Bulletin no. 7 4 December 2013

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

Welcome to the seventh 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 six Bulletins, which tell the story so far.

Recent Highlights

  • Heads of Terms Agreement – Newcastle West CCG are ready to sign a Heads of Terms agreement with Ways to Wellness. This follows very careful consideration of all aspects of the project, discussion at two meetings of the Newcastle West CCG Executive, and discussion and approval at the formal meeting of the NHS Newcastle Gateshead CCG Alliance Board. This is a milestone for the project and means that we can now start to approach social investors.
  • Progress on Metrics – NEQOS (North East Quality Observatory Service) produced a document setting out the pros, cons, recommendations and rationale of various metrics that could be used to measure the effectiveness of Ways to Wellness. This formed the basis of a meeting with the CCG (including participants from finance, information governance and commissioning) to pin down the metrics to use as the basis for the contract. This remains the most challenging aspect of the project, but progress is being made.
  • Strong engagement with CCG Commissioners – we now have a member of the commissioning team who has some dedicated time to work with Ways to Wellness and this is already making a significant difference to our ability to move forwards with the work.

On-going development work since 22 October

  • “Sense Checking” with Social Finance – we have engaged Social Finance (a national charity who are leaders in the Social Impact Bond field) to review our financial modelling, operational plan and investment strategy. This has involved meetings and desk based reviews, and there is helpful detailed feedback for us. The overall message is that we are progressing well and are on track. The main weak area is that we had not yet tied down which metrics to use for the contracting. They have been impressed by the level of engagement of the CCG and GPs.
  • Networking with developing Social Impact Bonds – via a conference call hosted by Department of Health, with Cabinet Office input. A useful round up of progress for the other developing health and social care related SIBs. Procurement was the main common issue we discussed.
  • NESTA Expression of Interest submitted – this bid is for work to strengthen the Peer to Peer element of the project. Recruiting, training and supporting patients with long term conditions who have been through social prescribing and who could help to motivate newer patients and potentially lead activities such as health walks.
  • GP Engagement – we met a wider group of GPs at their Forum meeting, where we had a useful discussion on the proposed patient target group. There has also been an article on Ways to Wellness in the GP weekly newsletter.
  • Contracts & Procurement – we are working with Muckle LLP to ensure that we have processes that are fair and transparent and that Ways to Wellness can procure the range of services from providers strongly linked with the local community. We are also consulting about an appropriate contract that will reward providers to help patients to achieve long term behaviour change whilst ensuring we do not incentivise dependency.
  • Financial Modelling – as we change the operational model to take account of stakeholder feedback and new thinking, the financial model needs to be refined. We are lucky to have a finance expert on our Steering Group who patiently re-works this for us – we are currently up to version 9 of the financial model.
  • Social Impact Bond Supporters event at Clarence House, hosted by Prince Charles – our Steering Group Chair attended this event, which was a useful opportunity to network with potential social investors.
  • Ongoing Communication with Local Stakeholders – including a presentation to the “Better Together” meeting (staff/medics from acute trust, CCGs, LA and community staff who meet regularly to look at improving services across pathways); attendance at CCG Community Forum; meeting with Newcastle CVS Chief Executive.
  • Guardian Article on Social Prescribing in Newcastle – good article, mostly on the NESTA pilot project but also with a mention on the work we are doing to develop social prescribing http://www.theguardian.com/society/2013/nov/05/social-prescribing-fishing-group-doctor-ordered
  • VOLSAG Meeting – VOLSAG have been progressing various areas of work around social prescribing and mental health, which are useful for Ways to Wellness, particularly around the skills link workers need to support patients with LTCs and depression/anxiety, and potential training courses for their induction.
  • Social Investment – we have been revising the social investment strategy and working on a short investment document to enable us to start conversations with potential social investors.

Recent Challenges

  • Management Information Systems and Metrics – we have a useful report from an MIS specialist which maps out our MIS needs, and articulates the work we need to do to ensure smooth referrals, relevant data capture and that we do this in a way that conforms to NHS information governance. MIS and, as previously mentioned, the metrics work, are critical to being able to prove that the project is working, and to support ongoing performance management. We know where we need to be with this but there is still a way to go before we have it all in place.
  • The Plate Spinning is getting harder! – whilst the project develops a pace, the practicalities are that there is a half-time project director with some paid support from a couple of the Steering Group members. This is an exciting and ambitious project, which has huge potential, however, we are running out of resources from our original development grant. We have submitted a bid to the Big Lottery for £150k funding for technical assistance from the Commissioning Better Outcomes and the Social Outcomes Fund. If we are successful this will ensure that we can buy in the necessary resource to establish a project company ready to commence operations.

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

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