1. The Green Dreams Project CIC Dr James Fleming MBChB MSc FRCGP www.greendreamsproject.co.uk Supported by:

2. Solutions to social problems when no other agency can help What we do See patients via GP referral with multiple social problems, when existing organisations are struggling to help and when these problems are impacting on their physical and mental health See patients who others can not help - isolated, long unemployed, furthest from labour market, agoraphobic, clinically dependant, excluded, low self-esteem Other issues - substance misuse, learning difficulties, educational difficulties, life crises, poor housing, financial problems. www.greendreamsproject.co.uk

3. Kate What we did  30 F ‘Am I depressed?’ Wants sick/fit note  Tearful, rock bottom, drinking  Rent arrears, debt, poor housing  Little self-esteem, not worked for years  Stuck where she is, can not see a future  Repeated attendances at GP, little progress o Send from GP, motivate, believe o Identify barriers to increased QOL o Contact JC+, go with her o Liaise c landlord, HMRC, DWP, Welfare Rights o Involve in one of our projects, build confidence o Documents, correspondence, CV o Access Training and coordinate o Lifestyle and health issues o Now self-employed after 6 years www.greendreamsproject.co.uk

4. Our Uniqueness is our Triad of Support: ‘The underlying approach to the Green Dreams Project is one of empowerment and enablement … a reduction of just chemical based intervention, to a more holistic view of the person’. (UCLAN, March 2013)

5. Elderly and Isolated Bingo, self funding Day trips – self funding (Hawes, Skipton) Meet old friends, laughter Now, seldom come to doctor Also, home visit, befriending, fitness, craft, voluntary organisations, walks, computer, procure space, Art Group, Theatre Group, Knit and Knatter

10. www.greendreamsproject.co.uk Independent Evaluation University of Central Lancashire March 2013 Regular Evaluation Study completed by a team of researchers from the UCLAN ‘School of Health’ who independently interviewed a range of key stakeholder and examining project data monitoring forms. Findings were cross referenced with a literature review to support conclusions. Stakeholders independently reported that the project is extremely beneficial to all service users. > Mood > Self esteem and confidence > Coping skills < Social isolation < Primary care attendance < Dependence on medical care We monitor : Service Users and their outcomes Service user satisfaction Stakeholder opinions Independent GP evaluations of every patient and their outcomes. Methods In house – quarterly reports Outside evaluation to reduce bias

11. www.greendreamsproject.co.uk Irwell Medical Centre, Rossendale 8 GPs 14,231 patients 1 part time Green Dreams Practitioner 101 patients engaged with The Green Dreams Project Based in small historic mill town - high levels of deprivation – wide variety of presenting issues

12. www.greendreamsproject.co.uk ‘The Green Dreams service has provided support and advice to many of our patients…improving self esteem and confidence and allowing patients to contribute and integrate back into the community, whether this is by returning to the workplace, becoming socially part of the community again or by helping improve the environment around them’. (Strategic Manager, Irwell Medical Practice, June 2014)

13. www.greendreamsproject.co.uk 20% sample of clients from 1 surgery Approx. £81,610 of social value generated We looked conservatively at what social costs might be incurred if our intervention had not taken place…….