Bulletin no. 6 22 October 2013

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

Welcome to the sixth 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 the first five Bulletins, which tell the story so far.

Recent Highlights

  • NEQOS Independent Review Document received – the headlines from the document are that there is a good evidence base for the effectiveness of the approach that Ways to Wellness is proposing, and that there is a reasonable level of confidence that treating 5,000 patients in this way could generate net savings to Newcastle West CCG of £2m-£7.5m. NEQOS (the NHS North East Quality Observatory System) had reviewed the Ways to Wellness Draft Operational Plan and also the available evidence base to produce the review document.
  • Passed Expression of Interest Stage forBig Lottery Commissioning Better Outcomes and the Social Outcomes Fund – this is excellent news as we can now apply both for funding for the technical support we need to complete the development of Ways to Wellness, and also means we can move to Stage 2 and that the CCG can apply for support for up to 20% of the costs of the outcomes payments once the project is operational.
  • Meeting Dr Mike Prentice, NHS England Area Team – the meeting was to introduce the Ways to Wellness project and get Mike’s views on the work. Mike was very supportive of the approach that Ways to Wellness is taking. He is keen to see CCGs work more effectively with patients with long term conditions, and thought that Ways to Wellness was a good way to do this.
  • Meeting with Newcastle West CCG Finance Director and their Solicitor – this was a really useful meeting where we answered questions that had been raised at last month’s CCG Executive meeting, and also started to look at the practicalities of how the CCG can move to procurement, ensuring that they meet all the rules and regulations around this. As with other elements of the development of Ways to Wellness, this raises questions that have not been answered before, as, to our knowledge, no other CCGs have looked to work with a social finance model in this way, and we have also spoken to Monitor who are considering what the implications might be.

On-going development work since 19 September

  • Work on Metrics – we are progressing the work on the metrics that could be applied to demonstrate the cost savings, including the availability of data to populate the metrics from sources such as RAIDr etc. We have been working with NEQOS on this, who are also producing pros, cons and feasibility of utilising each metric and the viability and validity of the proposed metrics available. We have also had discussions with other national projects to try to find if there are any other organisations who have found a way to do this, but have still not identified anyone who has cracked this! Hopefully once we can demonstrate a way to do this it will be of use not just to us but other projects nationally.
  • Various Presentations – these are all important to engage with local people and get feedback on the Ways to Wellness model as it develops. The three presentations this month took place at Newcastle West CCG Practice Managers Meeting; Newcastle CVS Wellbeing and Health Open Forum and also at the “Better Health, Fairer Health? Public Health in Newcastle 2013-16” event hosted by HealthWORKS.
  • First Draft Heads of Terms Document – we need to get a Heads of Terms Agreement to the meeting of Newcastle West CCG Executive on 5 November, ahead of the Formal Board Meeting at the end of November, where it will (hopefully!) be signed off. We have produced a first Draft and will be getting this looked over by our solicitors. Once we have this in place we can start formal approaches to social investors.
  • On-going work on Ways to Wellness incorporation and Board recruitment – we are getting advice on the best structure for Ways to Wellness (CIC, Company Ltd by Shares etc) as it needs to be incorporated within the next month or so. We are also looking at the key competencies we need for the Board Members, so that we can start the process of recruiting the Board.
  • Work on the Target Group – this is an on-going and important part of the project development, as we look to get the balance right between where the evidence base shows us we should target (in terms of most likely increases in patient health and also cost reductions to CCG), and where local GPs think the target group should be, based on their experience of working with patients and the issues they present.
  • Various meetings and phone calls with people interested to learn more about the Ways to Wellness Project - including Beverley Oliver, Head of Health Improvement, North East Public Health England Centre; Alma Caldwell, Chief Executive of Age UK North Tyneside (who are developing a Social Impact Bond in North Tyneside); Mark Davis, Middlesbrough Voluntary Development Agency (who are developing Social Prescribing work and particularly interested to see how we can demonstrate effectiveness).

Recent Challenges

  • Being turned down for ICRF funding – this was a real blow as we particularly need help with three critical elements of work linked to 1) “sense checking” ahead of approaching investors, 2) legal advice and support at the contracting stage and 3) establishing robust performance benchmarks. The ICRF pot was heavily oversubscribed and we were encouraged to apply to the Big Lottery Commissioning Better Outcomes and the Social Outcomes Fund.

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

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