Anne Welsh Head of Clinic Action Heart, Dudley BACR Annual Conference 7 th October 2010

Introduction Health Inequalities/barriers to attending cardiac rehabilitation - National - Elderly - Female - BME populations? National (NACR)

NHS Heart Improvement National Project –Elderly –Female –Black & minority ethnic –Deprivation –Employment –Travel/Geography –Identify barriers Health Inequalities – Local

Patient and staff discussions/consultation (Patient Involvement) Learning Difficulties Sensory/Physical Impairment Shy/lacking confidence Language Barriers Hard to Reach/Hard to Keep

Action Heart Phase III programme 3 one to one sessions Hard to Keep time? Limited resources

Former patients are trained to provide continued seamless support and surveillance for those individuals requiring further assistance in settling into Buddy System the Action Heart Phase III programme

Buddy System Requirements Ex Action Heart cardiac patient Desire to help other cardiac patients Empathetic approach/listening ear Physical ability to demonstrate use of equipment/warm up etc. Two hour commitment per week

Training (25 hours) –Listening Skills Course –Use of equipment, demonstration methods –Theory/Principles of exercise, understanding exercise programmes –Basic understanding of cardiac conditions/signs and symptoms Buddy System

Further training –Attendance at Action Heart Education Programme –Cardiac misconceptions –Manual handling –Optional: basic cardiopulmonary resuscitation Further shadowing in clinic by staff until proficient and confident Buddy System

What the role is not! Setting boundaries A replacement for staff A counselling opportunity Medical consultation Buddy System

Eight volunteers (choice of day/time of attendance) 6 men 2 women 2 retired nurses, 2 retired teachers, 1 retired local government officer, 1 schools inspector, 1 retired school caretaker, 1 bus driver Buddy System

Mrs P, severe anxiety, lacking in confidence, reclusive since heart condition Mr R, partially sighted, never accessed a gym Mrs B, speaks little English, unable to read or write Mr K, understanding/memory/retention issues following stroke, left sided weakness Buddy System

Patient Survey The staff are fantastic but the buddies have more time to help me. I would not have continued if the buddies had not been there to support me. the buddies are so helpful, kind, wonderful and provide excellent advice Buddy System

Buddies have flourished –expert listeners, –encouragers, –friends, –information givers, –thriving role models –excellent staff/patient interface Buddy System

What the Buddies say I enjoy all aspects of the role… meeting, supporting, getting to know interesting people. Seeing patients improve is all very satisfying

What the Buddies say Im pleased to have the opportunity to exercise, to receive recognition and to still practice inter-personal skills developed professionally over a life-time working with people

Completed 18 months 155 needy patients supported 27 hours/week of Buddy cover Positive satisfaction survey Reduced early drop out rate? Enhanced patient/staff links Ready to recruit/train new Buddies Outcomes

Innovative and effective intervention Cost effective Enhances patient/staff interface Captures patient expertise Increased referrals A Win-Win situation! Is this a model for using patient experience in the NHS? Summary

Thanks to our Buddies to our Patient Involvement groups to the BACR …………………..and to you for listening Any questions