Commissioning for Wellbeing Outcomes (bringing it all together) Tim Anfilogoff Head of Community Wellbeing

What is an outcome? A result A state of being we are trying to achieve Not a measure of how well we are doing but a measure of how well they are doing!

What is Community Wellbeing? ‘Flourish’ model (Perma) Positive Emotion Engagement Relationships Meaning Accomplishment (all have links to volunteering) Wellbeing and Public Policy, Martin E.P Seligman, July 2011

The Five Ways to Wellbeing Connect… Be active… Take notice… Keep learning… Give… A set of evidence-based public mental health messages aimed at improving the mental health and Wellbeing of the whole population. They were developed by the New Economics Foundation as result of a commission by Foresight, (HMG’s futures think-tank) as part of Project on Mental Capital and Wellbeing. Foresight. (2008). Foresight Mental Capital and Wellbeing Project: Final Project Report. London: The Government Office for Science.

The 49 Community Wellbeing Outcomes Built on 10 Priority Outcomes of Prevention and Wellbeing Review Looking at physical, mental, economic wellbeing and access Community Cohesion, Big Society, Social Capital Under development

CWB most identified outcomes (in top 3) OutcomeProjects Helped to have a life outside caring (breaks to support other outcomes) 48 People no longer isolated, with social networks of 4 or more 44 People know where to go for help34 People have more choice and control33 Helped to carry on caring32

CWB outcomes not yet identified (in projects’ top 3) People have given up smoking0 Reduction in obesity0 Reduction in falls/falls prevention0 People drinking safe amounts of alcohol or less/people reducing misuse of substances 0 People are encouraged to access appropriate immunisation (eg flu) 0 People into/back into learning0 People using medication properly/better0 People’s spiritual needs are being catered for0 Any/all outcomes achieved for groups protected by Equalities Legislation/other disadvantaged groups 0

Volunteering: tool or outcome? £1m invested in 82 lunch clubs 3,100 users 186 part-time staff 822 volunteers – mainly 70+ Only 8 projects identify volunteering in top 3 outcomes But….

Warwick-Edinburgh Mental Wellbeing Scale Seven item scale 1.I’ve been feeling optimistic about the future 2.I’ve been feeling useful 3.I’ve been feeling relaxed 4.I’ve been dealing with problems well 5.I’ve been thinking clearly 6.I’ve been feeling close to other people 7.I’ve been able to make up my own mind about things Five point Likert scoring system –None of the time = 1 –Rarely = 2 –Some of the time = 3 –Often = 4 –All of the time = 5

Wellbeing by Involvement

Wellbeing by Nature of Area

Building a ‘healthy community’ Community Connections Time- Bank New York 100% surveyed benefited from being a member Lowest self-reported annual income and those doing survey in Spanish had highest benefit 98% could use skills to help others 48% improvements in self-rated physical health 72% improvements in self-rated mental health

Building resilience of carers 40% of family carers have psychological distress/depression Increased rate of physical health problems One in five gives up work to care More than half fall into debt

PCT Breaks Monies Bringing Carers Breaks commissioning by HCC/PCT together in integrated way Measuring health outcomes from ‘breaks’/’low level services

Carers’ Risk of Depression SF12 Screening PCT funded breaks (includes Crossroads) Based on 137 Pre and Post Support Questionnaires (including Crossroads) Outcome 4: Stay fit and healthy and be safe

RCGP/e-Learning for Health Supporting Carers in General Practice (2011). Accessed via: lfh.org.uk/projects/supportingcarersingeneralpractice/index.html

Evidence of benefits of noticing carers early (improving resilience) Caring with Confidence (CWC): ‘CWC does what it says. It made me feel as though I was not alone and helped me with how to cope in different situations. I also made lots of wonderful new friends” ‘CWC has taken me from 'being a victim of my circumstances' to realizing it's in my hands to be more positive and make a difference to my own life".

Building resilience for all What do I do about? Anti-Social Neighbours Adaptations to home following a stroke Befriending service for a client in care home Looking for volunteering opportunities Information about free school meals Support with cleaning in the home Telephone We can help. Or we know someone who can

From small acorns… Recommissioning – adding PH outcomes Link to JSNA Clear outcomes for all partners/SROI Increased social capital Model of a ‘healthy community’