1. Alison Hannan Public Health Practitioner – Advanced
House of Care
Alison Hannan
Public Health Practitioner – Advanced

2. What is House of Care?
At the centre is the conversation between the patient and their healthcare professional.
The roof is made of organisational and clinical processes to be put into place.
The right wall is a commitment from the Health and Care Team to partnership working and being trained.
The left wall is an engaged, informed and empowered patient.
The floor is the variety amount of formal and informal sources of care that are available to the patient within their community.

3. Care and Support Planning the Process
Recording the agreed & shared care plan
Information gathering
The conversation
Information sharing
Disease surveillance
Tests and checks
performed where needed
Preparation
Results/agenda setting prompts
sent to patient > 1 week before
conversation
Conversation
A meeting of equals and experts
Prepared practitioner and patient:
review how things are going
consider what's important
share ideas
discuss options
develop a care plan

4. First Scottish Adopter Sites
NHS Greater Glasgow and Clyde
Patients experience more personalised , coordinated care, patients have increased self-efficacy.
NHS Lanarkshire
Biometric measures show improvements in blood pressure and cholesterol and a slight improvement in HBA1c for those with diabetes. Data collected 1 year before first HoC appointment and again 1 year later.
NHS Lothian
Assessing biometrics and have similar findings to Lanarkshire
NHS Greater Glasgow and Clyde - Long Term Outcome Assessment was carried out.
NHS Lanarkshire – report came from Dr Helen Alexander, aim to collect behaviour change data in the future, measuring exercise participation and weight loss.
NHS Ayrshire and Arron 2016 Alison Anderson Respiratory MCN Manager looking at patient evaluation including experience, signposting to other services and support and mental health wellbeing.
NHS Tayside also looking at on people’s experiences of CSP

5. NHS Grampian House of Care Six Month Interim Review
Positives
Healthcare professionals have increased confidence to have a care and support planning conversation with their patients.
Positive feedback on appointment system changes, longer time to have a deeper conversation with the patient.
Increase number of patients engaged with their annual review.
Greater job satisfaction, making a difference.
Increase skills to review wider number of chronic diseases.
Interviewed 13 staff members across three different practices from cohort 1.
Challenges with staggered start times was a challenge to the evaluation process.

6. NHS Grampian House of Care Six Month Interim Review
Challenges
Buy in from all staff levels on the House of Care Concept.
Mixed opinion Nurse Led/GP Led on for Chronic Disease Management.
Practice staff complement e.g. shortage of staff within practice.
Up-skilling staff to review multiple chronic diseases.
Physical space within the practice.

7. Kincorth & Cove Medical Practice
Start Date: June 2018 Practice Population: 12,688 No. of Patients included: % patients felt better able to keep themselves healthy

8. ‘I am really enjoying House of Care appointments and the majority of patients are also preferring the new approach. Getting the results before the appointment has taken away the shock factor and they have had time to process the results before they see me. The patients feel more empowered and leave the appointment feeling really positive and keen to make changes to their current lifestyle and health.’ Practice Nurse

9. Macduff Medical Practice
Start Date: July 2018 Practice Population: 6,033 No. of Patients included: 1,786 95% patients felt care and support planning helped them to take control

10. Patient Stories
This is the lady whose life changed after care and support planning.  She is a double amputee who never went out as her confidence was gone...After achieving mini-goals and building on her confidence there is no stopping her. She is attending various groups and enjoying the social contact.

11. Patient Stories

12. Empowered Patients Most of the patients feel empowered by receiving
their results beforehand by post and this has
enabled them to become equal partners in decisions
about their care. A secondary outcome was that
the new method of recall has identified a handful of
individuals who were lost to follow up; enhancing
patient-safety. The nurses have expressed increased
job-satisfaction. They feel the care they deliver is so
much more holistic and makes them feel positive
about health care delivery.

13. Grampian HoC Implementation 2018
City – Kincorth and Cove Jun 18
Shire – Macduff Jul18/Huntly Nov18/Cruden Bay & Hatten Jan 19/Banchory Mar 19
Moray – Fochabers Jul 18/Aberlour Jul 18
Orange: Already Implementing
Kincorth & Cove Medical Centre
Macduff Medical Practice
Fochabers Medical Practice
Aberlour Medical Practice
Red: Due to Implement
Bydand Medical Group (Huntly)
Cruden Medical Group (Hatton and Cruden Bay)
Banchory Group Practice

14. Grampian House of Care - Cohort 3 2019
Aberdeen City: Aberdeenshire: Whinhill Medical Practice Alford Medical Practice Calsayseat Medical Group Deveron Medical Practice Garthdee Medical Group Torphins Medical Practice Carden Medical Practice

15. Grampian House of Care - Cohort 4 2019/20
Advertising Cohort 4 - Summer 19
Application Deadline - 01Nov19
Liaise with HSCP – November 19
Announce Cohort 4 Practices 02Dec19
Training Jan-Mar 2020