Bulletin no. 2 10 May 2013

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

Welcome to the second Bulletin for the Ways to Wellness Project. If you are new to the project or want to refresh your memory then please refer to the FAQs and Bulletin no. 1, which tell the story so far, and can be found here.

Highlights of the month

  • “Critical Friends” Session with GPs, Practice Nurses and Practice Managers – the first of several “Critical Friends” sessions we are holding at this early stage in the design process to help us to get the operational model right. The enthusiasm was very encouraging, and we did not have to “sell” the concept of social prescribing (which was described three times by participants as being a “no-brainer”), rather we were able to spend the time getting useful advice on how best to implement the model to increase referrals and reach the most appropriate patients. We had been hoping to get 3 GPs, a practice nurse and a practice manager in the room to help us, but ended up with twice this number, plus the CCG head of commissioning and the CCG chair. A very encouraging start.
  • Meeting with the Senior Management Team at Newcastle West CCG – our first chance to sit down and explain in detail our early thoughts on the potential operational and financial model for the project. It was a positive meeting with the general tone being more “how do we make this work well for patients?” rather than “should we do this?”.
  • Nesta Published their People Powered Health Business Case - its executive summary says that People Powered Health innovations which involve patients, their families and communities more directly in the management of long term health conditions could generate savings equivalent to a “..7 per cent reduction in terms of reduced A&E attendance, planned and unplanned admissions, and outpatient admissions. There is therefore both a social and financial imperative to scale the People Powered Health approach”. The findings give support to the cautious assumptions which we included in our draft financial model. We will be drawing on the report’s findings as we refine our plans. The report can be downloaded from http://www.nesta.org.uk/about_us/assets/features/people_powered_health
  • Newcastle West CCG published their Commissioning Plan – for 2013/14 to 2015/16 and Social Prescribing was mentioned 5 times! http://www.newcastlewestccg.nhs.uk/wp-content/uploads/2012/07/NWCCG-Commissioning-Plan-Final-201314-201516.pdf
  • Meeting with The Big Lottery– who will be launching a Co-commissioning fund in July. This will provide the opportunity to apply for top up social investment payments and also for development funding to cover the costs of technical support, plus funding for an external evaluation running for up to 10 years.

On-going development work since 12 April

  • Follow up work from local Nesta social prescribing project– including meeting with Involve NE re the evaluation they are working on and the health signpost directory; meeting Sarah Richard re updates on care planning training, the work HAREF are doing re increasing access for BME communities; meeting with Volsag re their follow up work to improve competencies and confidence of link workers to work with patients with anxiety and depression linked to their LTC.
  • Patient Involvement - contact made with Martin Bell, (Practice Manger and one of Patient and Public Involvement leads for CCG) to discuss the best way to involve patient forums. Agreed with Involve NE to await outcomes of local Nesta evaluation (due out end June), which includes focus groups with patients re their experience of social prescribing, before running any further sessions with patients, so we can address any issues/good ideas coming out of the evaluation.
  • Governance – engaged specialist consultants to start work on what the structure and governance of the Ways to Wellness Special Purpose Vehicle should be. Current thinking is that it may be a Community Interest Company, but we are still looking into this.
  • Sense Checkers – phone calls with PWC and Social Finance to see how/if they might be able to help us in terms of undertaking a “sense checking” role for the project.
  • Communications – ongoing 1:1 meetings with stakeholders to try to keep people in the loop including Newcastle CVS, Northern Rock Foundation, local authority representatives etc.
  • Planning for “Critical Friends” session 2, the role of the link worker – the link worker within the VCS social prescribing providers will be key to the success or failure of this project. This will include their skills and competencies to help patients to set goals/actions plans, motivating patients to achieve long term behaviour change and their role in collecting and feeding back outcomes data etc. We need to get this right and the Critical Friends session later in May with 4 local VCS organisations, who have been main providers of social prescribing in the Nesta pilot, will form part of our work to address this.

Challenges this month

  • How to evidence the cost savings? – this was a challenge last month, and I have a feeling it will continue to be a challenge going forwards! We have now had an initial meeting with Ian Davidson at the CCG who has developed RAIDR, the bespoke software package which can track patient costs, and we are hopeful that we can start to identify what we will and won’t be able to evidence in this way.
  • Evaluation–How will we know this is a success? What do we measure? When do we measure it? Who collects what data? etc etc. In addition to what we may be able to collect through RAIDR, and from the social prescribing providers, we have had a couple of meetings with public health and research experts in universities to help us to start to think this through. But we are keen that this is “an evaluation of an operational model” rather than an academic research project.
  • Who are the target group? - this continues to be a challenge, but in a good way. In general terms, we know our target group is people with long term conditions in the West of Newcastle. However, having given it serious thought and producing a first attempt at closely defining the target group, based on strongest evidence of what works best with which patients, we were then greeted with enthusiastic GPs and practice staff who seem to want to refer any patients with LTCs. This is work in progress!

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