social prescribing for long term condions · chris drinkwater chair, ways to wellness re-balancing...
TRANSCRIPT
![Page 1: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/1.jpg)
Socialprescribingforlongtermcondi3ons
ChrisDrinkwaterChair,WaystoWellness
![Page 2: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/2.jpg)
Re-balancingthebio-medical&thesocial:Lookinginbothdirections
Hospital CCGsH&WB
Individuals&
Communities
GPsandPrimaryCare
LA&PH
Medicalmodel(QoF/healthchecks) Socialmodel
Evidence
Individualresponsibility&behaviourchangePatientcentredness
£££UnsustainableDemand
Physical CapitalSocial
ChoosingHealthWhitePaper2004
![Page 3: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/3.jpg)
Pathwaysbetweenmedicalandsocialmodelsofhealth
h3ps://www.diabetes.org.uk/upload/Professionals/Year%20of%20Care/thanks-for-the-petunias.pdf
![Page 4: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/4.jpg)
Challenges
• Socialprescribing–Whobenefits?Whatistheevidence?
• DevelopinganoperaIonalmodelwithinafinancialframework
• SIBOutcomesContracts,repaymentImescales• DedicatedMIS&be3eruseofdata• Culturechange
![Page 5: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/5.jpg)
WhyPhysicalLTCsinpeople40-74?
• SignificanceofsocialdeterminantsondevelopmentandoutcomeofLTCs.
• CostofLTCstopublicpurseandspecificallytoCCGs.
• OpportunitytoaddresssecondaryprevenIon.• QOFregistersforLTCsanddemandonGPs
![Page 6: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/6.jpg)
TheWaystoWellnessModel
h3ps://www.uk.ecorys.com/news/ecorys-uk-launches-report-uk%E2%80%99s-first-health-social-impact-bond.
![Page 7: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/7.jpg)
GeBngThere• 2011VONNEinterestintesIngSIBsasavehiclefortheVCSE.
• StrongsteeringgroupwithVCSEandNHScredibilityhostedbyVONNE.
• 2012-14developmentfundingSEIFandBLF-evidencecase-financial&operaIonalmodelling-servicespecificaIonandprocurement-managementinformaIonsystem
• April2015Launch
![Page 8: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/8.jpg)
Challenges1
• Tyingdownthetargetgroup–people40-74onLTCQOFRegisters
• OperaIonalcosts–acIviIesorlinkworkers?• Agreeingoutcomesandrepaymentmetrics• NegoIaIngasevenyearcontract• Doesthedeveloper(SPV)getthecontractorshoulditbeanopentender?
• Financialmodelling(Version18.2)
![Page 9: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/9.jpg)
Outcomes
2. SecondarycarecostsSavingsinscheduled&unscheduledadmissions,out-paIentandA&Ecostscomparedagainstamatchedcohortresultsinanagreedpayment(70%)
1. Well-beingStarTM
Averageimprovementover1.5resultsinanoutcome-basedpayment(30%)
![Page 10: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/10.jpg)
Challenges2
• Buildinglocalbuy-in–VCSE,GPs,paIentgroups.
• FindingandnegoIaIngwithinvestors.• SourcingaddiIonalfunding• Procurementofproviders• MeeIngNHSInformaIonGovernancerequirements(HSCICLevel2AQP)
• Retro-fiengtotheStandardNHSContract.
![Page 11: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/11.jpg)
Investors
• Payforearlyservicecosts,drivedeliveryandcarryriskoffailure.
• One-offset-upfacilityfee.• Monitoringfee–investorsexperIseandengagement.
• Royaltypayments–dependentonsuccess,fixed%withacap.
• TodateWaystoWellnesshasonlydrawndown£1.1mofthe£1.65m.
![Page 12: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/12.jpg)
Linkworkers22FTEacross4providers
![Page 13: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/13.jpg)
ReferralCriteria• RegisteredwithaGPpracIceinNewcastleWest(18pracIces,112,000
populaIon,14,229onLTCQOFRegister)
• Long-termcondiIon(LTC):• COPD,Asthma,Diabetes(Type1or2),CoronaryHeartDisease,Heart
Failure,Epilepsy,Osteoporosis
• 40to74yearsofage
• FurtherprioriIsedreferralcriteria:• socialisolaIon• poorunderstandingofcondiIon,frequenta3enderatGPorhospital,
pooradherencetoprescripIon• anxietyordepression(inaddiIontooneoftheaboveLTCs)• poorhealthbutwithscopetoimprovewithlifestylechange• poorEnglishliteracy• obeseorinacIve
![Page 14: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/14.jpg)
Service Metrics – Successful New Referrals Service to Date
14
Ø Successful New Referrals in Year 1: 1,127 = 103% of target (starts 924 = 84% of target) Ø Successful New Referrals in Year 2: 1,319 = 82% of target (starts 1,026 = 64% of target)
Ø To Date Successful New Referrals: 2,446 = 90% of target (starts 1,950 = 72% of target) Measuring Starts only - not those patients that are still open
4557 54
6674 74
92
135
82
133142
174
154166
133123
98
122128
108
60
116107
37
5665
74 74 74
108 108 108
130 130 130143 143 143 143 143 143 143 143 143
162 162
0
20
40
60
80
100
120
140
160
180
0
20
40
60
80
100
120
140
160
180
Successful New Referrals Service to Date
7 April 2015 - 28 February 2017 Target vs Actual
SuccessfulNewReferrals TargetSuccessfulNewReferrals CompleIonof1stStar CompleIonof2ndStar
![Page 15: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/15.jpg)
Service Metrics - Referrals by GP Practice
Service to Date
15
Above Target
Below Target
Target to 28 February 2017
0 50 100 150 200 250 300 350 400 450 500
NumberofReferralsbyGPPrac3ce7April2015-28February2017
![Page 16: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/16.jpg)
ReferralsbyLongTermCondi3onArthriIs,Chronic
MSKPain,7
COPDandAsthma,147
Angina,2
Asthma,260
COPD,214
DiabetesType1,50
DiabetesType2,533
DiabetesType1and2,120
HeartFailure,61
CoronaryHeartDisease,223
Epilepsy,50Osteoporosis,
46
![Page 17: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/17.jpg)
Highlightsfromfurtherdataanalysis:first1347pa3ents• Men46.6%(1stStar28.6)Women53.2%(27.4)• Age40-5945%(1stStar26.5)• Age60-7455%(1stStar30.4)• 40.6%with2ormoreLTCs,numbersincreasewithage.
• Linkworkersspendanaverageof8.4hourswitheachpaIent,whichrepresentsanaverageof23contactsperpaIent
![Page 18: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/18.jpg)
Incaseyouwerewondering
• SecondarycaresavingscomeonlineinYear3.• DataforthefirstthreequartersofYear2-AveragespendperpaIent£19(2.5%)lessthancontrolgroup-Monthlyvariancebetween+5.4%to-10.8%
![Page 19: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/19.jpg)
CultureChange
• Normalisingtheimportanceandvalidityofaddressingsocialdeterminants.
• Changingthewayservicesaredesignedandcommissioned.
• ChangingthebehaviourofGPs.• ChangingthebehaviourofVCSEproviders.• Theroleofspecialpurposevehiclesandsocialinvestors.
![Page 20: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/20.jpg)
Opera3onalvresearchdesign
• NIHRPublicHealthrejecIon2015-toomanyworkpackages-notheoreIcalbasistounderpinintervenIon-tooambiIous-be3ercontrolsrequired
• BarrierstomoregranularanalysisofNHSHESandRAIDRdata.
![Page 21: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/21.jpg)
Service Users …
“I feel really proud of myself that I’m getting out and about more.”
“I now have a totally different
outlook.”
“This service has resolved a lot of issues
that worried me.”
“It has helped to focus my mind and gave me belief that things can change.”
“I do believe that knowing the Ways to Wellness team is like
winning a lottery ticket in life.” “I feel like finally there is a light at
the end of the tunnel and I want to say thank you for calling me and listening, I really appreciate it.”
“I feel better already talking to
you. It helps motivate me.”
![Page 22: Social prescribing for long term condions · Chris Drinkwater Chair, Ways to Wellness Re-balancing the bio-medical & the social: Looking in both directions Hospital CCGs H&WB Individuals](https://reader035.vdocuments.us/reader035/viewer/2022071216/6047769ac3c91b3504142da3/html5/thumbnails/22.jpg)
Thankyoutoallourprovidersandfunders