patient empowerment project · • considering payday loan ... referred to ‘pay as you feel’...
TRANSCRIPT
Patient Empowerment Project Leeds, UK
Mark Fuller: Public Health Clinical Lead Tricia McKinney: Patient Representative
Chris Bridle: Engagement Lead Sue Wilkinson: Commissioning and
Development Manager
February 2015
Project feedback video
Case study one: 54 year old man Presenting issues Goals Outcomes
• No money • History of depression • Problematic alcohol
use • Recently rehoused • Considering payday
loan • Only one set of
clothes • Socially isolated
• Get more clothes • Make friends • Access free food • Reduce his alcohol
consumption • Return to work as an
electrician
• Referred to ‘Pay as You feel’ café
• Decided not to take out payday loan
• Halved alcohol consumption
• Seeking employment • Improved mood
Case study two: 56 year old female Presenting issues Goals Outcomes
• Long term depression/anxiety
• Lives alone and socially isolated
• Recent bereavement • Financial difficulties • History of
unemployment
• To manage her mental health
• Get back into employment
• Access bereavement support
• Supported to attend mental health appointment
• Information about bereavement service
• Attended local job centre
• Linked with local Healing Centre
Leeds – where are we?
The story so far - why?
The story so far - why? What do healthcare professionals in Leeds want?
• Better knowledge of local voluntary and community services • Better signposting and connecting to local voluntary and
community services • Better proactive self care management through patient
empowerment
Asset Based Community Development (ABCD) Identifying and mobilising individual and community ‘assets’
Social Prescribing (community referral) Links people to non-medical sources of support and activities
in the community that they might benefit from
PEP patients
Psychological therapies
Housing
Debt management
Domestic violence
Advocacy services
Drug and alcohol services
Benefit agencies
Adult Social Care
Community and activity groups
Healthy living services
Connecting patients to services
Aim of the PEP
‘To improve the wider health and wellbeing of patients by providing a referral route between GP practices
and local voluntary sector organisations, activities, groups and
services’
Patient empowerment model
Analyse and plan • JSNA • Needs and aspirations • Priority setting • Patient experience Design pathways • Focus groups/workshops • Engage VCF sector • Experience-based design Specify & procure • Involvement in contracting • Involvement in scoring and interview
process Deliver and improve • Patient experience • User-led audits • Mystery shopping
The engagement process The Commissioning Cycle
Engagement Process Initial engagement • Voluntary, community and faith (VCF) sector • Patients, carers and the public • Primary care What did people say? • It’s a good idea! • VCF must be involved • Consider paying volunteers • Provide support outside traditional working hours • Don’t duplicate what’s already there • Don’t make people wait too long
Engagement Process Recommendations:
• Incentivise champions • Develop resources to support referral • Voluntary sector role in the development of the
project • Monitor outcomes and evidence success • Avoid duplication • Motivate patients • Short waiting times • Involve patient in procurement process
Engagement Process Patient leader ‘to ensure that the voice of patients, carers and the public is taken into consideration when decisions are made that
affect patient care’ • Recruited through the engagement • Sits on strategic steering group • Involved in contracting, procurement and monitoring • Asked to be objective, passionate about improvement, and
champion the patient (VCF) voice
Who could benefit?
The list is endless…
Disadvantaged Long term
health problems
Vulnerable Depression
Socially isolated
Recently bereaved Marginalised Mild-moderate
anxiety
Procurement process • Patient representative member of procurement team • Consortia of local voluntary sector organisations
appointed:
Marketing
Patient empowerment project evaluation
Early Evaluation – January 2015 115 referrals so far
age not known
12% 18-39 24%
40-64 44%
65-74 4% >75
16%
Male referrals age not known
7%
18-39 19%
40-64 53%
65-74 11% >75
10%
Female referrals
Early Evaluation – January 2015
Those assessed by PEP are those patients that offer the biggest challenge to the health and social care system (Shortened Warwick Edinburgh Mental Well-being scale [SWEMWBS] and EQ5D self-reported health status scores)
Those reviewed to date show a meaningful positive change as an early indicator for the impact of PEP on mental well-being
Positive changes in levels of self-efficacy to self manage long term conditions. Patients enabled to consider helpful routines, coping strategies and activities
Project Learning
Better knowledge of the
procurement process
Keep an open mind
Adapting principles from
other successful projects
More engagement
with practices during model development
Involve a patient
leader much earlier
Exciting to see the impact on
patients
Learning continues as
we go...!
What do general practitioners say?
“As a doctor I now have two prescriptions available to me:
medical and social”
What do patients say? “I’m learning some really useful stuff, I’ve made some friends and it’s like holistic
therapy”
“The woods walk was brilliant. According to my doctor I’m only supposed to be able to
walk a few hundred yards – but I kept going all afternoon. I had a really good day.”
What do patients say? “You've been absolutely fantastic; I don't
know what I'd have done without you”
“Thank you for all the help, I've hit rock bottom and you are the only one that's
helped me”
Contact details • Dr Mark Fuller GP Clinical Lead for Public Health [email protected] • Chris Bridle Patient Engagement Lead [email protected] • Tricia McKinney Patient Representative [email protected] • Sue Wilkinson Commissioning and Development Manager [email protected]
Time for questions…