Why self care? In the UK, of 8,760 hours in a year, a patient with a long term condition will spend around 4 hours with a clinician – let’s support people to maximise their time managing their own health and care Activated patients have better outcomes and a lower impact of service use ‘Assets’ within communities, e.g. skills & knowledge, networks and community organisations are building blocks for good health Self Care is a key requirement of UK Health Policy Case for change People who have knowledge, skills and confidence (patient activation) tend to do better (outcomes) than does wo have lower levels – PAM is a tool for measuring activation level Community assets… ‘ look at what’s strong within a community, not what’s wrong’ As we move towards an Accountable care system – Greater Notts is – requirement to have population health management, supported slef care and patient activation…

Why engage in community activities? “A person who attends no community groups or activities extends their life expectancy by 5 years if they join one group” Robert Putnam (2000) Bowling Alone.

The challenge Many people are lonely, disconnected, inactive and have health problems that make it difficult to go out and do things. They often cope by doing things that are bad for their health – no exercise, poor diet, smoking, drinking, poor sleep patterns, little social connection. They may go to their GPs for help – but this does not get to the heart of their problems They may not seek help at all so their difficulties get worse …..

Our Goal To employ link workers in GP practices who will help people identify the things they’d like to do and support them to engage in these activities To employ health coaches in GP practices who can help people to identify ways in which they can develop healthier ways of living To develop community cafes which offer information, opportunities, workshops, peer support – somewhere to go … To build up confidence and competence across communities so that they become ‘friendlier’ places for everyone.

Outcomes we want to achieve Improve the lives of people with long term conditions and by: Supporting and enabling them to do the things they want to do – increasing their roles, relationships and activities Increasing their understanding of their own condition and improving their ability to manage their own condition – changing their health behaviour Reducing their reliance on health services – improving self management and self confidence

Outcomes continued Reducing their reliance on health services – improving self management and self confidence Increasing opportunities within local communities – improving attitudes and understanding of long term conditions Increasing partnerships between different organisations and sectors to reduce duplication and gaps between services.

The plan – initially in 3 GP practices in Rushcliffe On going health problems, lonely inactive, troubled “low levels of activation”, “under” or “over” use of health services Health Coaches – use PAM to determine best way of improving health through different behaviours. Tailored coaching approach to improve self management Supports for up to 6 sessions . May “refer” to Link worker Works in GP surgery Link workers – engages in discussion about things to do, places to go and the sorts of support that would help . Supports for up to 6 weeks, develops a community engagement plan May refer to “community connector” Works in GP surgery and in local community Community Cafes A “safe place to go”, something to do, people to meet, sharing experiences Recovery and well being courses Increased opportunities for people to learn about living life to the full with a long term condition Community Development Supporting community resources and facilities to be more confidence and capable.

Coproduction Whole project coproduced with an ever-expanding network of local organisations, groups, individuals: libraries, businesses, churches, cafes, self help groups, health service providers, educational providers, housing associations, job centres ….

What will link workers and health coaches do? An appreciative conversation Goal focused – what do you want to change? Strengths based The person is in control Encourages activity without it being “painful” from languishing to flourishing

All about well-being? The concept of wellbeing two main elements: feeling good - feelings of happiness, contentment, enjoyment, curiosity and engagement are characteristic of someone who has a positive experience of their life functioning well - experiencing positive relationships, having some control over one’s life and having a sense of purpose are all important attributes of wellbeing. To effectively communicate the main influencers of well-being, the messages have been organised into five key actions, each offering examples of more specific behaviours that enhance well-being.