2. Work with individual Important for... Important to…
Health and Adult Services (HAS)
Customer Service Centre
Living Well Partners
Key indicators
Lonely and/or socially isolated
Recently bereaved or loss of a support network/person
Recent loss of confidence
Face to face Information, Advice and Guidance
Referral to Living Well Team
Work with individual
(identify other key issues)
Risk of falls
Seasonal health
Fuel poverty
Environment
Lifestyles
Sensory issues
Important for...
Motivational Interviewing
Making Every Contact Count
Important to…
PC tools
Good day/bad day
e.G volunteering
Identify existing networks
Behaviour change techniques
Building confidence
Lifestyle Services
Personal and community assets
Connecting people

3. What do Living Well Coordinators do?
Support adults who need some help to prevent them from needing more intensive care and support.
Spend time with individuals on a one-to-one basis
Work to understand what is important to them, networks of support and priorities
Provide time limited interventions to support individuals to achieve the outcomes they want
Support them to make simple changes to manage their health and stay well
Identify barriers to change and use motivational interviewing to help remove these barriers
Work with Stronger Communities team to identify gaps, needs and community assets.

4. Identify a person meets trigger for Living Well:
Lonely/Social isolation
Recent loss of confidence
Bereavement or loss of support network
Information, Advice & Guidance
Gain person’s consent to refer to Living Well Team
*CONSENT IS NEEDED FOR ALL REFERRALS*
GP Practice contact CSC on to refer to Living Well
Customer Service Centre triage referral. If not appropriate, the referral will be sent to the right team.
Customer Service Centre triage referral. If appropriate, they will send referral to Living Well Team Tray via LLA
Living Well Team Manager checks referral, if not appropriate for Living Well, will ring GP Practice to discuss.
If appropriate, LWTM will allocate to LWC.
Living Well Coordinator supports individual.

5. Scarborough, Whitby and Ryedale
Since October 2015 there has been a total of 1540 referrals for the SWR area (of 4386 for North Yorkshire)
Of these 1117 are within the Scarborough and Ryedale CCG area

6. Scarborough and Ryedale CCG Living Well contacts

7. Scarborough, Whitby and Ryedale – health referrals
Increasing level of referrals from health partners – since engagement started in May 2016.
In 2017/18 - Referrals from health partners in SWR area constitutes 56% of all external referrals (compared with 43% for NY) and represent the biggest source of referrals for this area.
Includes referrals from primary care, mental health staff, community and secondary health staff.