Bulletin no. 3 18 June 2013

Ways to Wellness – a new approach to long term conditions in Newcastle

Welcome to the third Bulletin for the Ways to Wellness Project. The Bulletin assumes that readers are already familiar with the Ways to Wellness Project, so if you are not already aware of our work then please refer to the FAQs and Bulletin nos. 1 and 2, which tell the story so far.

Highlights of the month

  • Formal feedback from Newcastle West CCG to confirm they are happy to engage with Ways to Wellness - and, importantly, that they will allocate staff time to the project.
  • Meeting with Tamsyn Roberts, Head of Centre for Social Impact Bonds at the Cabinet Office, London – useful to make contact and to talk through how other SIBs are developing and how to approach various aspects of the project.
  • Homecare Innovation Challenge Summit, Department of Health with Norman Lamb MP – an interesting event, hosted by the Guardian and filmed by the BBC. The event was very much focussed on frail elderly people, whereas Ways to Wellness is focussing more “upstream”. Our pitch on this was that we need to do more to prevent, delay and shorten the period of time when people need homecare.
  • “Critical Friends” Session 2 with link worker organisations – as part of the design process we met with managers and link-workers from four VCS organisations who have been delivering social prescribing in the West of Newcastle (as part of a recent Nesta pilot project). This was really helpful particularly to test out 1) the role of the link worker, 2) measuring meaningful outcomes and 3) how link worker relationships work to communicate/refer between VCS organisations.
  • How might the contracts work? – following on from the above session we met with managers of the four VCS organisations to talk through how contracting arrangements could work between Ways to Wellness and the VCS delivery organisations (whilst making it clear that there would be an open procurement process and that their participation in discussions did not mean that they would, or would not, be successful in that process). The key issues for Ways to Wellness are to ensure that payment/contracting incentivises two key outcomes; long term behaviour change for patients with long term conditions and addressing health inequalities.
  • Sample Social Impact Bond contract received from Cabinet Office – debateable whether this is a highlight of the month, as it is 79 pages of contract and 46 pages of guidance notes, so not a riveting read! However, it is really useful to see a sample contract and should save some time if elements of it can be used for the Ways to Wellness project.

On-going development work since 12 June

  • Work on revised financial model – we are revising the original financial model, in light of feedback from the “critical friends” planning sessions and also to take on the information from the Nesta People Powered Health Business Case.
  • Communications –keeping people up to date and informed about the project is important. Meetings this month include Ian Kitt, Age UK North Tyneside who are developing a project using a social impact bond model; Dawn Scott, Acting Director of Public Health at Newcastle City Council; presentation to the VONNE Board. Also 2 short articles submitted for Newcastle CVS publications.
  • Meeting with GP Social Prescribing lead for the CCG – a useful discussion particularly around GP expectations/needs for the project.
  • Patient Engagement – met with Patient and Public Involvement (PPI) lead for Newcastle West CCG. Useful discussions re patient engagement options in the design process and also booked in to speak at various PPI meetings.
  • Investment and Contract Readiness Fund –an application to the fund is being prepared, with Social Finance. If successful this should pay for some expert “sense checkers” to review various elements of the project, and could also pay for specialist legal support that will be needed.
  • Expression of interest for legal work – the project will need legal advice especially around the contracting and the setting up of the special purpose vehicle. Several specialist national legal firms and three local firms were invited to put in an expression of interest and we are currently reviewing their submissions.
  • Social Marketing – part of the local “culture change” work that we need to do with patients, public and practice staff may involve a local social marketing campaign. We have started to have initial conversations with people about how this could work.
  • Project management – a reasonable amount of time is taken up just checking we are on track such as revising and reviewing our risk register, GANNT Chart, Project Plan and preparing papers for the Steering Group etc.

Challenges this month

  • Getting time with senior Newcastle West CCG Staff – whilst supportive of the project, the staff are very busy with conflicting priorities and getting time with them to talk through a couple of critical questions is proving difficult. This is our main challenge at this point in time and is becoming a risk to the project delivering on time and within budget.
  • Evaluation – This is such an exciting opportunity to test out the use of using social prescribing, at scale, over a long period of time. However, a lead person to take on the long term evaluation of this project has still have not been identified. Ideally there should be someone sitting in on Steering Group meetings to listen to deliberations and help to inform the design of the project. We are following up on a couple of conversations and have a couple more meetings with potential people coming up.
  • Managing expectations in the local VCS – Ways to Wellness will need to contract with a number of local organisations to deliver key elements of the social prescribing offer, especially around supporting and motivating patients to achieve long term behaviour change. However, the model will only work if we can prove that not only is patient health improved, but that the service saves the NHS money, so there will not be a large amount of funding to pay for activities, and the project will be looking for low cost/no cost activities. With significant funding cuts affecting VCS organisations we are aware that some organisations are looking to Ways to Wellness as a possible source of funding. Managing expectations is hard, as this project is unlikely to help with funding in the short term.

Sandra King – Project Director, on behalf of the Ways to Wellness Steering Group.

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