1. Winning Hearts and Minds Sandra Whiles and Mike Sandys

2. The Leicestershire Place Leicestershire County Council 7 District Councils Surrounds Unitary Leicester City Council Abuts Rutland Unitary Council 166 Parish Councils 2 CCGs Around 6660,000 population

3. Our Public Health Journey Early vision around PH and Local Government Locality PH approach PH and DC Health Networks Housing Services Partnership HWBB development Joint appointment of Director of Health Integration Focus on outcomes and place not organisations Shared leadership and relationships matter Healthy challenge The right partnerships Seeing things strategically

4. A strategic approach to prevention Secondary prevention underpinning integration plans Focus on secondary prevention brought new partners to the table Strengthening communities

5. So What? Prevention underpins Leicestershire BCF plan  Unified prevention offer  Integrated, proactive care for those with long term conditions  Integrated urgent response  Hospital discharge and reablement Better Care Together programme shaping long term strategy Unified Prevention Board

6. To provide assurance t the HWBB around the delivery of prevention projects within the BCF Plan To develop and deliver a strategic approach to prevention across the county Mapping, prioritising and focussing Priorities initially around Frail Older People and Mental Health

7. A Framework for Secondary Prevention Identification Supporting Independence Building Community Capacity Maximising the use of Community Resources Unified Prevention Evidencing the results - Prevention Intelligence Hub Sharing Best Practice - Prevention Community of Practice

8. Housing Offer to Health HSP raised awareness and understanding Secured money for CIH research Spring 2013 into the Housing Offer to HWBB Report welcomed by HWBB and led to partner support for 3 housing projects Project`s integrated into BCF

9. Housing Offer To Health Housing Pathway to support Hospital Discharge – to identify and deliver housing solutions to prevent delayed hospital discharge Establishing First Contact in GP surgeries – to reduce demand on Primary Care by effectively signposting to multiple agencies for practical interventions using one referral form Lightbulb – to provide practical primary prevention support to improve services for vulnerable people and reduce emergency admissions and delayed hospital discharge Our 3 Projects

10. Hospital Discharge Affects mental health services, acute services and community hospitals Different issues in different settings Mental Health Discharge Pilot 6 month pilot of housing based support linked to acute mental health ward £238 a day to keep someone in the Bradgate Unit Acute services and community hospitals Intermediate care options Housing hospital discharge pilot from winter pressures money Practical schemes including Hospital to Home

11. First Contact in GP surgeries A simple signposting referral service for vulnerable people Since January 2014 55 practices have had training, 27 practices operating FC Helping reduce demand for GPs In just one practice since April – 26 patients referred leading to 90 referrals and practical support such as assistive technology, benefit take up, help around the home and social activities Evaluation of outcomes planned to show ROI “First Contact is a valuable signposting service offering a variety of services to benefit our patients.” “Making referrals is a smooth and straightforward process.”

12. The Light Bulb Project Reducing the number of services it takes to change a light bulb (and other services you were afraid to ask for) We will integrate practical housing support and adaptations and other informal support into a single support service that is tenure neutral, stigma free and shaped around an individual’s need - not an organization’s threshold or capacity.

13. Loneliness & Stress Isolation Depression Housing: The Risks Emma Dangerous Stairs Cold Temperature Trip Hazards Access to burglars Hoarding Damp & Mould Colds lived alone in her own home. struggling to heat her home, get out and about and didn’t always have food she wanted. The carpets were worn and she had a lot of furniture packed into tight spaces. These things were precious to her and because she didn’t get out much. Her belongings were becoming increasingly important and so her home was becoming progressively less habitable and safe for her to live in. Falls Pneumonia & heart attacks = Costs to Health, Social Care Ambulance Call Out A&E UHL Admittance GP Appt Stress GP Appt Isolation Residential Care Housing Risks The Light Bulb Project

14. As is: The Offer Emma Dangerous Stairs Cold Temperature Trip Hazards Access to burglars Hoarding Damp & Mould became ill and had a fall. She was able to access step-up care in Loughborough hospital. She stayed their 46 days, got home for two days then became ill again and ended up in UHL this time, after she had been in UHL for five days Emma was transferred to a nursing home where she remains now. Perception Cost. Process, Stigma Process Thresholds, Financial & OT Assessment (County), Hand offs Minor Adaptations (County) Affordable Warmth (Districts) Aids & Equipment (County) Major Adaptations (Districts) Handyperson Service (Private) Assistive Technology (County) Barriers Solutions Problems The Light Bulb Project

15. The Light Bulb Offer Emma Dangerous Stairs Cold Temperature Trip Hazards Access to burglars Hoarding Damp & Mould would have access to GPs First Contact Discharge Local Area Co- ordination Marketing Word of Mouth Minor Adaptations Affordable Warmth Aids & Equipment Major Adaptations Handyperson Service Assistive Technology 1 Single point of contact or referral1 Assessment and Case management offer 2 Access to delivery of wider range of solutions3 Access & Referral DeliveryProblems Single Assessment The Light Bulb Project

16. Minor/Major Adaptations ie. hand rails / downstairs bathroom Affordable Warmth, secured by via better tariffs Aids & Equipment, prevent accident Security Check Handyperson Service manages space Assistive Technology More inclined to socialise Housing: The Savings Light Bulb Warmer A third of 75+ hospital admissions are considered avoidable and every care placement avoided or delayed represents a significant opportunity for saving. Together these admissions and placements cost Leicestershire’s health and social care budgets £77m. could deliver additional savings of around £19m over the next ten years to these health and care budgets. Housing Support as a whole already delivers a far greater value in its preventative offer. = Savings to Health, Social Care Less Ambulance Call Outs Less A&E Appts Less UHL Admissions Sense of Security Less GP Appts Less isolated Housing Solutions Less Falls Less Residential Care £10.6 m £2.25m £0.3m£6.5m Unknown The Light Bulb Project

17. As Is Emma 1 Light Bulb Emma lives alone struggling to heat and eat and her home was becoming progressively less habitable and safe for her to live in. £0 Emma is referred by a Local Area Co-ordinator or GP for home heating suggestions and housing adaptation shower conversion / carpets £11,500 Emma became ill and had a fall and accesses step-up care in Loughborough hospital. She stayed their 46 days £4500 Emma uses a lunch club once a week to reduce her isolation and also uses a handyperson one a month £500 Emma got home for two days, became ill again and ended up in UHL this time, after she had been in UHL for five days £1500 Emma also utilises the Assistive Technology on offer via Light Bulb as well Occupational Therapy for an hour per month. Daily meals at home are provided through community support. £4635 Emma is transferred to a nursing home where she remains now. £29640 Total £35640 £16635 Total The Light Bulb Project

18. Local Area Co-ordination Supporting people and their families to have a good life as part of their local community Divert people from formal services through sustainable, local individual and community solutions Builds resources, networks and resilience before people hit crisis Uses an asset-based approach – to identify resources and assets within a community Aims to reduce demand for costly care and support services by strengthening individuals, families and communities. Image courtesy of East Renfrewshire LAC project

19. Our Recipe for Making Things Happen? Relentless partnership working Focus on place and outcomes not organisations or egos Focus on secondary prevention to energise others to be involved Identify and build alliances with influencers Adopt a blinkered approach and stay focussed Evidence your impact Energise people around a whole system approach “Walk” in other people’s shoes Understanding the demands on health Getting better at evidence and evaluation Understanding each others worlds and keeping things simple