commissioning for wellbeing outcomes (bringing it all together) tim anfilogoff head of community...
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Commissioning for Wellbeing Outcomes
(bringing it all together)
Tim Anfilogoff
Head of Community Wellbeing
What is an outcome?
• A result• A state of being we
are trying to achieve• Not a measure of how
well we are doing but a measure of how well they are doing!
What is Community Wellbeing?
‘Flourish’ model (Perma)•Positive Emotion•Engagement•Relationships•Meaning•Accomplishment (all have links to volunteering)
Wellbeing and Public Policy, Martin E.P Seligman, July 2011
The Five Ways to Wellbeing
• Connect…
• Be active…
• Take notice…
• Keep learning…
• Give…
A set of evidence-based public mental health messages aimed at improving the mental health andWellbeing of the whole population. They were developed by the NewEconomics Foundation as resultof a commission by Foresight,(HMG’s futures think-tank) as part of Project on Mental Capitaland Wellbeing.
Foresight. (2008). Foresight Mental Capital andWellbeing Project: Final Project Report. London: TheGovernment Office for Science.
The 49 Community Wellbeing Outcomes
• Built on 10 Priority Outcomes of Prevention and Wellbeing Review
• Looking at physical, mental, economic wellbeing and access
• Community Cohesion, Big Society, Social Capital
• Under development
CWB most identified outcomes (in top 3)
Outcome ProjectsHelped to have a life outside caring
(breaks to support other outcomes)48
People no longer isolated, with social networks of 4 or more
44
People know where to go for help 34
People have more choice and control 33
Helped to carry on caring 32
CWB outcomes not yet identified (in projects’ top 3)
People have given up smoking 0 Reduction in obesity 0
Reduction in falls/falls prevention 0 People drinking safe amounts of alcohol or
less/people reducing misuse of substances0
People are encouraged to access appropriate immunisation (eg flu)
0
People into/back into learning 0 People using medication properly/better 0
People’s spiritual needs are being catered for 0 Any/all outcomes achieved for groups protected by
Equalities Legislation/other disadvantaged groups 0
Volunteering: tool or outcome?• £1m invested in 82
lunch clubs
• 3,100 users
• 186 part-time staff
• 822 volunteers – mainly 70+
• Only 8 projects identify volunteering in top 3 outcomes
• But….
Warwick-Edinburgh Mental Wellbeing Scale
Seven item scale 1. I’ve been feeling optimistic
about the future
2. I’ve been feeling useful3. I’ve been feeling relaxed4. I’ve been dealing with
problems well5. I’ve been thinking clearly6. I’ve been feeling close to other
people7. I’ve been able to make up my
own mind about things
Five point Likert scoring system
– None of the time = 1– Rarely = 2– Some of the time = 3– Often = 4– All of the time = 5
Wellbeing by Involvement
Wellbeing by Nature of Area
Building a ‘healthy community’Community Connections Time-Bank New York
•100% surveyed benefited from being a member• Lowest self-reported annual income and those doing survey in Spanish had highest benefit•98% could use skills to help others•48% improvements in self-rated physical health•72% improvements in self-rated mental health
Building resilience of carers
• 40% of family carers have psychological distress/depression
• Increased rate of physical health problems
• One in five gives up work to care
• More than half fall into debt
PCT Breaks Monies
• Bringing Carers Breaks commissioning by HCC/PCT together in integrated way
• Measuring health outcomes from ‘breaks’/’low level services
Carers’ Risk of Depression SF12 Screening PCT funded breaks (includes Crossroads)
39%
20% 20%
0%
5%
10%
15%
20%
25%
30%
35%
40%
% a
t ri
sk
Pre Support Post Support Whole population
Based on • 137 Pre and Post Support Questionnaires (including Crossroads)
Outcome 4: Stay fit and healthy and be safe
RCGP/e-Learning for Health Supporting Carers in General Practice (2011). Accessed via: www.e-lfh.org.uk/projects/supportingcarersingeneralpractice/index.html
Evidence of benefits of noticing carers early (improving resilience)
Caring with Confidence (CWC):
‘CWC does what it says. It made me feel as though I was
not alone and helped me with how to cope in different
situations. I also made lots of wonderful new friends”
‘CWC has taken me from 'being a victim of my
circumstances' to realizing it's in my hands to be
more positive and make a difference to my own life".
Building resilience for all
What do I do about?
• Anti-Social Neighbours• Adaptations to home
following a stroke• Befriending service for a
client in care home• Looking for volunteering
opportunities • Information about free
school meals• Support with cleaning in
the home
Telephone 0300 1234 044
We can help. Or we know someone who can
From small acorns…
• Recommissioning – adding PH outcomes
• Link to JSNA
• Clear outcomes for all partners/SROI
• Increased social capital
• Model of a ‘healthy community’
