Update. The latest news for our staff. On Day Service making a difference

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1 Update The latest news for our staff November 2017 #6 On Day Service making a difference The On Day Service is running in the areas of Ilkeston and Long Eaton to improve access to primary care. Patients who call their GP for an appointment may be directed on that same day to the On Day Service where they will be seen by a GP or advanced nurse practitioner (ANP) as appropriate. The On Day Service is available from 8am to 6.30pm on weekdays, excluding bank holidays. To use it, patients just call their normal GP number. One advanced nurse practitioner who has been there since the start of the service is Jenny Roby. She has seen this innovative pilot project set up, become deeply embedded in the Wellbeing Erewash vanguard, and go through various changes to be the service it is today. It is a service that Jenny is immensely proud of, taking great care in her work, providing local people with a fast response to their immediate care needs. By providing a timely and effective service, there are many benefits including freeing up the time of GPs to concentrate more on patients with chronic long-term conditions, and helping patients avoid hospital admissions. Jenny explains: I ve been an advanced nurse practitioner for 14 years and have worked within primary care settings since completing masters level training. My experienced ANP colleagues have studied at the same level or completed extra training in areas such as minor illness and minor injury. This enables us to diagnose, prescribe and refer when appropriate.

2 Jenny also believes the On Day Service is bridging the gap between general practice and other on day access/urgent services. Walk-in centres and out-ofhours services tend to deal with the problem that is presented with that day. For example, if somebody visits a walk-in centre with eczema, they may be given some cream and off they go. We would like to think we go the extra mile, working out whether their prescription needs altering, and providing tips on how much to use and when to apply it. I feel that we do provide a very good service. The other aspect that sets us apart from such centres is that we have full access to the patient record. We can for example see whether there are safeguarding issues with a child, when someone last received medication, the results of blood tests, or how many presentations someone has made. We also look at what has and what hasn t been done in general practice - so for example recently I saw a patient who needed urgent blood tests, these were taken by our healthcare assistant, the patient s routine tests for his thyroid disorder were overdue and these were also arranged. I feel we re bridging the gap between the GP and urgent care services, leaving the GP more availability for complex, chronic presentations. As experienced nurses we can add that extra dimension of care in our work. The On Day Service The On Day Service is running in the areas of Ilkeston and Long Eaton to improve access to primary care. Patients who call their GP for an appointment may be directed on that same day to the On Day Service where they will be seen by a GP or advanced nurse practitioner as appropriate. The On Day Service is available from 8am to 6.30pm on weekdays, excluding bank holidays. To use it, patients just call their normal GP number. There s nothing like this where I come from I wish there was as I think the service provided is excellent. The On Day Service runs during weekdays. After telephone assessment if the patient needs to be seen that day we can arrange this. There s normally two or three ANPs at each site in Ilkeston and Long Eaton each day so we ve got between four and six nurse practitioners providing the service daily. We will see a wide variety of illnesses and conditions that you would expect to see in general practice. It could be everything from coughs and colds, problems with eczema and asthma, acute abdominal pain, or maybe the discovery of a breast lump. The key thing is that we are seeing people with new problems rather than on-going chronic problems which are far better suited to routine GP care. There are also a few exceptions to the service at the moment, these include dealing with mental health issues and the care of very young babies. Jenny, who lives in Chesterfield and previously worked in the northern Derbyshire town, added: There s nothing like this where I come from I wish there was as I think the service provided is excellent. We hand out questionnaires to patients on a routine basis and the feedback has been really positive. The biggest problem that patients report is the difficulty accessing an appointment with their own GP so they are normally pleased to be seen by us because they can get seen on the day. We ve had lots of good feedback from our GP colleagues. When patients have a good experience and provide positive comments, and when this is backed up by the feedback from GPs, it really does give you job satisfaction. I ve been involved with the On Day Service since day one so I ve seen it really evolve and that s been based on staff experiences, uptake of the service, patient feedback, and the needs of the area. As more GP surgeries come on board and there is more availability that will be even better. I know the team has been working really hard to continue to expand the service with local GP practices. The On Day Service is: Making it easier for patients with an urgent need to receive a same day appointment with either an advanced nurse practitioner or a GP Reducing appointment waiting times for patients with an urgent need Seeing Practices work together to offer faster, more responsive access Giving patients improved, quicker access to the healthcare they need Reducing non-elective admissions

3 Members of the public set out their Erewash vision It s time to do something different. Our focus needs to be far more about what is good in our communities and how we can best utilise our assets Sara Bains Personal and Community Resilience Lead We had a packed room and a busy discussion forum at our recent public participation event held at Erewash Voluntary Action in Long Eaton. Patients, members of the public, staff, voluntary sector colleagues and representatives from Wellbeing Erewash projects such as Erewash Time Swap and Community Connectors took part in the event. Delegates were welcomed to the event by Stella Scott, Chief Executive of Erewash Voluntary Action, and Hannah Leaton, Vanguard Programme Lead of Wellbeing Erewash. Attendees took part in facilitated table discussions where they were encouraged to dream or vision what an ideal Erewash might look like in five years time. Suggestions put forward included ideas to reduce mental health stigma, value people and the resources they bring, create better communication from people to services, make communities happier, provide more one-stop services, and to help make communities prouder of the built environment. These views and ideas will help refine and shape the way in which the Wellbeing Erewash approach is taken forward towards Sara Bains, Personal and Community Resilience Lead for Wellbeing Erewash, talked about the progress made by the vanguard since initial engagement was held with the public. Representatives of the voluntary sector, Time Swap, Community Connectors and the Petersham Project spoke at the event providing updates on their project aims and recent achievements. Julie Wagstaff, citizen representative for Wellbeing Erewash, was also able to update the meeting about her role to date, the activities she has been involved, and her hopes for the future. Rachael Murfin, Engagement Lead at Erewash CCG, asked attendees to see how we could best spread public involvement within Wellbeing Erewash. Sara Bains said: It s time to do something different. Our focus needs to be far more about what is good in our communities and how we can best utilise our assets rather than what is wrong and needs fixing. It was really pleasing to hear from people at the event that we seem to be on the right track with what we re doing in Wellbeing Erewash; much of what people said they wanted to see in the future, we re already trying to work on now, but we know we need to be flexible in our approach, and through the changes that will inevitably come in the organisations involved, that we retain this sense of momentum

4 Swapping their stories of success Two attendees of the Wellbeing Erewash Participation Event were delighted to be able to share their message of involvement in their local project. Roy Smith of Long Eaton and Sandra Kimbley of Ilkeston are both long-serving members of Erewash Time Swap and were at the event at Erewash Voluntary Action to swap their stories of the benefits of volunteering and developing community cohesiveness. Sandra gave a talk to the meeting helping people gain a greater understanding of how Erewash Time Swap works. Time Swap is about giving time, so if we volunteer to give an hour or two, whether that may be gardening or walking someone s dog, you can bank those hours and receive a skill in return such as help around the house like getting a light fixed, says Sandra. Ilkeston has 61 members and Long Eaton has 92 - all the requests from those members are put into our monthly newsletter. To become a member you just need to fill out an application form and provide two references. It doesn t matter if you haven t worked in a long time, references from a good neighbour or friend are fine. You ll be given a one hour induction by Jo Perkins, our co-ordinator, who s absolutely fabulous, she s very approachable and always there. A lot of people think oh what can I do at my age but we have one member who s 91 and has lots of skills like sewing, crochet and knitting. There have been lots of people who have joined the group who are now knitting twiddle muffs for people with dementia and knitting toys for Home Start. My personal experience is that I joined Time Swap because I was retired and had something to give. I don t really need anything as I have a family that supports me with things. There s a lady in the group who can t get out to walk her little Jack Russell anymore so I did four hours last week walking the dog. That s four hours that I ve got banked. My spare bedroom needs redecorating so I ll probably be calling in some favours for that it s a fabulous scheme. People are learning such a lot of skills - photography, IT, trips out to the theatre, gardening, community litter picking... You never know what s going to come up. I became involved with Time Swap due to the selfsatisfaction from knowing that you re helping people. Roy Smith People are learning such a lot of skills - photography, IT, trips out to the theatre, gardening, community litter picking... You never know what s going to come up. We have another member now who says it s a long shot but that they d like to learn Spanish as it turns out we have another member who teaches Spanish and so that s another successful swap. Roy, a member of the Long Eaton and District 50- plus Forum, joined Erewash Time Swap when the scheme was initially advertised on the Derbyshire County Council website. A former retail manager with The Co-operative Stores, he provides computer skills training courses for local people and offers IT training as part of his offer with Erewash Time Swap. Roy says: I teach people how to use a computer, how to send s, how to do spreadsheets, how to surf the internet, and recently have been showing people how to use Skype. I became involved with Time Swap due to the self-satisfaction from knowing that you re helping people. I like seeing the look on their faces when they first come into a computer environment, they haven t got a clue what to do and then within a very short period of time they build up their confidence. We have two or three ladies who are well into their 80s who come into Long Eaton Library. A little while back they didn t know one end of a computer from another, now every Monday morning one of them is reading s from relatives in Canada. Because of the difference in time zones between here and Canada, while she s asleep they re sending her s. She s now in regular communication and receiving pictures of nephews and nieces which wasn t possible before except for through the post or expensive telephone calls. In Time Swap you need to swap the hours with people who are registered so I m hoping more people will sign up. I m also hoping someone will prune my apple tree soon, that would be good

5 More ways to find out about Wellbeing Erewash There s been a lot of audio-visual activity in the creative studio at Wellbeing Erewash with two new web channels to help people find out more about our work. Vimeo We have set up a Vimeo channel see vimeo.com/user to host all our videos. Vimeo is very similar to YouTube but does not have adverts interrupting the video viewing. Our Vimeo channel now hosts our latest video, shot on an iphone at the Transforming Erewash event held at Horsley Lodge. It features many interviews with people who have been central to the success of Wellbeing Erewash. Flickr We have also set up a new Flickr online account - Flickr has been around for many years now and acts as an online photo album. At the last count there were 183 photographs on the site have a look and see if you can see yourself. Anyone putting together presentations or publicity material about the various programmes and projects taking place in Erewash is welcome to use the images. All of these links and latest news updates are featured on the news pages of the Wellbeing Erewash website: You can also find social media conversations about our work on the Twitter page: twitter.com/wellerewash - we look forward to hearing from you. A day in the life of Lisa Gardner Wellbeing Erewash has found a new way to promote one of its services via an all-day Twitter tweetathon. In October we spent a day with care co-ordinator Lisa Gardner at Littlewick Medical Centre in Ilkeston, following her busy Monday schedule of activities. Live tweeting on the Wellbeing Erewash Twitter site took place during working hours with social media followers able to keep upto-date with developments using the #WEcare hashtag. During the day, Lisa had to balance a busy workload of planned and reactive phone calls, requests, letters to follow up and general administration. Constant updates were provided on the nature of the phone calls, which while protecting patient confidentiality, gave followers an idea of the types of patient issues that the care co-ordinators seek to resolve daily. A summary of some of the Twitter messages can be seen on our Storify page: /life-in-the-day-of-a-care-coordinator

6 Erewash GP profiled in national spotlight on the vanguards News in brief our round-up of Wellbeing Erewash news Dr Duncan Gooch, Erewash GP and clinical sponsor for Wellbeing Erewash has taken part in a series of videos designed to portray what it is like being a GP in a NHS England vanguard. The videos have been produced to support GPs to learn more about the new models of care being developed by the NHS. On the NHS England website, five GPs nationally were asked to reflect on the circumstances which led their practice to consider a new model of care and why they believe that making these changes would help to sustain general practice for the future. The videos are based on the GPs own views, are specific to the areas the participating GPs are based in and aim to demonstrate the experience each area has had. The video of Dr Gooch can also be seen on YouTube: youtube.com/watch?time_continue=22&v=kf60kz5cocm Dr Gooch speaks about how the proposed new ways of working have been received by GPs and the leadership role he has taken on. He says: The voice of the GPs within the MCP (multi-specialty community provider) is strong and it s respected by the other providers. The leadership team contains a number of GPs and all other providers feel it needs to be led by general practice. You feel you have some sense of control of the way services are around you and to feel you might be able to shape the way services are delivered is thoroughly rewarding. Rather than political rhetoric which we ve heard over a number of decades about the importance of general practice, what we ve managed to achieve within Wellbeing Erewash has put general practice in the leadership role, driving this forward. The voice of the GPs within the MCP is strong and it s respected by the other providers Dr Duncan Gooch, Erewash GP and clinical sponsor for Wellbeing Erewash More information at gp-participation-in-a-multispecialty-community-provider-mcp/ Brilliant Erewash We know it, you know it, now the nation knows it Erewash is one of the best places to live in Britain! The latest Halifax children s Quality of Life Survey has placed the borough as the 14th best place in the country to bring up children. It is the second highest ranking area in the East Midlands (trailing Rutland by only three places). Brilliant Erewash event Brilliant Erewash, the positivity and resilience in schools programme, has held a hugely popular Champions Event in partnership with the University of the First Age, attended by 60 school champions. The project is to be evaluated by the Child Outcomes Research Consortium (CORC). On Day Service expands The ninth GP practice has now joined the On Day Service in Erewash providing same day primary care access for patients. A new telephone triage service has been introduced. The service is now able to provide 43 slots a day with advanced nurse practitioners. Network widens The Development Workers Network is open to all development workers in the Erewash area. It provides a space for these workers to meet and exchange information, and to learn about services on offer. Latest figures now show 90 development workers have signed up to the network. Making the connections Community connectors, helping link up local people to local services and support, are going from strength to strength. Figures end of October showed a total of 29 connectors in place, 191 connections made, 73 meetings attended, 32 information packs sent out, 367 Facebook posts, and 1,177 Twitter posts. Carry on the great work Jo (Hallam)! Find out more about the STP NHS organisations and local councils have come together to develop plans for the future of health and social care. Derbyshire s Sustainability and Transformation Plan (STP), Joined Up Care Derbyshire, brings together work that has been taking place across the county to co-ordinate services better so they support people to stay well. You can find out more about the details of the plan on the STP website

7 Lending our support to Alcohol Awareness Week Wellbeing Erewash is running an alcohol and women aged over 45 project, finding out about why local people in this demographic drink too much and how best to tackle the issue. In November we also lent our support to the national Alcohol Awareness Week #AAW2017 campaign, run by Alcohol Concern, Alcohol Research UK and Adfam. Some of the campaign s key messages are shown here: Harmful drinking is the biggest risk factor for death, ill-health and disability among year-olds in the UK, and the biggest risk factor across all ages Alcohol is estimated to cost the NHS 3.5 billion annually An estimated 595,000 adults in England are alcohol dependent and in need of specialist treatment. However the number receiving treatment is closer to just 100,000 Reinvigorating our approach to dementia care 50% of violent crime can be attributed to alcohol 167,000 working years are lost in England yearly because of alcohol While overall levels of consumption are falling, around 2.5 million people drink more than 14 units on their heaviest-drinking days Around 220,000 children in England live with an alcohol-dependent adult Alcohol is linked to more than 60 medical conditions including liver disease, heart disease, some cancers and depression In 2015 there were 8,758 deaths related to alcohol in the UK. Visit alcohol-awareness-week Wellbeing Erewash, a leading NHS England vanguard, is making great strides in establishing a more dementia-friendly borough training staff, improving care resources, and providing more support for people living with dementia and their carers. In a series of initiatives led by Tracey Sims, Service Improvement Manager, a review of the current gaps in local services has been completed, a dementia directory of available support has been fully revised, and the Erewash Dementia Action Alliance has been re-instated. In partnership with Derbyshire County Council, two one-day workshops for health and care staff have been run to support the early recognition and early intervention of dementia in Erewash. Workshop evaluation found most participants saying their knowledge and confidence had increased. Proposals from the workshops will now be taken forward by the Erewash Dementia Action Alliance to further improve dementia care and support in Erewash. Information was directly relevant to practice in the current climate. It signposted to services and tools that can be used. The wide range of professionals/ services in the group facilitated networking. I personally networked with care home managers, district nurses, out of hours nurses, learning disability nurses (and) care agencies. I learned a great deal and strengthened links with health and social care providers

8 What next for Wellbeing Erewash? Wellbeing Erewash has developed a number of exciting and innovative projects over the years and now those who have championed this work are busy putting together plans for its longer-term sustainability. Wellbeing Erewash is a NHS England vanguard part of a national programme of forward-thinking areas originally set up in 2015 to try out new models of health and care. As we approach the end of national programme funding in March 2018, programme leads are working on ways of best taking forward the work into and potentially beyond. While the national funding is coming to an end, there is no need for our innovative work to conclude instead bespoke sustainability plans are being developed for the range of Wellbeing Erewash initiatives. There are likely to be different ways in which the various schemes and projects are handled from April 2018 onwards. Options will vary from mainstreaming activities completely to looking at altering methods of delivery or seeking different ways of funding with partner organisations potentially increasing their involvement. As Hannah Leaton, Wellbeing Erewash Programme Lead, explains: The national funding has been really welcome and has allowed us to attempt radical solutions to long-standing problems in the health and care system. However, as we reach the end of the final year of national funding, we do not see this as an end in itself; instead we will continue the good work based on the lessons learnt and insights gained, and will seek to transfer this into a new business as usual approach. Wellbeing Erewash representatives have been working with Erewash CCG and partner organisations to see how aspects of the vanguard, such as its culture, governance and the projects themselves, could best transition into the new arrangements post-april Talks have been taking place with partner organisations and it is likely that some partners will take on increased responsibilities for some projects. This could be the case for initiatives such as Brilliant Erewash, with the involvement of the University of the First Age for example, and various dementia projects where interested project stakeholders could help make the work become self-sustaining. Future activities being progressed by the workstreams of primary care and integrated care, personal resilience, and community resilience, will be overseen by the Erewash Alliance Board. This board is made up of representatives of provider organisations, voluntary sector organisations, and commissioners. Its remit is to consider the needs of the population within the place of Erewash rather than examining care and individual services in isolation. This place-based thinking is an important part of the way that the wider Derbyshire health and care community is organising itself as part of the county s Sustainability and Transformation Plan (STP). The vanguard will have been in place for three years by 2018 and evidence gained during this time is pointing to a number of achievements. These include a reduction in emergency admissions, a slower rise in A&E attendance, and high levels of patient satisfaction. Evaluation will continue to have an important role, as Hannah explains: As we come to the end of fixed term funding for the vanguard, there will be a natural concern among staff and in our partner organisations. We are in a strong position though of being able to demonstrate the impact of our work. It is important that we can continue to demonstrate that impact as we build the various business cases and that is the responsibility of all involved

9 Contact us Wellbeing Erewash Toll Bar House 1 Derby Road Ilkeston Derby DE7 5FH Phone: wellbeing.erewash@erewashccg.nhs.uk Web: Twitter: twitter.com/wellerewash