health and well being - accord · health and well-being other key challenges for public health: •...
TRANSCRIPT
Design & Challenge
Accord Group Service Model
Workshop
Health and Well Being 26th March 2013
key messages from
research / best practice
The Need for New Ways,
Creativity and Innovation
“The imperative to derive value from every pound of health and social care spend is never likely to have been greater than it will be over the next 20
years.
Innovation cannot be just about doing more things to more people. New technologies will need to be exploited to the full to drive up productivity or
the NHS and social care services could struggle as they try to meet growing demand with no equivalent growth in resources.
A need for creative and innovative workforce and service planning has never been more critical.”
“It is time to think differently about health and social care.”
Source: Future Trends Overview, The King’s Fund, November 2012
Demography
• Population is ageing Next 20 years population aged 65-84 will rise by 39% and those over 85 by 106%.
• Life expectancy and healthy life expectancy are growing
• Population is growing next 20 years up by 8 million in England to ~ 61 million (4.5m births – deaths; 3.5m net migration).
• Population is becoming more diverse
• More people living alone 11.3 million people (~40% all households) by 2032.
• Persistent health inequalities Highest socio-economic class live ~ 7 years longer than lowest socio-economic class, and more years disability free.
Illness and Disability
• Number with some diseases to double over the
next 20 years
e.g. 17 million with arthritis by 2030.
• Older people with care needs predicted to rise by 61% by
2030
• Number with more than one long-term condition growing
rapidly
people with 3 or more long-term conditions predicted to rise
from 1.9 to 2.9 million by 2018.
• Significant health inequalities are likely to persist
• Continuing threats from communicable disease
e.g. cases of HIV continuing to rise.
Illness and Disability
“A change in population lifestyles offers the
greatest opportunity to reduce the burden of
chronic disease”
Future Trends (the King’s Fund, 2012)
Lifestyles
Current lifestyles present a serious threat to health,
particularly for more disadvantaged groups
• 66% adults fail to meet minimum levels of activity
• 70% do not consume 5 a day fruit and vegetables (80% of
children)
• 26% are obese - predicted to continue to rise (higher rates in
more disadvantaged groups) - weight related probs likely to
cost £50bn 2050
• 21% smoke
• 27% of men and 18% of women drink above the safe limits
of alcohol.
Health and Well-being
Other key challenges for public health:
• social isolation
• poor mental health including depression (costs £105 billion
annually in England alone) - despite evidence based interventions with a
broad range of impacts, only a minority of people with a mental disorder
currently receive any treatment
• poverty (claiming benefits can improve health and well-being)
• malnutrition - 1 in 10 older people in community
• domestic violence
– 1.2 million women / 800,000 men each year in the UK.
– Leading cause of injury and illness for females aged 15-44.
– Accounts for ¼ of all violent crime.
Health and Well-being
Protective factors for health also include:
• having a purpose
• a sense of well-being
• feeling at home and connected to others.
Health and Well-being
“Significant innovations are
needed to support vulnerable
people”
Future Trends (the King’s Fund, 2012)
Technology
• Assistive technology / telecare / telehealth / mobile devices
Potential to make care more effective, efficient and personalised + help
generate and share knowledge. However, could also make care-givers
more remote, and reduce efficiency through data overload.
• Social Media
Given new power to consumers – share & evaluate; create & link to
communities; adapt content.
• ‘Apps’
Wide array of uses in health / social care, incl. providing information about
conditions and supporting self-diagnosis & management.
Research clearly indicates new technologies can be a force for good , e.g. health promotion.
Apps
App Examples
• GWEN Alert personal safety App to get immediate
help in an emergency
• MoodKit example of CBT / Self Help
• MOOD – txt msg reminder to submit mood score
• CANTABmobile
“accurately distinguishes normal age-related forgetfulness from
dementia and other treatable memory problems.”
What Works?
Helping to Keep Older People Healthy and Happy
* Helping to Keep Older People Healthy and Happy
* Community Health Champions
* Fit as a Fiddle Project
Examples of Effective Interventions
Coming Up …
Helping to Keep OP Healthy and Happy
What Works? – Evidence from Research
Most illnesses / disabilities in later years could be either prevented or postponed.
• Clear evidence OP benefit from well being and prevention services - including early detection / treatment of disease, healthy eating, falls, and loneliness prevention.
• Services must spot depression early and support good diet and mobility, e.g. foot care - healthy feet vital.
Source: Health Services Journal (2008) Get happy: the secret to a healthy old age
Community Health Champions
example of effective initiative
CHCs:
• Volunteers who motivate / help their friends,
families, work colleagues, and neighbours to lead
healthier and happier lives.
• Receive training and support skills, knowledge
and confidence to make a difference.
• Draw on their own life experience, ideas &
understanding of their local communities’ needs /
assets to design and deliver voluntary activities.
Community Health Champions
Examples of CHC-led activities:
• health walks
• chair-robics for OP
• men’s health groups
• cycling for people with disabilities
• self-help diabetes groups
• information sessions around depression
• talking to people informally as part of their daily
lives, providing individualised support if needed.
Research studies found positive impacts CHCs e.g.:
• increased uptake of preventive services like immunisation;
• positive behaviour changes, particularly with low income or minority ethnic communities;
• improved disease management for those with long term conditions such as diabetes or hypertension;
• more appropriate use of health services, for example decreased emergency admissions and improved appointment keeping;
• evidence on benefits for volunteers including positive outcomes re. quality of life, ADL, family functioning, psychological distress and depression.
Source: Health Services Journal (2012.) They are the champions: volunteers in the community. http://m.hsj.co.uk/5050168.article
Community Health Champions
Fit as a Fiddle Project
example of effective initiative
Age UK nationwide programme (going for 6 years)
• supports people over 50 with physical activity‚ healthy eating and mental well-being
• based around the needs and ideas of local people
• run by older people for older people
• strong links with different national activity / wellbeing programmes – share ideas, networks and inspiration
• work with key groups: Older Men, Faith and BME communities, people in Care Homes, Sheltered Housing, and older isolated people.
Fit as Fiddle Project
Research Findings:
• Significant effects on general health and well-being.
• Some activities aimed to improve physical health, also showed improvements in MH and quality of life.
• Improvements in the physical health of some taking part in the arts and choir groups.
Source: Age Uk (2012) Fit as a Fiddle Final Evaluation Report - Activities in Rural Cheshire (ARCH) North West region.
Represents a social value of £13.04 for every £1 invested. Source: Health Services Journal (June 2012) How Voluntary Organisations Can Demonstrate Their Value.
Fit as Fiddle Project
Cost Effectiveness – examples from Mental Health Intervention Studies
Intervention Savings per pound spent
Debt advice £4
Pre-school educational programmes for
3-4 year olds in low-income families
£17
Cognitive Behavioural Therapy for
people with Medically Unexplained
Symptoms (MUS)
£1.75
Training interventions for parents of
children with conduct disorder
£8
Screening and brief interventions for
alcohol misuse
£12
Early intervention in psychosis £18
Intervention Savings per person annually
Befriending services £235
Timebanks £850
Employment support (Individual
Placement and Support) for people with
severe mental illness
£6,000 per person annually
Housing schemes for men with enduring
mental illness
£11,000 – £20,000
Supported housing for women with
multiple complex needs
£120,000
Walking and physical activity programmes
in older people to promote mental
wellbeing
£5,000 – £12,000 (per Quality
Adjusted Life Year)
The Joint Commissioning Panel for Mental Health (2012) Guidance for commissioning public mental health services
Strong evidence to show that the
following are effective in improving mental
health:
• neighbourhood interventions
including activities which facilitate cohesion
• debt advice and enhanced financial capability
• physical activity through active travel, walkable
neighbourhoods and active leisure
• interventions to enhance social interaction (capital)
activities such as arts, music, creativity, learning,
volunteering, befriending and timebanks
• positive psychology and mindfulness
interventions (associated with positive mood,
improved quality of life, self-esteem, empathy,
optimism, meaning, reduced anxiety and depressive
symptoms)
• spiritual awareness, practices and beliefs
• addressing hearing loss
Effective in improving
mental health:
• programmes to support parents
• rapid treatment for depressed mothers to prevent
emotional or cognitive harm to their children
• neighbourhood enhancement and regeneration
• access to safe green community spaces including
allotments (associated with improved mental health,
reduced stress / aggression, improved physical health and
activity, and greater levels of social interaction)
Effective in improving
mental health:
• social support for unemployed people to help them to
find work
• practical information for those caring for people with
dementia
• self-help groups, e.g. for those recently widowed
• peer support initiatives - benefits those giving and
receiving: better mental health, an increased sense of
wellbeing, increased confidence and learning skills,
greater social connectedness, improved recovery and
coping skills and fewer hospital admissions.
Effective in improving
mental health:
