfcare What's driving the increase in your communities?
The following is a summary of what participants thought the drivers were in their areas (full notes are available on request): Increasing social isolation, breakdown in social networks, poor transport links Financial difficulties, debt, employability Domestic abuse and violence Increase in drug use e.g. Spice Unemployment, zero hour contracts, changes in manufacturing landscape and the resulting reskilling gap Work/life pressures Access to mental health services Multiple, long-term conditions Austerity and benefit reforms are
impacting on peoples wellbeing and leading to a greater demand on support @SocialEnt_UK @SocialEnt_UK @IVAR_UKservices for example debt advice and food @IVAR_UK #BHPselfcare banks #BHPselfcare Limited education around emotional resilience Fewer local resources e.g. housing officer, post offices, pubs which means more isolation Disabled people have less money and are
more isolated Lack of control in peoples lives High number of Carers Gap between mental health services and levels of support from funded meaningful activities/connections Lack of awareness of options for support GPs and people too wedded to medicines through choice or lack of easy, timely alternatives How might it be tackled collaboratively (and differently)? Summary from discussions on what is needed/whats getting in the way of a collaborative
approach to anti-depressant use: CAB, housing support, debt advice and social prescription as part of treatment not pre-curser or add on Educate GPs to consider non-medical approaches (e.g. Ways to Wellness, HealthWORKS) Link budgets e.g. adult education. Targets share priorities on other agendas Culture change across providers, challenge lack of trust in VCSE sector Enable time for organisations to come together
to build relationships VCSE sector to communicate internally better to strengthen their offer Common language and currency - navigator link worker people understand them as quite different things Link workers long term relationships with practices and local organisation and person (depending on need) Outcomes-focused commissioning; 10% braver commissioning Longer term investment and commissioning to allow for meaningful outcomes @SocialEnt_UK @SocialEnt_UK Keeping people in work employers dont
@IVAR_UK @IVAR_UK #BHPselfcare #BHPselfcaresupport people well enough Focus on peoples positives, asset based approach, meet them where they are Understanding responsibility and people being able to own their own choices Have a wide range of support available enable people to step from one to the other Asset mapping/profiles Open collaboration between mental health services and VCSE plan together, equitable status Bringing workforce together; education and
training of workforce in asset based approaches Making it stick In the second half of the session, participants were asked to think about the following question: What are the big things we need to do next to make the change/tackle this problem? Participants selected a theme to work on and went onto identify the changes needed to tackle the problem e.g. capacity (both inside and outside the room) they would need to draw on and the very next steps to take action.
@SocialEnt_UK @IVAR_UK #BHPselfcare Tees Valley What are the big things that we need to do to make the changes/tackle the problem? What do we need to make the changes to Theme: tackle the problem? Mapping social prescribing and what good Menu of options looks like with people that have used Speak to users projects or peer support and that havent Speak to providers and GPs
engaged with the approach yet but have accessed other support (control group) with Clarification on roles: navigators, link workers (awareness of dependency and withdrawal) the view to designing a pathway List of different navigator type roles in different environments i.e. Fulfilling Lives Who can refer into the Social Prescribing scheme? Multiple entries into the system What capacity/skills can we draw on? Inside/ Very next steps outside the room? Pull together group Fuse network of public health (5 NE Develop simple questions Universities) could support this work
@SocialEnt_UK @IVAR_UK #BHPselfcare South Tyneside What are the big things that we need to do to make the changes/tackle the problem? What do we need to make the changes to Theme tackle the problem? Trust within the sector, between the sector Bravery 10% braver enable commissioners and commissioner to feel safe in the change Being brave and taking a risk Voluntary sector showing successes that are recognised
Outcomes that matter to people commissioners valuing this different outcomes framework data collected differently, telling stories (housing, family, health) What capacity/skills can we draw on? Inside/outside the room? @SocialEnt_UK @IVAR_UK #BHPselfcare Very next steps Identify opportunities to bring commissioners and voluntary sector providers together
North Tyneside What are the big things that we need to do to make the changes/tackle the problem? What do we need to make the changes to Theme tackle the problem? How do we create a universal approach to accessing assets in the community? Start with the person and their needs (not condition specific) What capacity/skills can we draw on? Inside/outside the room?
Very next steps Joined with South Tyneside to share common discussion themes @SocialEnt_UK @IVAR_UK #BHPselfcare Framework Durham What are the big things that we need to do to make the changes/tackle the problem? What do we need to make the changes to tackle the Theme problem?
Local social prescribing network in Durham, smaller Engagement from all partners, voluntary sector, community/village level sub-groups medical professionals and commissioners credibility Explore role of navigators and link workers CCG level acknowledgement that social prescribing works Champions in each sector especially the NHS Map assets and needs locally What capacity/skills can we draw on? Inside/outside the room? Teams around patients - TAPS shared agenda Measuring and communicating value of social prescribing Organisations involved/stakeholders dont recognise
their own role in social prescribing Dont forget value of volunteers e.g. mentoring and befriending @SocialEnt_UK @IVAR_UK #BHPselfcare Very next steps Feedback from today to TAPs via Jenni and integration board Identify champions locally CQC rated outstanding surgeries as a starting point? Look for learning from other local networks Agree on purpose of network to get the buy-in Amanda to feedback to prevention workstream
Better Together forum (DCA) as next sounding board Newcastle Gateshead What are the big things that we need to do to make the changes/tackle the problem? Theme: Workforce, cultural shift, better relationships What do we need to make the changes to tackle the problem? Change workforce so there are more people who can help with the social determinants i.e. a shift of money and resources. Enhanced but fewer clinicians/GPs as part of a wider team which includes link workers, CAB, employed by local VCS etc. Link workers embedded in wider team
and enhance existing roles Improve understanding and collaboration this will need commissioner support Each sector needs to prepare separately before meeting together with commissioning partners Commissioning grants to encourage VCS to work together and commit to support each other in a difficult economic climate What capacity/skills can we draw on? Inside/outside the room? WAG Workforce Action Groups working with statutory sector can we help you re work transformation? We can be part of the team? How can we help with the deficit? VONNE, NCVA - to spread the message
Very next steps Spread the message Feed in re. training, support to WAG and LWAB Mapping where does the money sit? @SocialEnt_UK @IVAR_UK #BHPselfcare
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