making every opportunity count (meoc · benefits for our customers • access to increased support,...

Making every Opportunity Count (MeOC) https://www.hi-netgrampian.org/people-networks/public-

health-directorate/health-inequalities/making-every-

opportunity-count/

Dr Linda Leighton-Beck and Partners

Agencies in direct contact with people to raise awareness, motivate and signpost to enable them live as well as they can

Agencies with an opportunity toencourage and support people whosehealth and wellbeing could be at risk

Agencies withregular contact with people for 30 + minutes who are at higher risk

Tier 3 Extended Brief Interventions

Tier 2 Brief

Interventions

Tier 1 - Very

brief conversation/ signposting

Source: Adapted from MEEC Wessex/ Behaviour change interventions mapped to NICE Behaviour Change: Individual Approaches https://www.nice.org.uk/Guidance/PH49

Simple ,inclusive model

Building a system

ARI Woodend RCH Dr Gray’s

Primary Care

City Aberdeenshire Moray HSCPs

SFRS Care Providers Paramount

DWP

Criminal Justice Social Work

Local Authorities

Pathways

RGU – Pharmacy Nursing & Midwifery Public Health

Community Pharmacy

Scottish Ambulance Service

Victim Support

SACRO

Action for Children

Families Outside

MeOC

Richard Combe

Why do we want to do this?

• Realistic medicine

• Patient benefit

• Service benefit

What is our process?

• Addition to crew process on scene

• Optimised list

• Posters

• Business cards

• Champion monitors contacts

How successful has it been?

• Staff feedback

• Additional services added

• Contacts made

• Next steps

MeOC

Kirsty Jarman

Benefits for our customers

• Access to increased support, practical help and advice

• Increases Work Coaches’ understanding of customers circumstances

• Helpful way to introduce worries, concerns etc.

Benefits for Jobcentre Staff

• Find out more about customer and circumstances

• Great way to start a conversation about support

• Help to know what services are available to signpost to

• Non-threatening way to discuss health and wellbeing issues

• Test of Change – worked with NHS Grampian to identify

appropriate customer group and timescale to be able to evaluate

the benefits of introducing the model

• Claimant Group – given other changes introduced for customers

on the Health Journey, started with Jobseekers Allowance and

Universal credit customers from two Work Coach teams

• Expansion – expanded pilot quickly as other Work Coach teams

could see benefit of using tool and were keen to include their

customers. Within 6 months all Work Coaches had received

training and were using the tool.

• Ongoing review – monitor number of conversations and

signposting on an ongoing basis

Effect / impact

• Average 60 MeOC conversations in Aberdeen Jobcentre every month. Customers signposted to variety of support, including fuel poverty, dietary concerns, addition issues, free dental care.

• MeOC rolled out across all Grampian Jobcentres and DWP is working to include all Scottish sites in time.

• Success stories include accessing free dental care (which led to increased self confidence as well as pain reduction), referrals to the local Health Point for help with weight issues, money advice, addiction support, help with energy costs. Simple signposting has made a huge impact on a lot of peoples’ lives.

• Information gathered has helped to form Community Hubs in Jobcentres providing support for customers/ local communities

• Links with NHS and other partners are stronger and we’re working together more to offer support to our customers

MeOC

Elsie Green

• Focus is on prevention, early intervention and supported

self-management.

• To take the first steps to helping themselves lead a

healthier lifestyle.

• Empowering and motivating them to improve their

health.

• Will have better treatment outcomes.

• MEOC questionnaire given to all new patients.

• Brief discussion of their answers.

• Advice and/or leaflets given to help with health choices.

• Some are directed to Healthpoint or Citizens advice.

• Referrals can be made for smoking and alcohol

cessation.

• Improvement in health and wellbeing’.

• Reduction in stress.

• Some do not find it helpful or are already seeking help.

• Patients who return to clinic have thanked us as the advice

has helped them.

MeOC

Carrie Heddle

Realistic Medicine - Self Management Grampian Unscheduled Care

Connecting systems for people’s

health & wellbeing

Elaine Watson, Service Improvement Manager, 6 Essential Actions for Improving Unscheduled Care

Grampian Unscheduled Care

Making Every Opportunity Count system wide – How?

Grampian Respiratory Model Winter 2018/19 – Volume & Value

Test of change through bundle of focused interventions Letters/information to GP’s and Community Pharmacies MEOC approach supporting patient cohort Staff in multiple settings having MeOC conversations and signposting

Pulmonary Rehab delivery pre-winter

Rapid access to antibiotics

Temperature warnings

Inhaler awareness

Targeted flu immunisation

Medication review pre-winter

Essential Action 6 - Ensure patients are cared for in their own homes Admission Avoidance, Avoiding Attendances, Reducing Length of stay

Grampian Unscheduled Care Making Every Opportunity Count - With what effect?

Grampian Respiratory Model – Volume and Value

All using MEOC principles - helping to reduce exacerbations that result in attendance at A&E or admission to hospital Community Pharmacies -Inhaler awareness to reinforce good inhaler techniques. Well received by patients . Targeted flu immunisation increased uptake in the “0ver 65” population Pulmonary Rehab Classes – GP’s provided with information for promoting to patients as part of self-care . Capacity increased per month by average 54 places (68%) Outcomes - Number of people on waiting list fell by 76 (22%). Good uptake of Pulmonary Rehabilitation self referral access. New patient assessments increased by average of 13 (28%) a month . Waiting times reduced from average of 36.2 wks (Dec 18) to 9.7 wks (March 19)

General Practices, Community Pharmacies, Physiotherapy Services, Acute Hospitals

Key Messages

• Ownership is ALL

• Local leadership and drive

• Hearts & minds

• Granular markers for journey

• Enabling approach for prevention & self-care

• Scaling – enabling every sector, every service,

every group to do a little to make a big difference

• Acceptable, inclusive, feasible & transferable

• Sustainable and adaptable

• Suitable across public and third sectors

• Supports people, services and clinical strategy

• Evolves with service...

Thank you!

Making every Opportunity Count (MeOC) https://www.hi-netgrampian.org/people-networks/public-

health-directorate/health-inequalities/making-every-

opportunity-count/

Agencies in direct contact with people to raise awareness, motivate and signpost to enable them live as well as they can

Agencies with an opportunity toencourage and support people whosehealth and wellbeing could be at risk

Agencies withregular contact with people for 30 + minutes who are at higher risk

Tier 3 Extended Brief Interventions

Tier 2 Brief

Interventions

Tier 1 - Very

brief conversation/ signposting

Source: Adapted from MEEC Wessex/ Behaviour change interventions mapped to NICE Behaviour Change: Individual Approaches https://www.nice.org.uk/Guidance/PH49

Simple & inclusive

Building a system

ARI Woodend RCH Dr Gray’s

Primary Care

City Aberdeenshire Moray HSCPs

SFRS Care Providers Paramount

DWP

Criminal Justice Social Work

Local Authorities

Pathways

RGU – Pharmacy Nursing & Midwifery Public Health

Community Pharmacy

Scottish Ambulance Service

Victim Support

SACRO

Action for Children

Families Outside

MeOC

Ruth Gould

Aberdeen City Libraries – Why are we participating?

• MEOC is a natural fit for libraries and ties into national and

local strategies in libraries.

• MEOC conversations for library staff are not new but

recording them is

• Evidence captured will be useful for contributing to service

planning

Aberdeen City Libraries - How?

• Numbers of conversations are recorded on our Enquiry

Management System

• Small case studies are currently captured in a dedicated

Word document

Aberdeen City Libraries - With what effect?

Up to August there were 40 referrals recorded, recurring themes

for referral were social isolation and decreased mobility.

Regular borrower, single mum of 3 year old-, chat regarding her recent illness

(infection) and how she was unable to take a proper care of the child during her

illness; she has no family in Aberdeen nor many close friends; internal referral to the

Bookbug Session (to expand her social connections) and external referral to the

Parent Club (Early Learning and Childcare))

91 conversations

3 locations

May – June

173 conversations

9 locations

July - August

MeOC

Stephen Macnamee

• Why MeOC?

How?

Scale up existing approaches though training Health & Social Care Partnership Staff as a core tool we all should be able to use Tests of Change – peer-to-peer (Older Adults and Young People) to increase knowledge, awareness, resilience and peer-support within community Tests of Change – intergenerational (more digitally able young people) accessing quality and accurate information for older people within their families / communities

Effect/impact?

MeOC supports many strategic priorities:

Resilient and prosperous communities

Living well into older age

Improved mental health for younger people

Early intervention and prevention

Managing demand on services

• Expectation that the MeOC approach becomes commonplace

Our communities have more helpful and meaningful conversations with each other.

People accessing appropriate support and information EARLY rather than allowing issues to reach crisis point which invariably means these are harder fixed and need a more ‘professional’/ service intervention .

MeOC

Laura Sutherland

MeOC - The Moray Model

• Strategic Level – Health and Social Care

• Responsive to local needs

• Sharing and inclusive – Pan Grampian and

• Sustainability – locality model promoting

ownership

beyond!

Transformation Plan

Our Process

Engage

with

partners

Awareness

Training

DIY MOT

self

checks

Support

Wider impact • 27 Partner Organisations = 300 trained

• Over 1000 conversations

• Locality and National Delivery(DWP)

• MeOC Champions

• Case Studies

• Managers Toolbox supporting staff health

“MeOC has changed the way

we have our conversations”