Clinical Lead Self Care and Prevention through patient and staff activation Enid Feather Clinical Lead Self Care and Prevention

Aims of presentation National and local context What is self care and prevention? Models and Myths The self care journey Where are we now? Question time?

National Context NHS success at saving lives so people live longer Many with a significant proportion of poor health More people with more than one long term condition Some conditions attributable to lifestyle choice More people with caring responsibilities Increased demands on health and social care

Bradford District and Craven Self Care and Prevention Programme Reports to the Integration and Change Board and up the Health and Wellbeing Board Bradford has delegated responsibility for public health in North Yorkshire Priorities are Promoting health, wellbeing and independence for all Preventing deterioration , delaying dependence and supporting recovery for those with long term conditions

Airedale, Wharfedale and Craven, Clinical Commissioning Group Clinical Lead: Self Care and Prevention Self Care and Prevention reports into the New Models of Care Integrated Delivery Board Self Care and Prevention initiatives increasing since launch in November 2014 Maximise opportunities from Bradford and Craven programme and work streams

What is self care? Ref Health Care Forum. ‘Self Care is a lifelong habit for patients and the public dealing appropriately, effectively and safely with their own minor ailments and long term conditions, taking preventative measures to stay fit, and maintaining good physical and mental health and wellbeing.’ Ref Health Care Forum.

The Self Care Continuum

Prevention Primary prevention reduces the risk of health problems by reducing lifestyle risks or targeting high risk groups Secondary prevention intervenes in the early stages of disease to reduce the impact on function and independence 3. Tertiary prevention prevents or delays disability from long term conditions.

The Self Care Continuum Self management Self care Medical emergencies Management of general health and illnesses Shared roles for people with long term conditions Opportunity during recovery and rehabilitation Primary prevention Secondary and tertiary prevention

Self care and prevention is for everyone

Self care and prevention is for everyone…..so Massive cultural change Turning round a culture started at the beginning of the NHS and the social care system will take time Must utilise an asset based approach which acknowledges the strengths of people, families, carers, communities, voluntary organisations, and many more, for everyone to reach their potential.

Benefits of engaging people Can have a positive impact on people’s Physical symptoms and clinical outcomes Ability to cope day by day Attitudes and behaviours Quality of life and health and wellbeing The evidence that this reduces costs is variable

Self Care Myths 1 It is about patients doing it themselves 2 It is about making it harder for people to access services 3 It is about making it easy for staff 4 It is about saving money 5 It doesn’t work 6 It is too difficult and complicated to make the cultural change.

No clear road map for the journey

The Health Foundation says Foster local innovation and ownership Use the evidence available for what works Work with an incremental model of change Upscale over time Build in sustainability

What works for individuals?

What works for individuals? Finding out what is important to the person Involving people in decision making Joint goal setting, plans and reviews Structured information Self monitoring symptoms and escalation plans Support with social, emotional and physical impacts of illness Opportunities to share and learn from others

The house of care

What are we doing in AW&C? Promoting the self care and prevention message Working with staff teams across the area Co creation with service users Linking with partner organisations for win win Establishing a staff self care network Improving self care information on the CCG public website Reviewing the health navigators role for signposting and support

Current projects include Obesity and diabetes prevention and early intervention Changing approaches for people with long term conditions Falls prevention pathway Self management elements in patients escalation plans Self harming alcohol users

For spread and sustainability Launch of the self care network and toolkit Planning for Self Care week in November Including in service specifications eg Integrated Community Services Building into the New Models of Care Involving more groups and stakeholders Develop self care and prevention champions Spread good practice and success

Bradford District and Craven Self Care and Prevention Programme The work streams will include empowering the population, developing the workforce and technological solutions Bradford Public health have invested £200K Programme manager and admin support Communications and marketing Training and development Business analysis and evaluation

Question time?

References Person Centred Care: From ideas to action, The Health Foundation, October 2014 The Self Care Continuum adapted from the Self Care Forum Website The need for an integrated approach to supporting patients who should self manage, Jim Phillips, Self Care Journal, March 2012 Delivering better services for people with long term conditions: Building the house of care, The Kings Fund October 2013 Bradford District and Craven Self Care and Prevention Programme Brief. May 2015 The NHS Constitution March 2013 Five Year Forward View October 2014 The Health and Social care Act 2012